(A) insert the cup into the vaginal vault, ensuring that no maternal tissues are trapped by the cup.
(B) Apply the cup to the flexion point 3 cm in front of the posterior fontanel, centering the sagittal suture.
(C) Pull during a contraction with a steady motion, keeping the device at right angles to the plane of the cup. In occipitoposterior deliveries, maintain the right angle if the fetal head rotates.
(D) Remove the cup when the fetal jaw is reachable.