Symphysiotomy is a surgical procedure in which the cartilage of the pubic symphysis is divided to widen the pelvis allowing childbirth when there is a mechanical problem (obstructed labour).
[citation needed] They became less frequent in the late 20th century after the risk of maternal death from caesarean section decreased (due to improvement in techniques, hygiene, and clinical practice).
[4] The most common indications are a trapped head of a breech baby,[5][6] shoulder dystocia which does not resolve with routine manoeuvres, and obstructed labor at full cervical dilation, especially with failed vacuum extraction.
[9] Symphysiotomy results in a temporary increase in pelvic diameter (up to 2 centimetres (0.79 in)) by surgically dividing the ligaments of the symphysis under local anaesthesia.
[10] Symphysiotomy can be a life-saving procedure in areas of the world where caesarean section is not feasible or immediately available as it does not require an operating theatre or "advanced" surgical skills.