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Birth Injury - Vacuum Extractor and Forceps Delivery with Brachial Plexus Injury (Shoulder Dystocia). Shows the surgeon attempting to deliver the baby using a vacuum extractor.  Shows the baby at +1 station in LOP presentation. The surgeon uses a forceps to rotate the baby's head, which is shown at +2 station LOA presentation. Shows the surgeon delivering the baby manually with the infant's left shoulder trapped beneath the mother's pubic symphyis, causing shoulder dystocia.