"At a meeting of the American Gynecological Society in 1920, DeLee sparked controversy when he presented a paper advocating for the use of a systematic approach to childbirth for physicians, including the use of forceps and episiotomy even in women who had no labor complications.^[3] DeLee's "prophylactic forceps operation" consisted of several steps: scopolamine injections in the first stage of labor, ether anesthesia in the next stage, then episiotomy and forceps delivery. Ergot was used in the subsequent manual extraction of the placenta.^[10] DeLee reasoned that the episiotomy prevented perineal tears which could cause complications like uterine prolapse and vesicovaginal fistula. He said that the early use of forceps would avoid pressure from the pelvic bones against a baby's head, thus preventing complications like epilepsy and cerebral palsy; DeLee said that fatal complications occurred in 4–5% of labors managed with the traditional conservative approach.^[11] Though DeLee said that such interventions should only be carried out by a well-equipped physician specialist, John Whitridge Williams and other prominent obstetricians criticized DeLee sharply. They felt that DeLee was being too aggressive by removing a baby before complications occurred; DeLee's colleagues preferred to be conservative and to manage complications as they arose. (Wikipedia article on Joseph DeLee, accessed 4-2020).

Digital facsimile from academyofpelvicsurgery.com at this link.