(c) Both forceps and vacuum pulling are done during contraction to promote the quickest delivery.

(d) Episiotomy: To enlarge opening of perineum to facilitate birth. There are three types of incisions: midline, which is the quickest to heal; mediolateral, which provides the most space for exit but takes longer to heal; and tearing, a natural perineal skin tear.

(b) Pitocin (oxytocin) also can be used when labor is not progressing as a result of slow dilation or ineffective contractions.