This research used a retrospective, relation-searching design to examine the association between factors related to maternal condition, obstetrical practices, and perineal outcome. The sample included nurse-midwifery clients who delivered term infants in the occiput anterior position within an 18-month period (n = 275). Data were obtained from the clinical records. Chi square analysis was used to examine the association among factors. Those factors found to be significantly associated with perineal outcome during childbirth were parity, analgesia use, anesthesia use, maternal position at delivery, and infant weight. Analgesia and anesthesia use and maternal position were further analyzed, controlling for other variables. The implications of these findings to nurse-midwifery practice and the needs for future research are discussed.