Has anyone refused a forceps delivery when baby got stuck, and had a CS instead?

(34 Posts)
bronya Thu 15-Aug-13 14:30:35

I managed to stave one off (just) with my firstborn, but sometimes have nightmares about what could have happened. He'd only just descended into the birth canal and his heartbeat became erratic with the first few pushes. Luckily, as they were contemplating this, his heartbeat steadied and all was ok in the end. However, they kept saying to me that as I'd started pushing he was too low for a CS and they would have to use the long forceps to pull him out fast. Is this really true? It would have been pretty horrific given how far up he was, and the stats for injuries/brain damage/scarring kept going through my head. If I'd refused point blank, would they have doing a CS? About to try for DC2 and just can't stop thinking about it.

MrsWolowitz Thu 15-Aug-13 14:34:15

They know what to do for the best.

DD1 got stuck and was ventouse delivery but I just wanted her out safely so did whatever they told me to.

To be honest I was so exhausted and delirious I didn't really know what was going on.

They will advise you what is the best thing to do and my advice would be to trust them.

Theas18 Thu 15-Aug-13 14:40:59

You think that when a baby is stuck in the birth canal there is really time to " choose " a section? Sorry, to put it bluntly, you are dicing with a dead/damaged baby here because of your fears. if you are in a " stuck baby " situation that baby needs to be born now, which forceps/ventouse would achieve ( Ok yes still not risk free but birth is not), not in 5-10 mins when they've got you to theatre and under a GA .

Rarely this sort of thing happens with twins when one delivers and the other gets into an odd position. THis would be planned for with a team on standby and already in theatre, even then it's risky.

TAlk to your team, maybe opt for eective section if you can't sort your fears? Best wishes for both you and your baby.

mignonette Thu 15-Aug-13 14:43:50

I refused a forceps the first time and had an ELSCS. I knew they would fail because I could tell that the baby was in deep transverse arrest due to her head being wedged partially transverse. I was right.

The cord prolapsed as I was being prepped and I had a GA. The second time I had documented no forceps but had uterine/urinary bladder rupture and had another ELSCS.

I would never have forceps.

PoppyAmex Thu 15-Aug-13 14:52:23

"They know what to do for the best [...] They will advise you what is the best thing to do and my advice would be to trust them."

With all due respect for the medical profession, I think I've read too many threads with women with horrible prolapses and savaged bodies to be that trusting.

I agree they're the qualified professionals, but I also believe in taking some responsibility for my treatment/ care plan.

I think you should talk to your HCPs about this OP.

MrsWolowitz Thu 15-Aug-13 14:57:29

* I think I've read too many threads with women with horrible prolapses and savaged bodies to be that trusting.*

One of them might have been me! I had a terrible injury from giving birth to DD1 (episiotomy related) and I ended up back in hospital for a week when DD1 was 2 weeks old.

That still doesn't negate that they know what is better, faster and safer for that baby than I did. No way would I have insisted on a c section. Yes, I could have saved myself that injury but she needed to be born now and there was no time to waste arguing.

PoppyAmex Thu 15-Aug-13 15:35:21

Of course it's different when it's an emergency situation, but the OP is thinking ahead and has concerns about her future childbirth arrangements, so this is the right time to be proactive and speak to the HCPs.

I still maintain that the best way to manage your own care is to be as informed as possible and keep an open dialogue with the professionals.

Besides, to have blind faith in someone just because they're wearing a white coat, is naive at best. The sheer number of childbirth/antenatal/postnatal related horror stories on this forum are a life testimony to that.

bronya Thu 15-Aug-13 16:04:58

They are banned in the USA, aren't they? What do they do then? It's not the use of forceps when baby is almost out that I'm worried about, but their use much higher up the birth canal.

MrsBungle Thu 15-Aug-13 16:06:49

I had a forceps birth with DC1 - not even time for pain relief. She came out not breathing and had to be resuscitated. There was absolutely no time for a c section - she would have died had I refused the forceps.

I was speaking to an doctor about this the other day, and she was telling me about a case when a mum had very high forceps (and a fair bit of damage to her and child). She said no other consultant would have used them, everyone else would have gone CS.

So it's a judgement call, and you are to some extent at the mercy of how your consultant makes that decision and their preferred mode of delivery in taht circumstance. I can't see anything wrong with making it known that you would by preference go for CS rather than forceps if it comes down to that kind of decision, but it may well be the decision is made by events anyhow.

CogDat Thu 15-Aug-13 16:26:35

High forceps are a scary thought, but I would never say never, because giving birth is so unpredictable.

MrsWolowitz Thu 15-Aug-13 16:40:37

Of course it's different when it's an emergency situation, but the OP is thinking ahead and has concerns about her future childbirth arrangements

No. She's asking about refusing forceps and demanding a cs at the time isn't she?

Phineyj Thu 15-Aug-13 16:44:19

I did. From what I'd read and friends' experiences I wasn't prepared to risk the damage to me and the baby. They were a bit frowny and said I'd have to wait, but then DD's heart rate started dropping and I was rushed to theatre. Something to bear in mind is that C-sections show up as more expensive and post-birth repair work due to instrumental damage comes out of another budget. C-sections require more staff and a longer hospital stay.

So there is more to the decision from the HCP point of view than what's best for the baby and mother - and I'm not sure what's best for the mother is uppermost in minds a lot of the time. It definitely pays to think about this beforehand and to talk it over with your partner.

GuffSmuggler Thu 15-Aug-13 16:45:23

As others have said it's not as simple as choosing a c-section over foreceps because the baby is usually too far down and would need to be pushed back up for a c-section which is pretty dangerous.

I really didn't want foreceps but was advised during a difficult birth that it was the quickest way to get a distressed DS out and I didn't hesitate.

hazelnutlatte Thu 15-Aug-13 16:53:40

I asked my midwife about this as I was very scared about this possibility (I was born with the use of high forceps, my mum suffered a lot of damage as a result, also I had to be resuscitated.) I was told that high forceps are very unusual now, usually a c section is offered if the baby is still high in the birth canal when a potential problem is spotted. I was told not to worry about it as the chances of needing to have high forceps is so small now. I'm not sure that this is all that accurate but it did help to calm my fears a bit!

hazelnutlatte Thu 15-Aug-13 16:56:22

Just to add to my post - I'm specifically talking about high forceps here, not normal forceps (sorry don't know the proper name for them) which are obviously still used fairly commonly, but are much safer.

sorryitsanotherpilone Thu 15-Aug-13 17:00:00

My baby was tugged our with ventouse they also said she was too far down for c section....I.fully admit to being completely clueless on this subject but could you request ventouse over forceps? I didn't escape without injury mind you, but dd was safe so that's all I cared about but forceps look so barbaric in compassion. How do they choose which to use?

MummytoMog Thu 15-Aug-13 17:11:36

I pushed for six hours before they took me to theatre. Had a spinal and then they pulled at DD for 45 minutes with the ventouse before finally yanking her out with a pair of forceps. She was definitely too far down for a C section. I had a brilliant recovery, DD had meconium aspiration, and was a bit blue, but basically fine. I had said to DH (in all my naivety) that I didn't want a forceps delivery and he had to stop them and make them do a c section if they got out the forceps. So he leapt over the table practically when they pulled them out to try and stop them until I told him it was ok. And it was. I don't know about anyone else here, but when a hospital registrar tells me that forceps are the best way to deliver my baby with a minimum of danger, I'm going to trust him.

Frankly, the most likely outcome with your second child is that the delivery will be much easier. My DC2 slid out like a greased piglet 18 months after DC1 was yanked out.

Casmama Thu 15-Aug-13 17:13:53

I had Kielland forceps which I think are the same as high forceps- DS was back to back and I had only just dilated to 10cm so he had to be turned and pulled out. He was fine as was I but at the time I was just desperate to get him out so would have agreed to anything.

I don't think there s any harm in considering your options in advance but bear in mind that things don't always go as planned.

Kelly1814 Thu 15-Aug-13 17:34:19

Forceps make me shudder.

http://www.dailymail.co.uk/health/article-1253013/Forceps-killed-baby-doctors-using-them.html

fuckwittery Thu 15-Aug-13 17:38:36

I said I did not want high forceps, baby was in the end too high for them to use forceps at all, but I had horror stories through my head as well. It was however a very difficult EMCS, baby was deeply engaged and they had to push her out UP my vagina essentially and make a wider scar incision than usual to kind of dig her out, as a result I lost a lot of blood and had a transfusion, also difficult recovery from the EMCS due to the bigger incision and the internal bruising. So I don't think either way was an easy option but no long lasting damage from the EMCS.

CogDat Thu 15-Aug-13 18:34:51

fuckwittery, I had that too, all rather unpleasant, but what needs to be done, needs to be done!

MiaowTheCat Thu 15-Aug-13 18:50:24

I "resisted" in the sense I was attempting to get them to look at the gap I could open my legs pain free before putting a spinal in and stirruping me up to get the forceps done (severe SPD and I was terrified of being stuck with it post-natally). Not resisting the actual forceps as such, but wanting to make sure that the me-side of the equation was looked after as well. All I wanted was them to check my safe-gap and say they'd stick to it (they could have just done that and lied about sticking to it like they did with everything else).

I got a social services referral pulled on me for being a "resistant patient" - had to go through the full investigation of ringing the entire planet to check I wasn't some child protection risk. Case closed very rapidly - but we still have the "known to social services" tag on our file and it's always there niggling away in the background scaring me of every time I come into contact with medical bods, health visitors or the like. Had nightmares every night for a year that they'd come and take DD1 away... still live in fear of learning-to-walk bumps and bruises being misinterpreted in the light of the fact we're a family known to social services.

Ruined my life totally - I'm a shadow of the person I was once upon a time. (Oh and they left me with permanent SPD related issues cos they just ignored me totally - yanked my legs somewhere up around my neck and I'm in pain if I walk more than a few hundred meters for days on end afterwards)

Bluestocking Thu 15-Aug-13 18:55:38

I wish I'd had a C-section - DS was hoisted out with Keillands forceps and I ended up with a big hole between my vagina and my anus. If I were in your position, I'd ask for an ELCS.

PoppyAmex Thu 15-Aug-13 19:07:34

Miaow that's truly horrible; no one should h

PoppyAmex Thu 15-Aug-13 19:08:01

Should have to go through something like that.

RevoltingPeasant Thu 15-Aug-13 22:13:37

I must say that based on what I know about Kiellands or high forceps I don't think the whole HCPs know best line works.

Those forceps are banned in quite q few countries so it's obviously possible to not use them. They are banned due to the high rate of damage they cause.

There was a mini scandal after a dr at our local hosp used these on a woman and left her with very serious long term damage and her baby with permanent brain injuries. I'd be pushing for an eMCs if I got to that stage.

These are the one thing about giving birth that really scares me...

vez123 Mon 19-Aug-13 21:16:45

My friend had an ELCS. Her baby was in an awkward position and the doctors had to deliver him via forceps. So even during a Caesarian there is a chance of forceps!
I had a forceps delivery with my first and quite frankly if the heart rate of your baby is going down visibly and your baby is already very low in the birth canal I guess you would think twice about refusing forceps.

I had an EMCS after failure to progress in 2nd stage (after over 2 hours of pointless pushing and a 20 hour 1st stage). DD was back to back, halfway down birth canal and needed turning. Consultant suggested one attempt with forceps and then EMCS if that didn't work. I didn't fancy being damaged every where ( and jst wanted the whole thing over) so asked if we could skip the forceps and go straight to EMCS. They did.

Actually, I think my request to the consultant that she just take the baby out then kill me, as I couldn't take the pain any longer, may have informed the decision as well!

Steffnexis9 Tue 20-Aug-13 12:55:51

I have delat with a couple of babies damaged or even who have died after high forceps removal as doctors arent necessarily skilled enough to use them properly... I would do what i could to avoid a forceps and it is in my birth plan that forceps be the last thing concidered nless my bby is going to be hurt more by not using them... I would rther. Second c section if possible. Obviously it isnt necessrily possible

DolomitesDonkey Tue 20-Aug-13 13:05:53

As vez123 says, I've had an ELCS with ventouse delivery! That means, planned section and they still use ventouse to get the baby out through the section hole. If they'd gone for forceps I'd have been none the wiser behind the curtain of surprise. It's not always as clear-cut as "I won't have this/that".

BraveLilBear Wed 21-Aug-13 11:08:44

I always said I would refuse forceps but when I woubd up in theatre for a trial of ventouse/forceps then emcs I was relieved to have avoided csec.

My notes say mid cavity in some places and low cavity in others- but I'm pretty sure high forceps are banned/no longer used in this trust so it would have been a csec anyway if DS had been higher up.

Your mind goes to a different place in the moment.

PeriodMath Tue 27-Aug-13 05:57:25

Important you know there are different kinds of forceps. Kiellands are the high ones. Wrigleys are the low ones - very safe, for babies who are well down, waiting to pop out. Only a small amount of traction is needed.

DS was born this way with not a mark on him. My recovery was fine. So glad I didn't need a c-section. Don't underestimate major abdominal surgery.

PastaBeeandCheese Tue 27-Aug-13 06:26:02

periodmath is right on the money IMO. I marked my birth plan no high / rotational forceps and was told there was no real need as they are not used in my trust. Check this out with your midwife.

My DD had nasty merconion stained waters and they ended up hoiking her out with wrigleys forceps as her heart rate dropped so low and vontouse failed. 'twas fine. They hardly went in at all.... They just wanted to give DD to the paediatrician as soon as possible.

If I'd gone for a section at that point DD would have had to be pushed back up and given I hadn't had an epidural time wouldn't have been on my side.

I didn't even have to go to theatre. The Dr delivered her in the original room.

That said my friend's baby died of merconion aspiration at 2 days old the year before DD was born so I would have probably cut her out myself with a rusty spoon I was so scared she wasn't going to be ok.

I'm pregnant with #2 now and will out same thing in my plan but the midwife mentioned chances of an assisted birth are under 1% second time round so fingers crossed for us both.

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