Literature review was performed to analyze and define the current state of operative vaginal delivery. On the basis of published data, it is concluded that outlet and low forceps deliveries with < or = 45 degrees of rotation are effective and safe for both mother and baby. The greatest risk to mother or fetus occurs with operations performed at the 0 or +1 station or those involving rotations > 45 degrees. It is likely that operative deliveries involving > 45 degrees of rotation will be abandoned in the future. It is further recommended that The American College of Obstetricians and Gynecologists 1988 forceps classification system be adopted for deliveries by vacuum extractors.