Forceps: towards obsolescence or revival?

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Cesarean section rates have become a political issue, attracting the attention of governments, health bureaucrats and professional organizations. In some instances this has led to a renewed interest in forceps delivery, even Kielland's rotational forceps. It is suggested that calls for a greater use of forceps, especially rotational forceps, are ill-advised and commonly based on ignorance of recent urogynecological and imaging literature. Forceps use is associated with a much higher likelihood of major maternal trauma, especially to the anal sphincter and levator ani muscles, which may result in substantial future morbidity. Hence, its use should be avoided whenever possible. This is particularly obvious for rotational forceps.