That instrumental delivery should be banned?

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I know it’s the DM but this is shocking:

www.dailymail.co.uk/health/article-6797199/As-doctors-midwives-finally-act-searing-expos-childbirths-shameful-secret.html

They say 10 percent of mums suffer from some sort of anal incontinence! Claims forceps are the biggest cause so why are they still used? AIBU to say they should be banned? Why couldn’t you just get a C-sec at that point?

I’ve had a section and a vbac. Section was fucking horrible and the recovery awful. The vbac was sore after of course, as I had to have quite a lot of stitches, but was certainly much easier to be a mum straight away and recovery was so much faster than a section. I had to have a bit of ventouse help with the vbac, but I’d opt for it over section EVERY time (other than the fact my section was a medical emergency).

@Jessie94 have you experienced anal incontinence? Because it's for life. Have you read the experiences of other women?

Recovery time? Well 10 years on and still haven't recovered. I will never fully recover.

Mental health? Do you think being a ally incontinent, having serious prolapse etc doesn't effect mental health. I had PND after my horrific instrumental delivery because of the damage and brutality.

Quite simply, women should be offered a planned CS before it gets to the point of instrumental delivery.

The obsession with 'trying for' a vaginal birth despite it being far more distressing and painful and in my opinion, dangerous is clearly down to one thing. Cost.

I had a planned CS due to breech baby and it was calm, pain free and no problems healing. Emergency and elective are Not the same beast. Instrumental births are horrific and women should be offered a CS way way in advance of it even being an option.

user1492346620

Im guessing Denmark haven't banned vaginal delivery despite banning forceps.

My guess is that you manage a birth better and intervene earlier.

Is that always possible though treacletoots? I think forceps should be used as rarely as possible but haven’t posters here said once it’s apparent they’re going to be needed it’s too late to safely do a section?

They're rarely used in America because the c section rate is so high there. Vaginal birth isn't as supported.
Again, Denmark Doesnt often use them because of the total opppsite reason - they have a very high rate of hike births. Its usual for a woman to give birth in hospital there.

Denmark haven't banned them though. The BMJ state that around 4.9 births in Denmark are instrumental

@grubbyhipsterbeard obviously I'm not a medical professional... And can only speak from my experience but it feels like under staffed, over worked midwives adding to a culture of treating women like idiots who have no say in their care surely must contribute to the instrumental delivery.

Better management of labour from the beginning and listening to the woman is a key factor that is being poorly carried out

Your post wasn't very clearly expressed Jessie. Are you trying to claim that having a section places a woman at higher risk of MH issues than anal incontinence does? Or than a VB does? Either way, those are the sorts of claims that require evidence.

Looking at this as pure VB v section is also a flawed approach, because when a woman is in or progressing towards a situation where forceps might be required, she's not going to get the sort of straightforward birth where the recovery is shorter and the risk of mental health problems thereafter is lower than it would be with a CS. When the choice is between a complex VB (that might end up being an EMCS anyway, plenty of failed forceps births do) or a CS, sweeping comments about CS being a more risky approach are inaccurate.

I'd also be interested to hear you answer the questions about whether you have read the posts from women who suffer anal incontinence.

If I hadn't had an instrumental (forceps) delivery with my first there's a very high chance he wouldn't have made it and I might not have done either.
So no I don't think they should be banned and based on one article you shouldn't either.

I confess to not reading the linked article in OP. I'm fascinated to hear some counties don't use forceps. It's seems odd that so many women on this thread say if they didn't have a instrumental birth they and their baby would be dead, yet these counties that don't use them.

I do not have a good memory of them. I had a long labour on my last, pushing for an hour before I was taken to surgery for assisted birth. The ventouse failed (wasn't particularly painful) and then high forceps which was horrific: one nurse had her arms under my armpits pulling me up the bed as the doctor braced herself with her foot on the bed and pulled the other way. Outstandingly painful, haven't forgotten almost 13 years later. I was them prepped for a general anaesthetic as they pushed the baby back up.

He was quite bruised and cut on his head and eyes and spent 3 days in ICU. For me the psychological damage was worse than physical (does that make me lucky?!!).

My original midwife refered me to a psychologist who to me 'least I had a healthy baby'. The twat. Not exactly helpful.

I've actually never spoken about the detail before!!

I think women should be more aware of the risks of vaginal delivery. I ended up with a 4th degree tear following dc1 birth. Long, lots of induction meds, I requested a c section as I had a instinct that's what I needed.

It's taken me years to recover emotionally, mentally and physically. My pelvic floor is destroyed. I have a triple prolapse.

M ELCS for dc2 was a dream.

I want to know are obstetrics learning from the damage they're causing. Can instruments or techniques be improved? What can we do to reduce damage to women?

Pisspawpatrol, I had a section because my baby was too big (99th centile head). The doctor said there was a risk of her getting stuck in the birth canal and what they would then have to do is basically push the baby back up to where it can be taken out by section. I guess it depends where the baby gets to before they get stuck - if they’re quite far down then forceps and cutting might work but if it’s further up then they push it back so it can be taken out by section.

Ellen my doctor also put her foot up on the delivery table .

I dont think they should be banned. Yes I know, we're both still alive, but the impacts are huge. And awful.

Ova im also a petite 5'2". Never once mentioned.

I confess to not reading the linked article in OP. I'm fascinated to hear some counties don't use forceps. It's seems odd that so many women on this thread say if they didn't have a instrumental birth they and their baby would be dead, yet these counties that don't use them.

Yeah, there seems to be a lot of unwillingness to engage with the possibility that the forceps could have been safely avoided by an earlier section. That won't be true in all cases, but it will be in some. I don't agree with the OPs proposal, but it's pretty clear that a lot of us whose babies were saved by instrumental deliveries would, if instrumentals were banned or had never been invented, have had earlier sections instead. And ended up with the same live babies we have now.

@Jessie94
That isn’t correct though. Instrumental deliveries are just as risky as c-sections.

Planned c-sections are arguably a lot less riskier than instrumental vaginal births.

Also regarding mental health, statistics show that mothers who have an elective CS have a much higher degree of birth satisfaction than mothers who have instrumental births.
Instrumental deliveries and emergency c-sections were the lowest and scored similarly.

Which is not very surprising, since an instrumental delivery and an EMCS both mean something has gone wrong.

The obsession with 'trying for' a vaginal birth despite it being far more distressing and painful and in my opinion, dangerous is clearly down to one thing. Cost.

But they are not comparing the true cost of a VB with a CS.

They don't factor in the cost of necessary repairs and treatments, they don't factor in treatment costs for MH issues that may arise due to how the birth went, and so on. Prolapses that occur later on are just not included in the overall cost of a VB, and it's wrong.

Ultimately, we should be managing births better. And this won't happen until women's health stops being something that can be dismissed as unimportant.

I also think assessing a woman’s risk factors (age, position of the baby and so on) and working out how likely a bad tear is or the need for an instrumental delivery and discussing this with her so she can choose an ELCS if she wants to. Too many times women end up badly damaged before learning they were at a significantly increased risk of this happening and had no idea.

This is such a distressing read. to those of you that have suffered such catastrophic injuries. I can't even imagine.
I've had three c-sections. One emergency, I went in with reduced movement, no contractions and they had ds out within a couple of hours. Without question and undoubtedly saving his life.

A combination of NCT brainwashing and various Midwifes I spent the next pregnancy feeling like I hadn't done it 'properly' and agonising over a planned section or trying a 'natural' birth. All discussion with all medical staff was about c section risk. No mention of enhanced risks of intervention, especially with a previous section and what was effectively my first labour. Looking objectively now a planned c section was a no brainier but I agonised over it for months, went for Vbac, laboured for four days and ended up with another section.

Third was a planned section. A good experience, less stress in the pregnancy. My best birth.

I've been lucky in my recovery. My stomach muscles are shot, I've got an unpleasant overhang but very lucky. I wouldn't risk any more children.

I wish as adult women we were treated like adults. I'm not sure in any other area or medicine is there such personal bias shown in treatment and such belittling of the person giving births ability to make an informed choice based on actual facts. It's a mess.

I would obviously choose a straightforward vaginal over a section but would take the known risk of a section over a high risk vaginal birth without question.

They don't include the cost of after care for instrumental VB because they often don't follow through. It took me 6 years to get someone to listen to me about my issues and agree to refer me to a surgeon.

There are many, many women who never seek help and suffer in silence.

What is appalling is that women in the UK aren't offered specialist physio after birth until they complain of issues many years later, by which time physio is much less likely to work.

I have total urinary incontinence and partial anal. I had "wonder surgery" for it 5 years ago in the form of vaginal mesh sling, which basically ripped me apart over the following years. 2 surgeries to fix that damage down, and at least one more planned, probably 2.

Decent post natal health care would have prevented all of this for me.

I can attest to the damage this does to mental health. Imagine having to wear nappies at 40 years old, constant severe nappy rash, the worry of smelling, no sex life and almost constant UTI's.

Personally, if my ds had not been delivered quickly by ventouse (Not as bad as forceps but still left damage) he would have either died or been brain damaged. He got stuck with the cord wrapped firmly around his neck. I don’t deny that some such deliveries may be unnecessary or could have been replaced by a c section but not all can. As with most things, it can be dangerous to generalize

For me forceps were necessary as I was at the pushing stage and was too exhausted to carry on. If I didn't have a last minute burst of energy they would've had to pull my little girl out as her heart rate was already slowing down.