How can we reduce the rate of instrumental delivery?
- Ensure operative delivery is really necessary
- One-to-one support in labour (especially birth partner)
- Upright/lateral positions
- Avoidance of epidural analgesia
- Use of partograms
- Consider oxytocin for primiparous women with inadequate contractions/prolonged second stage/epidural analgesia
- Delayed pushing in primiparous women with epidurals.