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 was delivered with forceps.

I was on Jamaican People Time thanks to my dads genes and was chilling out in no hurry to come out apparently. So in the end they had to help pull me out with forceps

If a baby is in trouble, a C section would be too late. That baby has to come out one way or another.

I haven't got to end of the thread yet but I also had krill and forceps at st Thomas's - do they have some sort of policy?

I continually best myself up about not putting my foot down and refusing their trial of forceps. I specifically asked about rotational and was told they would rotate her head manually then use forceps - only saw on my discharge notes that keillands were used. By the time they brought the forms I'd been in labour for 48 hours, induced with pessary, the next thing (I forget what it was) and drip. Water broke naturally and the it kicked off with me projectile vomiting everywhere. Hadn't been allowed to eat due to GD and possibility of C section. I was in no state to argue really.

I was induced for GD and had gone in for reduced movements that morning to be told she'd turned back to back and for a VERY long time during labour midwives/dr's were aware that she was back to back with face turned. I had to lie on the bed for monitoring despite only wanting to stand due to back labour. I believe a CS should have been performed at a much earlier stage. Reading the daily mail article brought tears to my eyes. I had a bad 3C tear very slight anal leakage sometimes. My DD had cuts and bruises on her face and a black eye.

I am so sad to hear of all the suffering and misery that PPs are going through.

Of course if the choice was between lifelong damage/incontinence or a baby that didn't survive everyone would suffer that for their babies. The point is those shouldn't be the only options!

Surely we deserve good care that avoids this kind of shit and equally good aftercare when said shit cannot be avoided. We deserve lives without incontinence, pain, discomfort, humiliation or the inability to have/enjoy sex.

VBs are seen as cheaper than CSs because they are when no fucks are given about fixing the physical and mental damage caused by injuries from VBs.

I feel as if I have got off lightly with an EMCS plus PTSD followed by an ELCS. to everyone who has had a horrible experience.

Battenburg1978 very similar to my experience at St Thomas’. for all on here with ongoing issues.

Just wanted to add to those saying that once the baby is passed a certain point a section is not possible that I had an emergency section after failed instrumental delivery. Both ventouse and forceps failed.

Assisted delivery was necessary and life saving. I had initial complications but with good aftercare, including women’s physiotherapy, no lasting impact. YABU for being influenced by the daily mail!! There can be complications with any birth and all options should be available when it comes to managing these.

Yes when I had my emergency forceps delivery, I was taken to theatre first and prepared for a c-section. ‘We will try forceps first and if that fails we will do a caesarean’

So clearly it wasn’t too late to do a c-section. Also they were willing to add time to having baby delivered by ‘trying’ with forceps first. Obviously a trial of forceps followed by a c-section would take longer than just doing the c-section to begin with.

I also beat myself up on a regular basis for not declining the trial of forceps. Unfortunately it was not presented as a choice and I had literally no idea about this type of scenario, about different forceps, about my rights during birth and so on. I wish I’d also raised a complaint and spoken to somebody about this. I was too traumatised at the time and years have gone by now.

I also remember going to see a friend with her new baby. She’d had an EMCS but was showing me marks on her sons head from where they had tried and failed with forceps first.

I was a forceps delivery. I was overdue and stuck (shoulder torsion). I was in distress but too far down for EMCS. My mum was losing a lot of blood. Forceps saved her life, and by some miracle mine.

They're the smash in case of emergency option.

For all of you who say instrumental delivery was life-saving or saved the baby, how did you know this? Were you told this by the medical people managing your labour? Did you ever consider the broader question of how your labour was managed? Whether there could have been other, better, options for you in which the baby was fine and you were also fine?

If someone botches an operation and a leg has to be amputated in an emergency situation, then that amputation is "life-saving" but not good medical practice.

High forceps delivery probably "saved" my baby. but only because no one was willing to do a c-section earlier. It also resulted in me nearly dying and other very serious consequences for me and my baby (breastfeeding was a nightmare because I was trying to stay alive in his first 12 hours)

I think we have to see all those "save the baby" in context. And view them against the horrific stories of incontinence as described so movingly by WhereDoWeGo upthread.

It's not a stupid question despite the tone of some responses. We can split the atom, and send people to the moon so why are the tools used during childbirth still causing catastrophic damage? Could it be because they haven't figured out how to make men give birth yet??!!!...

DD1 was a mid-cavity forceps delivery, she was back to back and OP and I was just too exhausted not to click when the midwife said it was 'lucky' because it was a very senior consultant on during the day. Some years later, a woman at the same hospital who'd been induced of an IVF baby was struggling and because it was all so underfunded, got someone, not in any way senior using Keillands rather than a CS as there were no senior consultants available to deliver. Both she and her husband had been begging for CS. Her baby died a couple of days later and she was too ill to even been there having sustained major trauma from the delivery and still in ICU. No lessons learned apparently because last year at that same hospital, a woman who'd been delivered early due to pre-eclampsia was transferred there from another regional hospital and was allowed to go on her own to see her son in NICU. It was 7 hours before they twigged she was missing. She was found dead in an used part of the hospital from a brain haemorrhage. No one was looking after this patient despite her having been admitted due to a serious and potentially lethal (in her case, probably lethal) condition.

Because you can't do a C sec that late on in delivery?

The thing is as PPs have said you clearly can do a CS that late (I'm talking about high forceps here). In fact the forms I signed were for trial of forceps followed by CS and was taken to theatre and prepped with spinal for both outcomes. In fact from early on they suspected a CS could have been needed as I was not allowed to eat (I'm talking at least 12 hours before she was actually delivered). So ny medics/midwives clearly believed it could end up in theatre. It's not beyond the wit of man for someone to have said- hey actually his isn't going well, we know baby is in a bad position and not likely to be born without instruments/CS. Do you want to go straight to CS, instead of leaving it until the very last minute (pushing hard for 2 hours to no avail- she was stuck) and using so much force that my body was pulled down the bed and causing a large PPH. I strongly believe that in another jurisdiction my delivery would have been a CS much much earlier.

You can do a CS that late but just because you can doesn't mean it's the best option.

The risk of haemorrhage is high. There have also been cases of babies dying at this point when been pushed back up the birth canal as they're so low down, dying from tentorial tears from the trauma of being pushed up.

@pallisers because by the time anyone knew there would be a problem with DS's delivery he was too far down for CS to be a sensible option. He'd have needed to be pushed back up. As it was he was so stuck that the first time they tried to pull him out I actually moved on the table. I have no doubt at all forceps saves his life.

I have seen deliveries by forceps and C/S on numerous occasions as a midwife.
I believe there are many people on this post and in general who really underestimate a ceasrean section. It is not an easy alternagive to a vaginal delivery or instrumental. It is MAJOR ABDOMINAL SURGERY! Often made worse by the fact it’s done in an emergency, so a little more rushed.
I’m now in a job role (Health visiting team) where I do home visits and see mums for weeks and months following deliveries. And I can assure you the ones I see any ongoing birth complications with are usually C/S; not instruments.

Now that’s not to say that they don’t cause problems. And I can further assure you I have seen some- what I would describe as - brutal instrumental deliveries; where as the midwife I have shouted stop in the room and demanded we go to theatre.

Instruments and they’re use are very much down to the practitioner and their judgement and experience. Of knowing when the right time is to use them. And knowing when they’re failing, with a potential to cause damage.

They still very much have a place in our delivery rooms in 2019, until an alternagive and better option is available.

The same way we measure your bump when we see you in clinic, which is completely outdated and inaccurate. But it’s the best tool we have at the current time.

My last delivery was a Keillands forceps and it saved the life of my baby who had been in distress for over an hour (unknown to us) and had to be delivered immediately. I've issues from her delivery but I have never once regretted her delivery or how she was born. I am only grateful that we have her alive with us

I gave birth to twins. I was in labour for 8 and half hours. Thenpushing for two. The doctor was called and hit the roof. He felt they should have called him much sooner. I ended up with dd 1 being pulled out with forceps and dd2 was breech. He turned her by inserting his hand inside me and turning her. Then putting forceps inside and pulling her out. I almost died in the process. My blood pressure was sky high and I lost a lot of blood had to go to intensive care (maternity). Additionally, they left part of the afterbirth inside me. The sizef of a whole placenta. I now have continence issues, bladder issues. Nerve damage
What happened was barbaric. This was 1983. These days I would have had a C-section and wish that I had.

It's all very well saying its necessary to save the baby. But why is my ds' life worth more than mine. Because I can tell you that being anally incontinent, prolapse, no sex life, no ability to ever have a romantic relationship again, not being able to work- this isn't much of a life. You might be physically alive, but what about quality of life.

And given so many women don't talk about the damage it is likely a bigger issue than we realise.

I’m now in a job role (Health visiting team) where I do home visits and see mums for weeks and months following deliveries. And I can assure you the ones I see any ongoing birth complications with are usually C/S; not instruments.

Then either your experiences are unrepresentative or there are a lot of complications not mentioned to you, because there are some complications that we absolutely know are more common in VB than CS. Prolapse, for example. Of course, prolapse may well happen many years later, so it's not a great surprise that a HV wouldn't see the extent of it.

Oh and lest you should think I'm underestimating the significance of a section, I've had both an EMCS and an instrumental delivery. People saying MAJOR SURGERY!!!! wrt sections is not particularly helpful. Clearly when you're approaching or get to the stage that either forceps or EMCS is being considered, there aren't any easy options. Only major things are left.

Surely if it were "banned" like OP said, they'd have to go to c section earlier to avoid potential complications? So would increase c sections not just for people who would have an instrumental but for anyone who may look like they might have an instrumental?

I don't necessarily think that's a bad thing, just something to bare in mind.

I’m now in a job role (Health visiting team) where I do home visits and see mums for weeks and months following deliveries. And I can assure you the ones I see any ongoing birth complications with are usually C/S; not instruments.*

Are you sure that's not a) because it's easier for women to talk about the caesarians b) because sometimes damage from vaginal delivery takes longer to materialise?

When I had my CS I was treated like a patient in hospital, brought my breakfast tray, asked how I was feeling, checked up on.

When I had my vaginal I was told I would jolly well have to get up and get my own breakfast (I nearly fainted), nobody was very interested in my wellbeing, and I kept having it drummed into me that this was a natural process and I'd be fine. The only one who did show an interest was my GP who told me I'd have to go into hospital to be restitched because otherwise my husband would leave me (he didn't).

Guess which one I thought I was meant to talk to the HV about.

mommaduck

My health visitor has no idea about my prolapse. I’m too mortified to say anything.

What kind of complications are we talking about from the CS? Is there anything as long lasting and distressing as anal incontinence as described by some of the women on this thread?