Is it possible to totally refuse forceps?

(133 Posts)
RevoltingPeasant Tue 26-Mar-13 17:38:32

This is a musing rather than urgent Q, as not even pg yet! Am v organised grin

The Birthrights thread got me thinking: can you refuse in advance one specific procedure, or is this just really not possible?

In an ideal world I'd want a homebirth but would transfer to hospital if any probs. However, once there, would it be possible to say I simply don't want forceps under any circs, and to go straight to CS if it's tending that way?

Or will an NHS hospital not have that flexibility?

I ask because I've seen some forceps horror stories, and that + episiotomy is my real fear during birth! <wimp>

Flisspaps Tue 26-Mar-13 19:17:34

I refused forceps with DS - they were already prepping me for CS as they were fairly sure forceps would fail, and I'd had forceps with DD. The Dr was hmm but I'd heard her and the MW suggest that DS was transverse.

Anyway, after discussion with DH I agreed to one attempt with forceps in theatre, with spinal in place ready to go to CS, and they worked, with none of the damage I suffered first time round.

It would have been possible to go straight to CS though, the Dr wasn't 'happy' when I was refusing forceps but she didn't have any option but to accept my choice. I don't know what made me change my mind to this day - there was no pressure placed on me to try, even with the Drs hmm face!

Lonecatwithkitten Tue 26-Mar-13 19:17:44

Even in very urgent situations a good PBS will explain the risks of all options. I never wanted forceps or episiotomy. However, when it came to it the risks of C-section were considerably greater than the forceps risk, so I took the forceps. We are both alive and well, but forceps was the least bad if a lot of very bad options. But then as a vet I am horribly aware that some positionings are very, very high risk whatever you do.

TwitchyTail Tue 26-Mar-13 19:51:52

Yes, you can absolutely refuse any intervention you wish. But please make sure you are willing to accept the potential consequences, which have been pointed out very well by previous posters. Crucially, a C-section is not always a viable or safe alternative to a forceps delivery.

I've never had forceps so can't speak about these personally, but had a (recent!) delivery with ventouse and episiotomy (with just gas and air). Just to balance out the horror stories: my experience was that it was a extremely easy, barely felt a thing (on gas and air only), recovered quickly and fully, pelvic floor perfect from day one. And, most importantly, my baby was brought out safely and completely unscathed. Of course everyone is different, but when I see instrumentation being discussed as if it is the work of the devil, I feel the need to stick up for it grin

In your position, I would make it clear from the outset that you would very much prefer to avoid forceps if at all possible, and to go to ventouse or C-section if it is safe to do so . Sometimes it is a genuinely equal choice between two options. But I would not rule it out altogether. In my humble opinion, labour and delivery tend to work best if you keep an open mind.

TwitchyTail Tue 26-Mar-13 19:53:15

Just seen that I said gas and air only twice blush Probably still under the residual influence of it...

Coconutty Tue 26-Mar-13 20:05:16

DS1 was born with forceps, his heart rate dropped suddenly and thank God the consultant was with me and got him out as quick as humanly possible.

He was the Queens gyno consultant so I think I was in safe hands.

Personally, when I heard the MW saying the heart rate is dropping dangerously, we need to deliver this baby right now, I didn't think okay then I'll just wait here while you prep a theatre, find an anaesthetist, take me to theatre etc. I just wanted him out right then. Regardless of the episiotomy and million stitches.

MiaowTheCat Tue 26-Mar-13 20:45:40

I had "I will become very very distressed if forceps are mentioned, please try to explore any other avenues if it's looking like they will be required" written down - I didn't dare point-blank refuse (other forceps threads will tell the tale of why I didn't feel capable of doing so) but I wanted to make my strong aversion to them clear.

And can we quit the semi-judgemental "oooh but you'd put your fanjo on the line for your baby" comments that basically bash anyone as not a good altruistic mother for having wibbles about the infernal things please - they're actually very very hurtful for those who got upset or were coerced into a forceps procedure.

propertyNIGHTmareBEFOREXMAS Tue 26-Mar-13 20:48:51

Agree entirely, Miaow. Well said [ smile]

Coconutty Tue 26-Mar-13 20:51:48

I don't know anyone who would put their minnie before their baby though, and if the fastest way to get the baby out was with forceps why would anyone refuse? Genuine question.

Flisspaps Tue 26-Mar-13 20:54:24

coconutty You don't need to understand why anyone would refuse, the point is that it is perfectly legal and within a woman's rights to do so. Take a look at the ragged bits thread over in Health if you want to have a small insight into why some women may consider declining forceps during birth.

YABVU (I know it's not AIBU but still) to use the word 'minnie' hmm

Coconutty Tue 26-Mar-13 21:01:54

I am just so bored of Fanjo that I have reverted to Minnie.

Of course it's legal to refuse, but didn't realise it was such a big deal. I had DS when I was quite young and never had a birth plan - didn't realise that I even could tbh. Until I read this thread I had actually forgotten than he was a forceps baby. It was such a non issue. He did have a big red mark on his face when he was born from the forceps but that was the only negative thing I could say from my personal experience.

tilder Tue 26-Mar-13 21:02:54

What peoniesplease said.

Op of you are worried about intervention rates at your hospital, the stats are available to check. Unhelpfully I can't remember where. I'm sorry you know people who had a bad experience, but please don't think that happens to everyone.

Coconutty Tue 26-Mar-13 21:03:29

Any chance of a link to that thread? I can't find it. Thanks if you can do it.

VinegarDrinker Tue 26-Mar-13 21:04:18

As everyone else has said, it's your body, your choice. However do be aware that it is sometimes the quickest and safest option for the baby.

I had in my mind that I didn't really want forceps if possible .... Ended up with forceps + episiotomy in theatre after 2.5 hours pushing. Tbh if the cleaner had said they wanted to Hoover him out at that point I think I would have agreed!

Very pleased I did consent to forceps though, I had no nasty tears, no pelvic floor issues and a pretty damn quick recovery all things considered. And DS was absolutely fine, couple of small forceps marks that disappeared within a day.

MiaowTheCat Tue 26-Mar-13 21:07:04

I didn't put my vagina before my baby - but I got absolutely fucking terrified by how hostilely I was being yelled at to consent to forceps, panicked utterly at the idea of being stuck in the crippling SPD hell I'd been in permanently when they wanted to do a spinal and was desperately trying to get them to note and stick to my pain-free gap when they were going to spinal and forcep me... while they just yelled at me more and more making me more and more terrified... I had no choice but to consent, didn't consent to episiotomy - in fact I was explicitly told they wouldn't without asking me, didn't sign any consent forms so they proceeded on verbal consent... epi was done anyway and I ended up with a social services referral for being resistant during the birth. It completely and totally ruined my life if you must know - I ended up with severe PTSD, nightmares every single day, flashbacks, utter terror of health professionals - they basically ripped a huge chunk of "me" out along with the baby that time and I've never recovered from it. The 3c tear in contrast was a piece of piss. I was so utterly, totally terrified, I just wanted everything to stop - I wanted to be dead to make it all go away and them stop shouting at me to be honest - and because of how dreadfully it affected me, part of me still wishes I'd died in that delivery room.

Hence my reluctance to have them even entertained last time... I'd hardly call that an attempt at fanjo preservation - and my noting down that I'd become very distressed if they were mentioned because of how traumatised they'd left me with their behaviour at the previous birth.

Still want to lump me in with someone wanting to keep their vag nice and tight and shiny?

Coconutty Tue 26-Mar-13 21:10:48

I think I've missed something, has someone suggested that you wanted to keep your vag nice and tight and shiny?

Flisspaps Tue 26-Mar-13 21:10:52

Coconutty here.

Having had a 3rd degree tear myself where the episiotomy extended, followed by a PPH and manual removal of placenta (all things that are risks of intervention including forceps), for me, forceps WERE an issue. And DS had marks on his face and facial palsy for several weeks from the forceps, had that not healed then I would probably have been left regretting my decision to change my mind and consent a second time.

Flisspaps Tue 26-Mar-13 21:17:43

I don't know anyone who would put their minnie before their baby though, and if the fastest way to get the baby out was with forceps why would anyone refuse?

I think ^ this has been construed as you suggesting some women woulld want to keep their 'vag nice and tight and shiny', rather than putting their physical and mental health and their baby first.

Coconutty Tue 26-Mar-13 21:18:40

Oh okay, making much more sense now. Thanks fliss.

I honestly didn't realise that some people think that others don't want forceps to preserve their bits. That would be utterly ridiculous. As I said, I was clueless when I had my first, had never even seen forceps let alone knew what they were used for. DH said they looked like giant salad tongs.

Miaow it sounds like you have had a terrible experience, I hope you didn't have your second in the same hospital and I hope you complained afterwards about what happened to you.

Coconutty Tue 26-Mar-13 21:20:08

And wasn't suggesting that.

TheChaoGoesMu Tue 26-Mar-13 21:22:42

You obviously can refuse, but I would do whatever it takes to get the baby out safely. I guess the best thing to do is educate yourself on the risks and alternatives.

Lonecatwithkitten Tue 26-Mar-13 22:04:32

Being informed is the most important thing. In certain cases you really do have to weigh up the risks I had a tear and have ongoing problems due to the forceps delivery I was told these risks. However, in my case c-section had a considerably increased risk of anoxic brain injury or death to baby. So on balance in my mind I would rather take the risk and then accept the damage to myself rather than risk DD.

BackforGood Tue 26-Mar-13 23:01:55

Thanks revolting for explaining smile
Do remember though, that people will complain when they've had a bad experience, but there will be loads more women who were very glad of the intervention, who you won't hear from, because they were perfectly happy with their care.

BraveLilBear Wed 27-Mar-13 10:33:08

This is an interesting thread as I remember one fairly recently that said it was impossible to refuse consent, as they make you sign for a trial of forceps before c section. This is heartening to know there are choices available. The only hope is that there is enough time to be informed of the specific risks in any given scenario so you can make an informed decision - ie if forceps are considered likely to fail, then c section should be presented as the preferable choice. If c section would take too long, then that should also be made clear.

I think that my concern is that so much is made of the drive to try and avoid c sections that you may not be presented with the risks in a balanced way, ie you will be encouraged to try forceps even if not likely to work. Having watched OBEM and read plenty of threads on both sides of the debate on here, there is a certain endemic mistrust of the motivations of HCPs. Obviously not all HCPs will have stats at the forefront of their mind in these circumstances, but there is certainly an implication that some do.

How would you be able to tell in an emotionally distressing scenario whether your HCP genuinely had yours and baby's health at forefront, or whether they had half an eye on stats? I think that is a challenge, and one of the things that makes childbirth such a terrifying prospect to many women - especially with tales of shortstaffed midwives who you may not have been able to make a connection with and therefore trust up to that point.

Chunderella Wed 27-Mar-13 13:11:11

Twitchy, in fairness a forceps delivery is generally considered to be worse than ventouse. I also had a ventouse delivery and, like you, didn't find it to be too bad. In fact I only needed two stitches. The stuff that led to me needing it was hard, but the delivery itself was ok. I've never had a forceps birth myself so can't directly compare, admittedly, but not sure it's a good idea to compare it with ventouse. It seems to be rather more traumatic.

Interesting to hear that BraveLilBear but I'm not sure how anyone could be made to sign for a trial of forceps as a condition of a CS. You'd just write that you consented to one and not the other.

OneLittleToddleTerror Wed 27-Mar-13 13:33:10

I had an episiotomy, and trust me, by that time, all you want for the baby is to come out. All I had in my mind was, oh no, my baby is stuck in the birth canal. It actually didn't hurt, but I have been in labour for over 2 days.

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