This chapter presents some important labor room operative procedures used during the management of a parturient in active labor. These include artificial rupture of membranes, episiotomies/perineotomy, bladder catheterization, dilatation and evacuation (D and E), and symphysiotomy. Episiotomy is an incision made into the perineum to enlarge the birth passage to facilitate the birth of the baby. It prevents undue stretching of the vaginal walls which predispose to future cystocele, rectocele, uterine prolapse, deficient perineum, and loose vaginal outlet. Bladder catheterization is conducted for the retention of urine during pregnancy and in eclamptic patient, to monitor urinary output and to test urine for albumin. Dilatation and evacuation is conducted to terminate pregnancy for first trimester MTP, Incomplete abortion, inevitable abortion, and missed abortion.