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Although most deliveries will result in spontaneous vaginal delivery, under some circumstances, additional assistance is required to deliver the infant. Assisted delivery is defined as any procedure undertaken to facilitate the delivery of the infant. These procedures may include vacuum-assisted delivery, use of forceps, and cesarean delivery. Indications for assisted delivery include prolonged second stage of labor (with adequate contractile force and documented insufficient progress), maternal factors that limit or preclude pushing or vaginal delivery (e.g., active genital herpes infection or vasa previa), fetal factors, or maternal medical problems indicating the need for urgent delivery. When present, these factors should be noted in the medical record and referenced in documentation of decision-making regarding assisted delivery.