Operative Delivery

Operative delivery means the use of obstetrical forceps or cesarean section to achieve the delivery. Operative delivery is indicated any time it becomes safer to delivery the baby immediately than to allow pregnancy to continue.

Maternal hemorrhage
Uterine rupture
Unremediable fetal distress
Fetal intolerance of labor
Maternal exhaustion
Failure to progress in labor
Failure of descent in labor
Arrest of labor
Uterine inertia
Placenta previa
Placental abruption
Previous cesarean section
Previous perineal repair for incontinence
Fetal malformation

Any condition that increases the maternal risk for pushing, including:

Stroke
Cerebral aneurism
Eclampsia

Fetal malpresentation or malposition, including:

Fetal transverse lie
Breech
Deep transverse arrest
Face presentation, particularly mentum posterior

These indications are sometimes relative, not absolute, and clinical judgment must be applied in any individual clinical situation to determine whether operative delivery is a good idea or not. Other aspects of clinical judgment are the specific form of operative delivery (forceps vs. cesarean section) and the timing of the operative delivery.