The classical Indications for vaginal or abdominal operative delivery are obstructed labour, foetal distress and maternal distress. These indications have broadened over the years, chiefly because of the Increased safety of anaesthesia and cæsarean section. Low application of forceps under pudendal block with epislotomy has become almost routine if any delay in the second stage of labour is present. The place of difficult delivery by middle application of forceps is changing. As caesarean section becomes safer, difficult vaginal delivery becomes relatively more hazardous. Another reason for the change is the better understanding of fætal well‐being from studies of foetal heart patterns and acid‐base status. During the last decade in particular, there has been an avoidance of procedures such as internal version and breech extraction, except under optimal conditions, in favour of delivery by caesarean section. The overall caesarean section rate has almost doubled in New South Wales in the last decade, having risen to 5% in 1969. One of the big problems today is the recognition and subsequent management of minor degrees of disproportion due to large babies, occipito‐posterior position and ineffective uterine activity. Eighteen hours seem to be a dividing line beyond which perinatal mortality increases and operative delivery can be expected.