Instrumental delivery: how to meet the need for improvements in training


Conquest Hospital, The Ridge, St Leonard's on Sea, East Sussex TN37 7RD, UK Email:


Key content

  • Rates of second-stage caesarean section are increasing, while rates of successful instrumental delivery are decreasing.
  • Recent attempts at reducing caesarean section rates have highlighted a need for further training in instrumental delivery.
  • A reduction in training hours, lack of senior supervision and fear of litigation have made it difficult to achieve the level of experience required for proficiency.

Learning objectives

  • To learn how to conduct an instrumental vaginal delivery safely.
  • To prevent excessive morbidity by identifying maternal and fetal factors associated with failed instrumental vaginal delivery.
  • To maximise expertise by training on simulators and mannequins prior to clinical application.

Ethical issues

  • Does training on models and simulators provide a safe level of expertise and competence?
  • Is 24-hour consultant cover on the labour ward a practical solution to improving the use of this technique in practice?

Please cite this article as: Sinha P, Dutta A, Langford K. Instrumental delivery: how to meet the need for improvements in training. The Obstetrician & Gynaecologist 2010;12:265–271.