Forceps delivery should only be performed if there are clear indications and no contraindications. Both maternal and fetal factors may be contraindications.
Absolute maternal contraindications
(1) cervix not fully dilated
(2) intact membranes
(3) fetal head not engaged
(4) cephalopelvic disproportion
(5) fetal head position unknown
Relative maternal contraindications:
(1) connective tissue disorder
(2) malpresentation if not planned breech extraction
Absolute fetal contraindications:
(1) presence of a bleeding disorder (hemophilia, thrombocytopenia, etc)
(2) osteogenesis imperfecta or other disorder of bone demineralization
Relative fetal contraindications:
(1) prematurity
(2) macrosomia
