Can Use of Forceps or Vacuum Reduce the Need for Cesarean Birth?

Increased use of instrumental delivery (with forceps, vacuum, or both) could help lower rates of cesarean birth, but what factors predict successful instrumental delivery? In a retrospective cohort study of singleton, term infants born at a U.K. tertiary center from 2008 to 2012, an unsuccessful instrumental birth was defined as one in which an instrument was applied to the fetal head but the eventual delivery was cesarean. Attending obstetricians were stratified into four levels by seniority and experience.

In all, 3800 instrumental deliveries were attempted, only 246 (6.5%) of which were unsuccessful. Failure of instrumental delivery was associated with later gestational age, higher birth weight, longer time fully dilated before delivery, …