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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>

Gardentreehouse Tue 26-Mar-13 17:47:54

Of course, you can refuse anything

PeoniesPlease Tue 26-Mar-13 17:58:48

Yes, you have an absolute right to decline any treatment offered to you.

However, I suppose there may be circumstances where it would be more detrimental to your health/your baby's health to go for CS rather than forceps - if the baby is low in your pelvis for example, it may well be more damaging to have to pull it up again for CS.

But even if this was the case, you would still be able to decline - you just might decide differently in those sorts of circumstances iyswim?

Pendulum Tue 26-Mar-13 18:05:10

Yes, I did exactly that. Was taken to theatre for trial of forceps. Before she did anything the registrar said the the nurse, this will be a very high forceps. She looked v apprehensive. I said very loudly, I withdraw consent for forceps and she did a cs instead.

PeoniesPlease Tue 26-Mar-13 18:07:21

Btw, I am not a midwife/doctor, so this was just my musings!

I am totally with you on fear of forceps/episiotomy - just trying to think through what might be factored in when discussing forceps at hospital.

JakeBullet Tue 26-Mar-13 18:08:00

Yes it is utterly your choice and your consent. I am an ex midwife, when I was expecting DS I wrote in capital letters on my notes "I will not consent to a forceps delivery".

In the end it wasn't needed as DS decided to be breech so I had a straightforward caesarean section instead.

birdsnotbees Tue 26-Mar-13 18:12:27

Yes it is though like someone said up stream there may be circumstances where it is better for the baby. Best thing is to get as informed as possible, make sure your partner is equally informed & able to speak on your behalf, be willing to fight your corner but also flexible enough to consent if it is entirely necessary.

badguider Tue 26-Mar-13 18:14:53

It depends on how far the baby is down the birth canal, if it's too far down then a cs is not an option really. I don't know what they/you could do if you refuse forceps (venouse only i guess?)

PastaBeeandCheese Tue 26-Mar-13 18:16:36

I think there are also circumstances where it would be better for you. If the baby has descended into the birth canal it would need to be moved back up to be born by CS which sounded more horrendous than forceps to me.....

I put that I would not consent to high or rotational forceps on my birth plan. The midwife said that was fine and they weren't really used at the hospital where I gave birth anyway.

FrillyMilly Tue 26-Mar-13 18:18:34

I was going to refuse forceps but it wasn't required in the end. Dd was head down but head to the side, facing my hip. If she hasn't moved during labour it would have needed keillands forceps which I would not have allowed.

BackforGood Tue 26-Mar-13 18:20:42

When I needed them, I was only glad that I was in the right place (a hospital in the Western World) with trained medical staff who knew what they were doing. If you need them, I can't imagine any circumstance where you would then choose to refuse them if it gives a chance of your baby getting out alive and well, now. Of course it's not a particularly nice thought but the circumstances where they are telling you that's what's needed, then there just isn't any question, IME

PeoniesPlease Tue 26-Mar-13 18:23:49

BackforGood, but she doesn't have to have them, even if the baby is in danger - she still has an absolute right to decline.

munchkinmaster Tue 26-Mar-13 18:24:09

If the baby is low in birth canal and needs dragging back up for a c section there is a high risk of anoxic injury and damage to the baby as others have said above. I had failed forceps and then a c section. Baby managed to ping herself back up but a scary moment for all when we realised had to go for a cs. I think it's so hard as you can put a strong view across then things just happen during birth.

SatsukiKusukabe Tue 26-Mar-13 18:30:39

I do not give consent first ventouse or forcepts delivery, if the baby cannot be delivered naturally I will need a cesarean. that's what my plan said,

BackforGood Tue 26-Mar-13 18:31:02

I think that's the key point though if the baby is in danger - why wouldn't you do whatever you could to ensure a safe delivery ? confused

PeoniesPlease Tue 26-Mar-13 18:34:08

I don't think you need to understand why someone would make a decision in order to support their right to make it. I'm sure most people would accept a forceps delivery if that was their only option to save the life of the baby, but that doesn't mean that they are under any obligation to do so.

propertyNIGHTmareBEFOREXMAS Tue 26-Mar-13 18:38:55

Yes it is, I wrote 'no consent to forceps' on all my birthplans. I would have gone to CS if absolutely necessary. Ended up with 4 very easy births though so it was all unnecessary.

Zoomania Tue 26-Mar-13 18:44:19

You can refuse anything but you may need to accept this may harm the baby. What if baby was low down and suddenly dropped his heart rate/ became distressed. If they could pull him out in a few minutes would to take the risk of waiting 10 mins to be prepared for theatre and a c section, with the risk of further damage as he was pushed up the birth canal?

JollyYellowGiant Tue 26-Mar-13 18:54:52

Yes, I think it is.

However, if my spinal block had failed then forceps would have been the only option as I could not have had a general anaesthetic.

Thankfully the spinal worked and the forceps worked.

Although you can refuse them, if there are really dire circumstances (I had a punctured lung) then not many people will be looking at your birth plan - they will just trying to get you and baby through the process alive.

RevoltingPeasant Tue 26-Mar-13 19:06:33

Jake did you really? That is v interesting! May I ask what moved you to do that?

BackFG the backstory is, our local hospital had a bit of fuck up recently where a woman was advised to go for a high forceps delivery. Will spare you gory details but she is now doubly incontinent and baby brain damaged. Hence, I'm not sure I'd listen to a dr there saying you need forceps!

Of course if it really was the only only option, whatever. But I might put 'no Keillands/ high forceps' as an insurance policy.

RevoltingPeasant Tue 26-Mar-13 19:08:14

Also very reassuring to hear how many women apparently do this. Am glad I am not the only lunatic alone.

Jemimapuddleduk Tue 26-Mar-13 19:10:32

I requested no high forceps (keillands) on birth plan. To be honest if I had got to that stage I would prob have changed my mind as I was so desperate to meet baby and get her out. As it was I ended up with c sec as she wasn't descending.
Good luck

SergeantSnarky Tue 26-Mar-13 19:11:50

Would personally not consent to forceps unless it was a last resort/life or death but would and have consented to ventouse with no consequences for my DC, not even a conehead: episiotomy once, not ideal but wanted DC out and safe and daresay me being cut was unpleasant but the healing certainly no worse and probably a hell of a lot easier than cs abdominal surgery (and frankly my pain tolerance is zilch)

RevoltingPeasant Tue 26-Mar-13 19:15:42

Sarge may I ask, did you write that in your birth plan or just keep it stored in your head in case?

I am a bit jittery about this as my local hosp seems v high intervention: the two women I know personally who have given birth there have had 3 sections between them, and then this woman with the poor damaged baby is the only other one I know about (on the grapevine). Obviously not a statistically significant sample, but they seem very gung ho!

Toptack Tue 26-Mar-13 19:16:30

Just noticed that you mentioned a fear of having an episiotomy as well - I was on the brink of needing forceps when the midwife gave me an episiotomy, baby slithered out in 3 pushes (after 24 hours of labour) and everything healed up nicely with very little discomfort and no lasting damage. So for me, the episiotomy helped me avoid any further intervention and was well worth it.

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