Operative vaginal delivery

Operative vaginal delivery (OVD) refers to a vaginal birth with the use of any type of forceps or vacuum extractor. Obstetricians should be confident and competent in the use of both instruments for non-rotational delivery and in the use of at least one technique for rotational delivery. The potential for increased maternal and neonatal morbidity in relation to OVD is long established although with careful practice the risk of significant trauma is low. Caesarean section in the second stage of labour is an alternative to operative vaginal delivery, but also carries the risk of significant morbidity and implications for future births. This case-based review gives three illustrative scenarios that highlight the complexity and diversity of the decision making process, and the considerations that must be taken into account when providing care to individual women.