| September 2006 · Vol. 18, No. 9 COMMENT & CONTROVERSY
Lawyers to blame for demise of forceps
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Fast Track
“Our everyday practice is suffused with value judgments, financial incentives, and beliefs not based on scientific merit”
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Finally, someone has stepped up to the plate with an article that explains the virtues of operative vaginal delivery. As one of those senior “skilled operators,” I was always shocked to encounter physicians who had completed ObGyn residencies without ever performing a forceps delivery. Imagine an orthopod who has never handled a fracture, an anesthesiologist who never put anyone to sleep! The sorry thing is that the article is addressed not to first-year residents but to board-certified, working ObGyns! These doctors graduated from residency programs that lacked staff experienced in instrumental delivery and thus had no opportunity to learn technique, since forceps can only be learned with hands-on experience. Lawyers have been instrumental in killing this skill.
I want to contribute 2 minor additions to the article. First, there is nothing magical about a right mediolateral episiotomy. Right-handed doctors (most of us) simply find it easier to cut this type of episiotomy. Lefties can cut to the left with the same result. I preferred midline in all situations, but its use seems to vary geographically.
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