• Assisted vaginal birth (AVB) attempts to mimic spontaneous vaginal birth.
  • Delivery by AVB may benefit both mothers and neonates by decreasing risks of serious morbidity associated with prolonged delays in delivery, or a caesarean delivery late in second stage.
  • Various types of forceps or vacuum devices can be used to safely and successfully achieve vaginal delivery, provided the prerequisites for AVB are met.
  • This video will discuss preliminary considerations to achieve safe forceps-assisted vaginal birth.
  • A list of prerequisites known as FORCEPS must be met before assisted vaginal birth is attempted. 
    • F: Fully dilated
    • O: Occiput anterior / posterior/ transverse
    • R: Ruptured memberanes
    • C: Cephalic presentation or head first
    • E: Engaged presenting part, fetal head has descended to below the ischial spines
    • P: Position patient, pain relief
    • S: Sphincter bladder empty
  • Comprehensive abdominal and vaginal examinations must be performed to confirm that the patient meets all criteria to proceed safely.
  • Fetal head engagement is measured in fifth. The fetal head must be palpated at no more than 1 finger breadth or 1/5th above the pubic brim and at least at or below spines on vaginal exam in order to safely proceed with forceps delivery.