Really, really hate the idea of forceps or ventouse... please share your thoughts on declining them and proceeding to C section instead

[LoveInAColdClimate]

I think I'm probably being a bit silly. I really, really hate the idea of either forceps or a ventouse delivery, to the point where I am considering putting on my birth plan that in the event that either is necessary, I would prefer a C section. I'm not even sure why I loathe the idea so much that I'm prepared to opt for major surgery instead. Has anyone refused forceps/ventouse? If so, why? How did the hospital react? Were you pressured to agree? Has anyone had them and found it not really that bad? Am I worrying unecessarily (and possibly focusing my fear of the birth into this one area)?

Will the hospital always discuss their use with you before doing it? A gradutate of my active birth class was convinced that forceps had been used on her without consent, but she did say she was so out of it that she might have consented without really realising.

TIA.

I always just thought of them as useful tools and trusted my carers to know when they should be recommended. And in the event I did opt for a trial of ventouse as dd's head was in the birth canal and wedged. It would have been easier and less traumatic to get her out vaginally. For both of us. It didn't work and the cs was v difficult because of how far her head had moved down and how wedged she was.

i had ventous right at the end to help me. cs would not have been an option by then. no episiotomy, one tear (not associated) and no problems. if they had not have told me they were using it i would not have known but i had had an epidural....

You usually won't get the choice I'm afraid, because by that stage time will be of the essence and they will have to get the baby out quickly, plus the baby might be so far down the birth canal that it would be difficult to perform a cs. You can put it on your birth plan, but it may count for nothing. Don't worry about this too much. Firstly, it may never happen, and secondly, you can have good and bad forceps/ventouse deliveries just as you can with c-sections.

I had a ventouse delivery with DD, after almost 3 hours of pushing (she was back-to-back). They did ask if I wanted to go straight to CS, and I gave consent to try ventouse first. I still had to push, but the ventouse just kept DD moving in the right direction iyswim. I didn't find it that bad. Having the episiotomy stitched up wasn't fun, but I'd guess there were fewer stitches than with a CS. DD had a bump on her head for a day or two afterwards but was (and still is!) otherwise perfectly fine.

I've never had a CS so can't really offer a comparison, but I'd imagine that an assisted vaginal delivery is (broadly speaking) less traumatic for both the mother and the baby than a CS. Every birth is different though. It may come down to whatever the quickest and safest method is at the time.

Thanks, everyone.

I need to just man up and accept that incredibly umpleasant things are going to happen to me in the course of getting this baby out, don't I? Oh dear...

supa - I find it reassuring that you didn't need an episotomy. Thank you.

Dd's head was in a tilted position, but too far down for a section, they did threaten forceps, but I managed to dislodge her by some serious rocking of hips!

Just to allay your worries, forceps and ventouse do not mean guranteed birth injuries. My two friends who had forcep deliveries around the same time as me healed fine, so problems. I had an easy delivery, small tear, but have had ongoing problems which means I need to be restitched.

Or you could choose a MLU, no chance of forceps there.

You can actually need to have a forceps delivery even with a CS if the baby is so far down! Wait and see what happens.

accept that incredibly umpleasant things are going to happen to me in the course of getting this baby out

Not necessarily. But I do think you have to accept that much of the experience is beyond your control; at each step along the way the MWs/doctors should advise you what they think is best & ask you which way you'd like to proceed, so it's worthwhile to understand the various options well & have your answers rehearsed.

Recovery after a CS tends to be much harder, especially an emergency CS. I know it's debateable, but when I read comparisons, it always seems to me like CS will usually carry many more risks over all (or worse risks), than a instrumental vaginal birth.

I think it's important that you dig down deep into why the ventouse/forceps options bother you so much, especially when they are acceptable to others, so that you can feel confident in whatever decision you ultimately make about them.

June - I'm actually booked into the MLU, but it's just down the corridor from the scary delivery suite with the big forceps so I'm worried about being transferred down there. Reassuring about the lack of birth injuries - thank you. Sorry to hear about your ongoing problems - hope things all recover very soon.

Tubby - so sometimes they do a C-section incision, then shove the baby down from above (presumably through said incision) and use forceps to pull it out through your fanjo ? I may faint... please tell me I have misunderstood this...

I can totally sympathise with your anxieties re ventouse/forceps!

In reality I don't think you really have a 'choice' to decline them- it will all depend on where the baby is/position/heart rate etc

In situations where decisions must be made quickly, it's more a case that you are told something is going to happen- that is, rather than you be given all the information, time to weigh it up and come to an informed decision.

Childbirth is like that, things can escalate quickly and it comes down to the midwives & doctors to make decisions about what needs to be done for the best outcome for mother & baby.

For what it's worth, I'd rather choose a CS over having forceps or a ventouse, but that's just my personal opinion. I could write this in a birth plan- but I know that these are barely read by the midwife, let alone adhered to.

I so sympathise reading your worries, this was me one year ago right now. The only thing that helped me beforehand was focussing on how relatively short childbirth is (though not short enough!) in comparison to baby bliss. It is such an intimidating prospect - I was also comforted by thinking of how many women understand this feeling and come out the other side. Very best of luck, when are you due?

Sorry, x posts with lljkk. I really don't know why the idea bothers me so much. I have no history of abuse or traumatic medical intervention for anything else. I really struggle to understand why it scares me so much. I am normally fairly logical and pragmatic about things, but for some frustrating reason seem to have latched on to this as something that horrifies me. I wonder if I perhaps overheard some particularly traumatic birth story as a child or something but that seems a bit unlikely to be the cause of this...

I sympathise with your worries, too. I have only had c-sections (for health reasons) and I know that my recovery, even from an emergency section, was nowhere near as bad as my firend who had Keilands forceps used. However, i ahve also known a fair few women who have had the other more common type of forceps / ventouse and episiotomies and have recovered quickly and had no 'horror story' to tell.

It is hard to weigh these things up, isn't it? I dont really have any advice, I'm afraid, but try not to imagine the worst.

Oh, sorry, more x posts. Amandine - in some ways, the idea that it will be out of my hands worries me less than the idea of being given a choice and then being able to blame myself if I end up with some awful birth injury or the baby gets hurt by the forceps.

beatofthedrum - Thanks. Did you end up with forceps? Due in March so have started thinking about birth plan etc and am now panicking!

Do you feel brave enough to delve into it?
Do you want your unstated/vague fear to define this for you just as it is, wouldn't you feel more confident making this decision knowing why it was Ventouse/forceps were so upsetting?

The idea of a CS freaks me out, cutting into my tummy, blood and all that. But I must admit that in the midst of labour if they had advised it & there was obvious reasons (like plummeting foetal heart rate) I would have accepted a CS well enough (I think so, anyway, never had to go there). So it's possible that your current feelings are not how you'd feel if it came down to the moment of making actual decision.

Thanks, EatMeDates. I think the uncertainty is the worst thing...

DH has just said that if he could do it for me, he would... very sweet but sadly impractical!

lljkk - how would you go about delving into it? Do you mean really thinking about what it is that scares me so much? Thanks.

Forceps in a cs can be used to pull the baby back up when they've descended too far and been stuck.

I had an episiotomy with dd, recovered fine. Also had 2 emcs and recovered fine. In the event you will be utterly fixed on getting your baby out safely. IRL I would never, ever leave my bedroom, let alone my house naked. In labour I trudged, fully dilated, contracting, sobbing and butt naked across my neighbour's lupins towards a waiting ambulance while the midwife chased behind begging me to get dressed.

Also, I agree with SOH that in the event you will be completely focused on getting your baby out safely. I was absolutely terrified of needles, operations etc before I had my first child and never imagined for a minute I would end up with a c-section. I skipped that bit in my baby books, in fact . The idea of a spinal/epidural, a catheter, someone cutting me open - couldnt even let my mind go there.

In the end, I did have an emergency section with my first child and, after a long drawn out induction and labour, when they told me my baby's heart rate was erratic and they wanted to get him out, I didn't think twice about it. I'm not saying I wasnt afraid - I was shaking with fear - but that fear was dwarfed by my need to get my baby out and in my arms safely.

I can't help much but I had a ventouse and very naively, had not given any thought to this pre delivery!! I'm not sure why, I just assumed they were quite rare. First baby, no clue etc! Though maybe blissful ignorance was a good plan.
Anyway, it's all a blur really and I assume I was asked but I was just so relieved to get the baby out, I didn't really care how! Listen to what your mw/dr tell you to do, to minimise tearing etc. Yes there was a bit of a lump on his head but all was fine.

When I have baby no. 2, if it was necessary I'd rather ventouse again than c section, though no experience of the latter.

I had Keillands Forceps in theatre. One push, one pull of the forceps and my daughter was born. Completely unmarked, nothing wrong with her at all. And I didn't feel a thing, was numb from the waist down

I had an episiotomy, but didn't give a shit at the time, and it healed without a second of bother.

I think there is probably a lot you can read online about how dreadful they are, but actually most people are unaffected by them or left with minor issues that heal.

Like Show says, forceps can be used in CS anyway so there are no guarantees at all.

yeah, just thinking hard on why you're afraid. Infant injury, injury to you, whatever it might be.

I think it's usually best if you understand your own reasons fully.

Suppose you had a CS and there were unpleasant complications (possible). If you looked back & said "But why was I so bothered about ventouse, things would have turned out better!" -- best to avoid that position of regrets. You want to be able to tell yourself that you felt solid in your reasons for not taking any particular option. I personally couldn't feel that solid about it if I didn't understand my adversion better than you seem to.

Conversely, A friend said that "Every decision I make IS the best decision I could make at the time": if you think like that, you're covered anyway. :)

Ah, that explanation is less terrifying than my fevered imaginings - thank you, SOH. How have neighbourly relations been since the lupins ?

SOH and EatMeDates - thank you, I will try to keep the end goal that in mind amidst all my worries about being sliced asunder and having my pelvic floor wrecked with forceps...

I've just been looking at this as i'm due shortly. As I understand it, if the baby hasn't descended far then the only assistance they can give vaginally is to use high cavity forceps - which I think are Keiland's Forceps. I have stated in my birth plan that I would far rather have a CS than high cavity forceps (and I've trained my birth partners well to support that view).

Once the baby has descended a bit further then a CS is a much less practical solution - because parts of the baby (and probably the biggest bit - the head) have already descended through your pelvis, so to get the baby out via CS would require them to be pushed back up which is quite a risky process. In that situation I'd probably have a mild preference for forceps IF the person operating them was skilled and competent. My understanding is that the damage that can be done with ventouse is pretty self-limitting, but that in skilled hands forceps can be used very gently...

I came to the conclusion when expecting DC1 that what I was afraid of was not events overtaking me, but of being subjected to a time line and care plan that was being dictated and if my body didn't perform within someone else's parameters then there would be lots of pressure to have interventions I may not want or feel necessary. With DC2 things didn't go entirely to plan and I wound up being induced. Not my first choice, but DH and I were very pro-active in asking questions and taking ownership of the whole process - and actually it was OK. Yes - there is always scope for a genuine emergency to develop, but it is also usually possible to ask at least a few questions so that you understand what's being recommended and why, and whether it really is an all-hands-on-deck emergency situation right now this second...

Having had the experience that it is possible to remain in control of decisions (even if not in control of the situation) I feel much more relaxed about the possibility of giving birth in a CLU this time round.

Fingers crossed this is all contingency planning and things are very straightforward for you :)

I think that having fear about this or that is perfectly normal - just not everyone voices it that much. The thing to remember, and you might not like this, is that no two pregnancies/births are the same so as much as we all want to hear reassurance and experiences from other Mums it really doesn't/can't have any bearing on what might or might not happen to you.

I do mean this in a friendly and supportive way by the way so please don't think I'm having a go! If you're that nervous or scared about it then I would say have a really open chat with your midwife, I'm expecting No2 and have a lot of anxiety after a scary first labour but I've had a really good chat with my midwife about my fears (with a lot of tears thrown in there) and with all the best will in the world, there's no guarantees either way, but I feel a lot better after having the chat with her and getting my fears and feelings out in the open!

Personally after having a c-section myself, I do think that people underestimate just how long and painful recovery can be in an awful lot of cases and I'm doing all I can to avoid having another one if possible! I'm looking into hynobirthing after reading about it here www.direct2mum.co.uk/1078/hypnobirthing and also speaking to my midwife, who thought it was a brilliant idea. If nothing else I think if it helps me to feel less stressed and anxious then there's a lot better chance of having a better experience!

I would definately say though, have a good look around at other birthing options and classes if you can and try to get any nervous feelings out of the way so you can enjoy the labour as much as possible...above all it is an amazing experience!

Best of luck xxx