The group of instruments known as perforators were used as a last resort in obstructed labour. A life saving procedure (for the mother) involving the extraction of the foetus by collapsing the skull.
The joint mechanism allowed the point to be opened within the skull by pushing the handles together, which allowed more force to be applied than would be possible by pulling them apart. The second half of the blade was truncated allowing a single perforating point. (Other perforators required various locking mechanisms). A rare example with beautifully carved and cross-hatched ebony handles and two small areas of corrosion in in keeping with its age.