[1] Operative vaginal delivery is required in times of maternal or fetal distress to assist in childbirth as an alternative to caesarean section.

[2] An analysis of multiple studies found that detecting the angle of the fetal head using an ultrasound is a reliable way to predict where uncomplicated operative vaginal delivery can be used, especially in first-time mothers.

[9] Compared to caesarean section, operative vaginal delivery have been more beneficial, and has been recognized to have a reduction in complications such as death, venous thromboembolism, costs of procedure, time of recovery and infection.

[3] The procedure relies primarily on either a pair of curved forceps blades or a vacuum extractor that applies negative pressure inside the womb.

The forceps are designed to reach the top of the fetal head and create the necessary traction to pull and rotate the baby out.

On the other hand, the vacuum extractor uses a small metal or silicon cap that exerts negative pressure on the fetal scalp to facilitate pulling of the infant.

[9] An analysis of 4 studies showed that the use of rotational forceps had low rates of postpartum hemorrhage and obstetric anal sphincter injury to the mother.

Additionally, neonatal complication rates were similar to those seen with other methods for assisted birth, such as the use of a vacuum cup, manual rotation, or second-stage cesarean section.

[9] An additional analysis of 31 studies found that forceps were more likely to lead to vaginal birth than vacuum cups, but were more likely to have perineal tears to the anus or rectum.

[5] Vacuum suction can have either rigid or flexible cups, and can be operated with handheld devices or a foot-operated electric pump.

[5] Injuries such as tears, cuts, or bruises to the birth canal, cervix, anus, or vaginal openings will be assessed and addressed.

The effectiveness of antibiotic prophylaxis was studied in both the use of either forceps or vacuum in operative delivery to reduce the risk of infection.

The result showed that antibiotic prophylaxis has been shown to effectively reduce infections in operative vaginal deliveries, and should be used.

[5] James Young Simpson in 1849 invented the air tractor used in vacuum extraction to help with operative vaginal delivery.