Thoughts on forceps

(100 Posts)
Sammi1986 Sat 14-Sep-13 13:23:08

Hi all, I'm only 8+3 so it's a loooong way off yet, but I'm wondering how safe forceps really are?

They terrify me and I have always said I would refuse to have forceps if i needed an assisted birth because of the horror stories I have heard.

Are my fears genuine or unessasary? Is vacuum better or if it comes to it is a c-section better? Obviously I'm hoping I would never need anything.

I think I've been watching too many "one born every minute"!

bumpybumps Sat 14-Sep-13 22:15:37

I had a forceps delivery, and to be honest I never gave consent I was just told that was what was happening.

In a way I'm glad I had them because it got dd out safely and meant that had a vb, but the recovery was hell if I'm honest. They cut me, so I had a lot of stiches, the forceps bruised me and cut me inside, I was so swollen, its taken a good 12 weeks for me to feel "normal" again in that area.

What's interesting is I read a lot of posts where people have said it was in their birth plan to not have forceps, but they ended up with them. I'm more inclined to think now that drs/midwives disregard the birth plan if someone has put no forceps and go ahead anyway.

BlackMogul Sat 14-Sep-13 22:30:04

Don't you just need to have a healthy baby no matter how it is delivered? I never gave this a second thought. I am sure I am older than everyone posting here but honestly, you just have to get on with it and trust the people around you. Lets face it, they are all more experienced than you. It is not about preconceived ideas, it is about what needs to happen for the baby.

NomDeClavier Sat 14-Sep-13 22:30:29

bumpy I do think a blanket 'no forceps' is more likely to be disregarded than a well-reasoned, structured consideration of the different possibilities including forceps.

It's rare that there is really no time for a doctor to read 3/4 lines of text which will communicate far more clearly than certainly I could in labour and then they're more likely to be open to discussing the options.

If they're taking you to theatre to use forceps it's likely that a CS is still an option. They wouldn't be moving you if baby was practically out.

AnitaManeater Sat 14-Sep-13 22:30:36

I had an attempted forceps delivery with DS1 with no pain reliefshock They still couldn't shift him and he was in distress already. Ended up in a general anaesthetic c section and a post partum haemorrhage. DS spent a bit of time in special care and was a bit battered and bruised to say the least. He had a caput from an attempted ventouse, and the bruise marks from the forceps down the side of his face. He also had jaundice and he scratched his face so badly within minutes of being born you can still see the scars now 15yrs later! I still thought he was the most beautiful baby ever though.

I didn't consent to the forceps but I was just happy he was born alive. He had the clips on his head throughout labour and I could hear his heartbeat failing to return after each contraction. If I had been handed a sharp knife at that point I would have got him out myself. No ongoing problems from the attempted forceps - this was in 1999

mysticminstrel Sat 14-Sep-13 22:50:49

"Don't you just need to have a healthy baby no matter how it is delivered?"

No, you don't just need that. Aiming for that, and that alone, sets a low expectation and contributes to a culture of ignoring labouring mother's needs.

Obviously we want to deliver our babies safely - but a little bit of pain relief when needed, or a bit of communication as to what's going on isn't too much to ask in the majority of cases.

Sammi1986 Sat 14-Sep-13 23:07:59

I don't want anyone to think the safety of my child wouldn't be paramount. I know in certain circumstances it can't be helped, such as too far down. I just wonder if there are other options, should they not be taken. I dunno, I know my knowledge of it is limited so I think I need to do more research!

NomDeClavier Sat 14-Sep-13 23:14:29

It really depends what you think those other options are for you. Some people will do anything to avoid a CS so between high forceps and a CS they'd take the forceps. Some people will trust their judgement of how labour is progressing and the evidence on the monitor over an arbitrary policy which says you can push for an hour max. There are ways for you to express your preferences and you should definitely be considering what those are an uncovering why, but at the same time try to write an informed birth plan rather than believing that forceps are terrifying or unsafe and just ruling them out.

If it comes to it and the doctor says they need to use for eps you can ask why and when you've heard their reasons suggest alternatives, which they may then consider or explain why it's no longer an option.

It is a balance between respecting their knowledge and professionalism and retaining control over your body by giving informed consent. Educating yourself ahead of time will save time when it comes to it and you aren't necessarily in a position to follow complex explanations.

CoconutRing Sat 14-Sep-13 23:22:45

I have noticed that all the women I know who had a homebirth did not have either a forceps or ventouse delivery.

I would suggest that there really is no point in putting "no forceps" on a birth plan - your wishes would probably be ignored.

Ireallymustbemad Sat 14-Sep-13 23:23:26

I had an attempted forceps with ds1 who was high up and not descending at all. I wasn't asked for consent or even told what she was doing. I can still visualise the forceps in her hands and me, having seen them, saying "what, are you using forceps?" and she said "I'll tell you later". To be fair she did give me local anaesthetic first but I was petrified as suddenly the rom was full, the consultant in her white wellies and I wasn't being told what was going on. I can honestly say it was horrible, and afterwards I was told I'd been as stretched as anyone despite not actually having given birth vaginally.
The forceps failed so I ended with a c section under general as there was no time for a spinal. Ds1 ended up with a few cuts to the face and was I understand delivered using forceps during the section (but obviously was knocked out so didn't see it).

Ds2 was a planned section and forceps were also used to get him out as he was tricky to get out.

Ds1 has cranial osteopathy as he was a grumpy baby and the cranial osteopath said his skull was quite misaligned due to the birth. Other than being grumpy and having a few cuts there were no other effects.
Ds2 just had a cut to the side of his head but no other effects but then he hadn't been through a long labour first either.

mysticminstrel Sat 14-Sep-13 23:32:17

"I have noticed that all the women I know who had a homebirth did not have either a forceps or ventouse delivery"

That's because you have to be transferred to hospital if you need an assisted delivery. Community midwives don't perform assisted deliveries in the home.

LadyMedea Sat 14-Sep-13 23:37:17

This is from my birth plan (I'm 28 weeks):

'Forceps not to be used unless there is no other option - emergency c section strongly preferred in anything other than 'lift out'/low/outlet circumstances'

I have a friend who is 100% 'no forceps' which I think is a litte unrealistic. I've done my research and if the baby is well descended forceps can be the only way and do minimal damage to mum and baby.

I would not consent to high rotational forceps (too risky all round) or probably even mid, as I would prefer a c section and that should still be a good option with the baby in a higher position. I want a healthy baby but I also want my wishes known, so unless there is absolutely no alternative, then they know a c section is my preference.

I'd rather have a knackered stomach than a trashed vagina!

bonzo77 Sat 14-Sep-13 23:42:07

Once forceps are on the cards you tend to have 2 choices: forceps or a very damaged / dead baby. Maybe if you're lucky a CS might be an option. When the CS is not appropriate, I know what I'd go for. I've had 2 CS's, both unrelated to the reasons forceps are normally used. Though both babies did need forceps deliveries. Obviously my pelvic floor was not involved, but there was not a mark on either baby. In my original birth plan I'd written "whatever intervention required to keep me and baby safe. Ideally with as much pain relief as I demand". My mum had high forceps with me (1977). She needed some repairs, but both my brothers (1980 & 1992) were very straight forward deliveries.

hettienne Sat 14-Sep-13 23:43:40

Forceps are banned in some countries aren't they? So "no forceps" can't be an entirely unrealistic option.

ZingWantsCake Sat 14-Sep-13 23:46:39

DS1 was forceps delivery. it was a traumatic birth and I had to have an episiotomy which took months to heal.

he was stuck in the birth canal, so C-section wasn't an option and he wasn't far down enough for ventouse.

there was no other option, but use forceps. it worked fine.

he had a little mark on his cheek from forceps and a bloodshot bruise on his head where he was stuck, so he head a cranial osteopathy session at 3 weeks to check him over.

the osteopath reassured me that he was perfect, no damage whatsoever, the doctor (or whoever?) did a very good job.

I went onto have 5 more kids and although my 4th ELSC due to being breech all the others were normal vaginal deliveries.

hth

ZingWantsCake Sat 14-Sep-13 23:47:49

my 4th *was ELSC

btw congratulations on your pregnancy! thanks

PenelopeLane Sun 15-Sep-13 09:05:09

hettienne where are forceps banned? <curious>

Sammi1986 Sun 15-Sep-13 09:25:59

Penelope apparently most hospitals in the US won't use them, they use the ventuse (sp?!) instead

gallicgirl Sun 15-Sep-13 10:19:08

There are different types of forceps so maybe you need to do some research around that. I think keillands are the high position twist forceps which can be tricky.

rallytog1 Sun 15-Sep-13 20:13:18

Sometimes there just isn't a choice. And as for the pp who said they'd sue on principle if not asked about it first, what would you do if they delayed to talk you through it and your baby was injured as a result?

It's all very well saying expectations should be higher, but ultimately childbirth is not pleasant (unless you're one of the lucky few) and interventions save the lives of mothers and babies every year.

My mantra is this: you're going to have a baby, not a birth experience.

herethereandeverywhere Sun 15-Sep-13 23:01:24

I had on my birth plan I wanted the option to go straight to CS if an instrumental delivery was being considered.

I was effectively press-ganged into having forceps. They told me ventouse was not possible due to swelling on the baby's head (I suspect this wasn't true - her position meant that the ventouse wouldn't have attached as it would have been on the side of her face).

I didn't know then that there are different types of forceps (no-one told me, I'd never read it anywhere).

I was taken to theatre for a Keillands forceps delivery. She was in deep transverse arrest, had not descended the birth canal and WAS NOT IN DISTRESS OR SHOWING ANY SIGNS of it. I'd just reached the end of the time they were allowing me to try to push out a baby they knew was malpositioned. I was the perfect candidate for a CS, had my request been heeded.

DD was born with horrendous bruising and a cut to her face. She still is and always will be scarred by her eye. The trauma of birth left her too sleepy to feed and 3 days later she was in the children's hospital being fed formula via a tube up her nose.

I'd had a massive episiotomy. The stitches all came undone so was left with an open wound which took 2 months to heal. The pain was horrific and unrelenting for at least the first month, then manageable with paracetamol for the second. I suffered bouts of faecal incontinence but my bladder on the other hand was numb so I had to re-learn weeing.

The day after the delivery a midwife introduced the consultant who performed the procedure as "the man who keeps our CS rates down". It is this statement which means I could never again take the advice that "you need to trust the medical staff around you as they know what's best for baby/you" or words to that effect. Actually there is often a hidden agenda. The money to repair my body and mind and any compensation for damage to DD will not come from the same budget as the one the man who wielded the forceps is responsible for.

I'd genuinely rather be shot than go through that again. I had an ELCS for my second delivery which was a walk in the park for both me and my baby by comparison.

herethereandeverywhere Sun 15-Sep-13 23:08:30

Oh, in terms of understanding the reasons for medical staff suggesting forceps and weighing up options etc before consenting do bear in mind you may well be in the most excruciating pain of your whole life at the time you're required to make that decision. So research and planning ahead - such as the OP is doing here, is a good idea.

1944girl Mon 16-Sep-13 00:06:53

Both of my two born by EMCS.

DS2 had to have forceps applied to his head to get him out though as he was wedged deep inside my pelvis.He had a red mark down one side of his face which faded after a week.

I don't know about injuries caused by forceps today, but I was born by forceps in 1944 and the GP who delivered me pulled so hard he cut my head and my mother said I had a bandage round it for a week.

My mother's cousin, born in 1920, was delivered by forceps at home, also by a GP. She suffered a permanent facial injury caused by her birth which left her disfigured for the rest of her life.The poor soul never married, because she said ''What man wants to look at my ugly mug every day''.She was a very nice person who eventually managed to train as a nurse despite her obvious disfigurement(sp).

In days gone by forceps were used when now the birth would be a ceasarian.They were called high forceps and caused alot of the above mentioned injuries, also to the mother.I did midwifery training in the late '60s and remember alot of horrible injuries caused to mother and baby because of forceps.They can be life saving which was why they were used. Ceasarian sections were rarely performed in comparision to today.All CS required a GA and the longitudinal incision which is what I had.While I would not wish that on anybody it is the reason why myself and my two sons are here today.

LadyFlumpalot Mon 16-Sep-13 16:20:22

I tried to have a homebirth but DS got stuck. I transferred in where the ventouse failed twice. By that point I had no choice but to have a forceps as DS was too far down for a CS.

I and DS would have died without a forceps delivery.

He was left with a bruisemto the side of his face, a blood blister on his lip and jaundice. I was left with a huge scar (luckily healed well and quickly) and some loss of sensation down there.

Still glad they did it though!

Due tomorrow with DC2 and trying for a homebirth again! grin

upsydaisy33 Mon 16-Sep-13 19:25:25

My story almost the same as LadyFlumpalot!
Yes, I was aiming for home birth but dc got stuck and forceps were, imho, the good solution. Ventouse failed, am tempted to say waste of time but presumably works sometimes!
We were both safe and healed up. It did take me a while to heal from fairly major episiotomy cut but I can see it was needed and am absolutely fine now.
Aiming for home birth again in next month, but will write a birth plan that says I rule nothing out if considered sensible at the time. I will stay at home as long as poss and hopefully all the way but believe doctors/midwives do their honest best in often difficult circumstances. (Not to say they never get the judgement wrong, just that I do too sometimes!)

cravingcake Mon 16-Sep-13 20:18:41

Forceps can cause a lot of damage to both baby and mum. I had a forceps delivery almost 2 years ago. In my birth plan I said I had a preference to have ventouse rather than forceps if it was necessary. The consultant listened to my request - which by that stage my DH had to say for me. He explained that with ventouse they only attempt it 3 times max as it can cause damage to baby - I think its something to do with the suction pressure on baby's head. Ventouse was attempted but baby was too high and I needed mid cavity forceps, although at the time they just said forceps and did not state what kind. I also had a very generous episiotomy and ended up with a 4th degree tear. My recovery back to my 'new' normal took about a year and was extremely painful and difficult. I'm left with a prolapse and will be having perennial refashion surgery (fixing the scar tissue and original stitching) next year - currently pregnant with DC2 so waiting until after this one has arrived by ELCS.

We also had shoulder dystocia (head is out but shoulders are stuck behind pubic bone) and I will never know if the severity of my tear was due to the forceps or the manoeuvring to get my DS out.

My DS was left with 3 neck vertebrae out of line, which the health visitors, GP and midwives I saw in the weeks after the birth didn't pick up on. I trusted my instinct and took him to see a chiropractor (who specialises in baby and children) when he was about 11 weeks old and this has been corrected. DS also had a very badly bruised ear and struggled to feed for the first few days.

A friend of mine had a ventouse delivery with her DD and the suction cup actually tore the skin on her DD's forehead and she is left with a scar, which was very noticeable until her hair grew long enough to cover it.

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