vacuum extraction, but maternal perineal trauma is more likely with forceps. [New 2020]”
We leave it to the readers of the guideline and those responsible for local implementation to determine if this represents a pro-forceps bias. Where we agree with Dietz & Esegbona is that much of the published literature is dated, and that further high quality longitudinal research is required. We would highlight for those conducting research in this field that they should differentiate between intended forceps-assisted delivery and sequential delivery (forceps following failed vacuum delivery) when reporting instrument specific pelvic floor morbidity, as the two are not the same.
Deirdre J Murphy,1 Rachna Bahl,2Bryony Strachan2
1) Coombe Women & Infants University Hospital
Cork St, Dublin 8, Republic of Ireland
2) St Michael’s Hospital, Bristol