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Operative Vaginal Delivery (Green-top Guideline No. 26)

Published: 01/02/2011

This is the third edition of this guideline. The previous editions were published in 2000 and 2005.


Update December 2014: New evidence and guidance in this field were reviewed in 2014 and it was decided that revision of this guideline would be deferred to a later date. The version available on the website and app will remain valid until replaced.


The aim of this guideline is to provide up-to-date information on the use of the forceps and vacuum extractor for both rotational and non-rotational operative vaginal deliveries. Obstetricians should be confident and competent in the use of both instruments. The anatomy of the birth canal and the fetal head must be understood as a prerequisite to becoming skilled in the safe use of the forceps or vacuum extractor.

The RCOG recommends that obstetricians achieve experience in spontaneous vaginal delivery prior to commencing training in operative vaginal delivery. The goal of operative vaginal delivery is to mimic spontaneous vaginal birth, thereby expediting delivery with a minimum of maternal or neonatal morbidity.

The scope of this guideline includes:

  • Indications for operative vaginal delivery
  • Choice of instrument
  • Aspects of safe clinical practice
  • Risk of physical and psychological complications
  • Brief review of special circumstances

Elsewhere on the site

Consent advice for operative vaginal delivery
Consent Advice No. 11 provides advice for clinicians on obtaining consent from a women undergoing operative vaginal delivery