Bearing in mind that the reasons for needing any of those 3 can either be seen well in advance or completely avoided during labour i doubt i would find yself in a snap-decision type situation.

The part of me that is rational would like to know what the sudden need for immediate deliver actually IS, because i seriously can't think of one. Sudden foetal distress - why? I wouldn't let them augment me, or have an epidural, or other drugs, so why is the baby distressed suddenly? In unaugmented natural labours one usually can tell something which might later cause distress (usually poor foetal positioning) is afoot because the labour is slow and doesn't progress much - babies drive labour in normal circumstances and will not do so to the point that they are struggling. If the cord is so tangled inside that the baby can't descend without distress then we NEED a c-section. If there is a prolapsed cord but i am fully dilated and pushing, if i need any assistance at all from forceps or ventouse then my baby is very probably going to die or be severely damaged because you have only a few moments to get the baby fully born in that situation. If there is deep transverse arrest - why? I wouldn't have an epidural and in the absence of them DTA is incredibly rare.

I know i'm not really answering the question, but that's the key issue for me. Not the intervention itself but the reason for it. If you NEED a c-section there is no decision to make. Michael Odent never used forceps and he never needed to, their major popularity grew to a fever pitch in the middle of the 20th century when labouring women were given general anaesthetic and hadthe baby dragged out of them while they slept. Odent states that he used c-section when needed, which was about 11% of the time overall, and didn't offer forceps, or anything else that required the supine position.

Inertia it may interest you to know that in almost all emergency c-sections where the baby has descended into the pelvis (i.e. was "engaged") the Ob uses forceps to drag the head back up and out of the incision, an incision which is as small as possible to minimise damage to the uterus. The baby is fundamentally physiologically designed to be pushed out of the vagina, however tight the fit, and the vagina is designed to massage the baby into life as it emerges. C-sections are (theoretically) used ONLY when there is no alternative but damage or death, and it would be a mistake to think that choosing one over an assisted vaginal delivery would save the baby trauma.

Bx