Forceps are surgical instruments that resemble a pair of tongs, that can be used in surgery for grabbing, maneuvering, or removing various things within or from the body.

• Maternal factors:
  • Maternal exhaustion
  • Prolonged 2nd stage
  • Maternal illness, e.g. heart disease, HTN, glaucoma, aneurysm, or other things which make pushing difficult or dangerous
  • Hemorrhage
  • Analgesic drug-related inhibition of maternal effort, especially with epidural/spinal
• Fetal factors:
  • Non-reassuring CTG

• Anglo-American types, including:
  • Neville Barnes forceps
  • Simpson forceps
  • Elliot forceps
  • Keilland forceps
  • Wrigley's forceps
  • Piper's forceps

• Outlet forceps, where forceps are applied when the fetal head has reached the perineal floor and its scalp is visible between contractions. It is performed only when the fetal head is in a straight forward or backward vertex position or in slight rotation (<45 degrees to the R o L) from 1 of these positions
• Low forceps, when the baby's head is at +2 station or lower. There is no restriction on rotation for this type of delivery
• Mid forceps, when the baby's head is above +2 station. There must be head engagement before it can be carried out
• High forceps, is NOT performed in modern obstetrics practice

• Avoidance of C section
• Reduction of delivery time
• General applicability with cephalic presentation

• Fetal:
  • Cuts and bruises
  • Deformation
  • Facial nerve injury, usually temporary, occasionally
  • Clavicle fracture, rarely
  • Skull fractures
  • Intracranial hemorrhage
  • Cervical cord injury
  • Strabismus, due to improper twisting of the neck, causing damage to CN6
• Mother:
  • Perineal lacerations
  • Pelvic organ prolapse
  • Incontinence
  • Increased postnatal time and pain
  • Difficulty evacuating during the recovery time
  • Rectovaginal fistula

• Ventouse
• C-section