Instrumental Vaginal Deliveries- A Lost Art?
V P Paily
Instrumental Vaginal Deliveries- A Lost Art?
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About Instrumental Vaginal Deliveries- A Lost Art?

Wherever vaginal delivery is practiced there will be the need for helping out the fetus with instruments. Today,  instrumental deliveries are being abandoned in favour of Cesarean section; If at all instruments are being used, it is mainly ventouse; forceps is being abandoned. Reasons for the decline in forceps use is the fear of complications. This trend can be reversed by adhering to standard protocols, proper case selection, modifying   forceps and by training. Proper case selection (station- double deck), digital rotation, analgesic- pudendal block, direct application of forceps with fingers for guidance, traction following the natural curve of the birth canal will help minimize complications. One should select instruments judiciously depending on the case and the indication.

Dr. Paily discusses the safeguards of ventouse vaginal delivery. One should choose between forceps and vacuum delivery depending on the situation. Destructive operations like craniotomy may have to be performed In case of dead or non-salvageable fetus. It is essential to maintain the art of instrumental delivery.


  • Chapters
    1. Chapter 01
    2. Chapter 02
    3. Chapter 03
    4. Chapter 04

About V P Paily

Obstetrician and Gynecologist, Aluva


Special interest in Urogynecology , High risk Obstetrics, Endoscopy and Infertility.


  • Consultant, Rajagiri Hospital, Aluva - Currently working here
  • Consultant - Mother Hospital Thrissur - 1998 to 2015
  • Consultant - Raji Nursing Home Thrissur - 2003 to 2015
  • Professor - Jubilee Mission Medical College - 2007 to 2015
  • Professor and Professor - Govt Medical College, Thrissur - 1990 to 1998
  • Consultant and HOD - Dammam Maternity Hosp. , Saudi Arabia -1984 to 1990
  • Senior Registrar - Simpson Memorial Mat. Pavilion, Edinburgh - 1983 to 1984
  • Registrar - Western General Hospital, Edinburgh - 1980 to 1983
  • Tutor and Assist Professor - various Medical Colleges in Kerala - 1968 to 1980


  • Editor, “ Why Mothers Die, Kerala-2004-05 ”
  • Editor “ Why Mothers Die, Kerala-2006-09“
  • Editor- Obstetric Management Protocols , First Edition. 2001
  • Chapters in several books and articles in several journals (national and international)


Instrumental Vaginal Deliveries- A Lost Art?
By V P Paily
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