Abstract
The rate of operative vaginal births (OVBs) is stable in the UK running at approximately 12% of all deliveries. OVB is in the main a safe practice when performed in the correct setting by an appropriately trained operator, producing good outcomes for the majority of mothers and babies. There should be a balance of risk. Instrumental delivery is safer than a caesarean section at full dilatation for the mother and causes less impact on future pregnancies, as most women will achieve a vaginal birth in a subsequent pregnancy. A caesarean section at full dilatation, however, shows reduced rates of traumatic birth injury to the baby. Despite the fact that in most cases the outcomes are good for forceps and vacuum assisted deliveries, these births still generate a considerable cost in terms of litigation when they are performed sub optimally, or when the baby is born in poor condition. All obstetricians require appropriate training and supervision to ensure these deliveries are performed safely in line with national guidance.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Murphy DJ, Liebling RE, Verity L, Swingler R, Patel R. Early maternal and neonatal morbidity associated with operative delivery in second stage of labour: a cohort study. Lancet. 2001;358(9289):1203–7.
Murphy DJ, Koh DKM. Cohort study of the decision to delivery interval and neonatal outcome for emergency operative vaginal delivery. Am J Obstet Gynecol. 2007;196(2):145.e1–7.
Bahl R, Strachan B, Murphy DJ. Outcome of subsequent pregnancy three years after previous operative delivery in the second stage of labour: cohort study. BMJ. 2004;328(7435):311.
Jolly J, Walker J, Bhabra K. Subsequent obstetric performance related to primary mode of delivery. BJOG. 1999;106(3):227–32.
Clark EAS, Silver RM. Long-term maternal morbidity associated with repeat cesarean delivery. Am J Obstet Gynecol. 2011;205(6 Suppl):S2–10.
Moraitis AA, Oliver-Williams C, Wood AM, Fleming M, Pell JP, Smith G. Previous caesarean delivery and the risk of unexplained stillbirth: retrospective cohort study and meta-analysis. BJOG. 2015;122(11):1467–74.
NHS Litigation Authority. Ten years of maternity claims. London: NHS Litigation Authority; 2012.
RCOG. Operative vaginal delivery. 2011. pp. 1–19.
Watts P, Maguire S, Kwok T, Talabani B, Mann M, Wiener J, et al. Newborn retinal hemorrhages: a systematic review. J AAPOS Elsevier. 2013;17(1):70–8.
Senécal J, Xiong X, Fraser WD. Pushing early or pushing late with epidural study group. Effect of fetal position on second-stage duration and labor outcome. Obstet Gynecol. 2005;105(4):763–72.
Bahl R, Murphy DJ, Strachan B. Qualitative analysis by interviews and video recordings to establish the components of a skilled rotational forceps delivery. Eur J Obstet Gynecol Reprod Biol Elsevier. 2013;170(2):341–7.
Aiken AR, Aiken CE, Alberry MS, Brockelsby JC, Scott JG. Management of fetal malposition in the second stage of labor: a propensity score analysis. Am J Obstet Gynecol. 2015;212(3):355.e1–7.
O'Brien S, Day F, Lenguerrand E, Cornthwaite K, Edwards S, Siassakos D. Rotational forceps versus manual rotation and direct forceps: a retrospective cohort study. EJOG. Elsevier Ireland Ltd. 2017;212:119–25.
Wattar Al BH, Wattar BA, Gallos I, Pirie AM. Rotational vaginal delivery with Kiellandʼs forceps. Curr Opin Obstet Gynecol. 2015;27(6):438–44.
Murphy DJ, Macleod M, Bahl R, Strachan B. A cohort study of maternal and neonatal morbidity in relation to use of sequential instruments at operative vaginal delivery. EJOG Elsevier Ireland Ltd. 2011;156(1):41–5.
Hamasaki T, Hagihara A. A comparison of medical litigation filed against obstetrics and gynecology, internal medicine, and surgery departments. BMC Med Ethics. 2015;16(1):72.
GMC. Consent: patients and doctors making decisions together. 2017. p. 1–66.
UKSC TSC. Montgomery (Appellant) v Lanarkshire Health Board (Respondent). 2015. pp. 1–38.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2018 Springer International Publishing AG, part of Springer Nature
About this chapter
Cite this chapter
O’Brien, S., ElHodaiby, M., Draycott, T. (2018). Operative Vaginal Birth. In: Jha, S., Ferriman, E. (eds) Medicolegal Issues in Obstetrics and Gynaecology. Springer, Cham. https://doi.org/10.1007/978-3-319-78683-4_26
Download citation
DOI: https://doi.org/10.1007/978-3-319-78683-4_26
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-78682-7
Online ISBN: 978-3-319-78683-4
eBook Packages: MedicineMedicine (R0)