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Choice of instrument for vaginal delivery.

This review covers a selection of the important recently published papers that show enormous variations in obstetric intervention rates. It includes references to the forceps versus vacuum extractor controversy, discussing the controlled trial data as well as selected observational studies. Papers on new equipment and techniques of delivery are reviewed, although in the recent literature these are principally related to the vacuum extractor and not to forceps. Final discussion is made of methods of ensuring adequate training.