The place of Kielland's forceps in reducing caesarean section rates.

The rise in births by caesarean section (CS) is a global issue. A skilled obstetrician with a midwife knowledgeable in Kielland's forceps (KF) is often able to achieve a successful rotational vaginal birth when safe. The KF, however, has risks--and outcomes must be audited. In this article we present the results of a literature review and retrospective audit, evaluate maternal and neonatal morbidity associated with KF in our unit and compliance with national standards. Our conclusion is that our unit complies with national standards and offers the woman an alternative to CS when it is safe to do so. Adverse outcomes with KF are not different from other modes of operative birth.