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?

Sometimes the baby IS in an okay position to a c-section but they use high rotational forceps to deliver it (or attempt to deliver it before resorting to CS). That’s why so many women are taken to theatre, prepped for a section before having forceps used.

These are also the type of forceps that are riskier to the baby and to the mothers body.

I wasn’t given a choice in the matter and the risks were never explained to me during pregnancy. Even looking for the information yourself is difficult on websites like the NHS that avoid explaining different types of forceps and scenarios where a c-section is an alternative choice.

So many women are just told ‘we are taking you to theatre to have forceps’, they don’t understand the risks of the procedure or that a c-section is an alternative with a different set of risks. Some women would still wish to proceed with forceps first but you would definitely get many women who would decline and opt to have a CS.

The cesarean rate is lower in Denmark than the UK

As a midwife, it's worth noting that if the head is so low its visible and advancing albeit slowly, doing a CS at that stage comes with huge risks not least to the baby because you'd need to push the baby back up and that's dangerous in and of itself.

Lumping all instrumental births together isn't helpful, there's a big difference between a ventouse and a high or rotational forceps (which are thankfully not done as often as they perhaps used to be because of their risks).

And as others have mentioned, if baby shows signs of distress and is low enough that you can expedite birth instrumentally, this is much quicker and safer for the baby than a CS (bearing in mind this also depends on level of analgesia and what the concern about the baby is).

I think we need to discuss alternatives to forceps given the widespread problems associated with their use. Better medical care for a start - how many women are ignored/belittled while in labour? I'm quite shocked that given the advances in almost every other aspect of healthcare, there isn't more effort to find better and safer ways of assisting delivery than a rather brutal instrument that has been in use unchanged for hundreds of years.

My DS got stuck labour was too far along for a c section without a ventouse he would've likely died and I would've suffered serious injury. I had to sign the paperwork for a c section in case instrumental delivery didn't work but I was told it would be major complex surgery and very risky for us both at that stage, a very very last resort. We're both fine. YABU.

I suffered awful internal damage from forceps, but both me and DS did survive. His poor head was properly mashed too and I'll never know if his traumatic birth was partly to blame for his SPLDs and autism.

Clearly, they are a tool of fairly last resort. In our case the ventouse had failed and it was all really horrible emergency stuff and they were unable to force his head back up to do a c-section. It was so traumatic I was diagnosed with PTSD 7 months later.

I'm all for advocating better ante-natal and maternal care but wish the DM would be less alarmist. Presumably there are thousands of women about to give birth reading this stuff and feeling very anxious now.

@keepforgettingmyusername I agree with you about pushing for vaginal deliveries. I was told that my induction at 38 weeks (type 1 diabetic) was '60 to 70% likely to end up in an emergency c section' but it would be 'better to go through the process first as you may be successful.' As this meant I would be hooked up and messed about with (they reckoned they'd be able to break my waters by day 3) and probably knackered, but they insisted 'natural is better.' I pointed out that the only natural thing was the exit orifice and thankfully, after a lot of negotiation, got the planned section which was a lovely and calm experience

Actually the OP is not totally off the mark necessarily. The question is (as is a debate with some c-sections) was the foreceps necessary and could they have been avoided with better management of the labour? We all know that with human judgement there can be over cautious (good reason) and lack of thought or time or resource (bad reason) that ultimately results in an needing foreceps. In my case all was going fine, but slowly, and the registrar was doing their rounds with an entourage and made a big decision that I needed to push now, completely overriding my midwife (who had been there all night compared to the registrar who had been there 5 mins). I was forced to push immediately, with my midwife in the background asking numerous times for the registrar to reconsider as she didn’t feel it was necessary or right, directly after my epidural had been topped up so I could feel nothing. Soon they were using ventouse and foreceps, dragging me down the bed by the vagina and I remember clearly the rage pouring off my midwife.

Afterwards she was visibly upset, apologised for how things went and sorted a private room for me in a hospital known to never give a private room.

I 100% believe we might have avoided the foreceps if the registrar hadn’t been on his bloody rounds, showboating to his student doctors. I should never have been put in the position to push directly after my epidural top up which my midwife had just given me with the exact plan for it to wear off in time for me to push an hour later. It was what we agreed together. The registrar treated me like meat and ignored my questions and pushed me into a situation where I would never have been able to push my baby out.

Any professionals around who can explain why a vebtouse can’t be used instead?

Oh and they also gave me MRSA in my vaginal wounds. And left me permenantly damaged with those forceps. So I wish the dr had given my Midwife’s opinion a little more weight.

Gregory, the ventouse is not as strong so it can fail. If it fails twice, they shouldn’t do it again as it sucks hard on the delicate baby head and they start to risk properly damaging the baby. So the forceps come out next.

The last thing I remember the doctor saying was "too late for a section, get him out" if they hadn't used forceps and the ventouse (sp) both my son and I would be dead.. I don't really need to say anymore

IMO, forceps are used firstly because the birth has been poorly managed, leaving it too late for a c/section. Secondly, the drive to reduce the number of sections takes precedence over any damage a woman may endure. It’s doesn’t matter about the long term physical or mental health of a woman, as long as the baby is ok. Right?

I'm not a medical profession GregoryPeckingDuck but the ventouse failed for me and DS. It just wasn't strong enough to pull DS's very stuck head out. As it was, he was not just mashed from the forceps but a cone head too.

I think they have recently taken the emphasis off maternity units c-section rates. Both units I gave birth in had the stats displayed on posters as you walked in, compared with the national average.

So my high rotational forceps delivery that left me with incontience in my 20s, pain and discomfort during sex, during my period, during work when I’m on my feet all day and basically ruined, butchered, prolapsed nether regions would have contributed to a ‘good’ statistic. An emphasis on those stats would also mean women making informed choices in their labour about having a c-section, or women opting for maternal request CS and having her choice supported would negatively affect the statistics. So I think it’s a good thin not to focus solely on that. It is so much more complex than ‘VB good, CS bad’.

slightly of topic but in poorer countries women don't always have any medical help and can /do die as a result as do babies. it's a bad situation for first world countries but as others have said some times needed as last resort, and potentially life saving.

*off topic

I don’t think the DM is a useful starting point for this discussion but, yes, having had a delivery that was about to become instrumental and then post-birth reading up about this, I am concerned about the continued use of Kiellands (sp?)/ high forceps in UK deliveries.

I had a forceps delivery with one DC and whilst the damage I now have is something I'd prefer not to, I'm glad everything was done to keep my baby safe.

I'd really like to know more about how they manage childbirth in Denmark. Apparently there hasn't been an instrumental delivery in 14 years and section rates are also lower.

I'm sure they serve a purpose and many PPs have said, but personally an instrumental delivery is my worst nightmare.

I've had an emergency CS and a planned CS. I would never risk trying for a vaginal birth due to a previous horror labour and being absolutely terrified of me or the baby being injured by forceps or otherwise getting into difficulty.

I do sometimes wonder whether if men were the ones giving birth, that regularly butchering their genitals with scalpels and medieval looking equipment that can cause lifelong damage would still be the done thing.

@PanamaPattie I completely agree with you there. Doesn’t matter that my midwife was a cunt who refused to give me pain relief other than gas and air, doesn’t matter that she forced me to lie on the bed constantly, doesn’t matter that repeatedly ignored me begging for a Doctor as something didn’t feel right, doesn’t matter that I endured rotational forceps without an epidural whilst being pinned to the bed with the midwife screaming at me “to stop moving” (sorry hun I’m being dragged off the bed by the force the Doctor is using), doesn’t matter that I had 47 stitches, that they had to go back in and restitch me, doesn’t matter that I was anally incontinent for a year, doesn’t matter that I was so traumatised by the birth that I have PTSD, doesn’t matter that my DS is fucking BLIND in one eye due to the forceps, doesnt matter that the room was a blood bath, doesn’t matter that my mother needed therapy after witnessing it all, doesn’t matter that the midwife forced me to push for FOUR HOURS before getting help, doesn’t matter that subsequently the midwife was sacked, or that the student midwife I had was also traumatised by it, or that the Doctor said if the midwife had done her fucking job and listened to me, then he would have been able to do an emergency but calm c-section 5 hours prior to the forceps.

Doesn’t matter that. None of it does.

Because he’s alive so it’s okay, right?

Tinkly, if that’s true then it definitely merits some serious consideration.

But the reality is that people, including many women unfortunately, can’t or won’t hear that things have been done wrong or could have been done better when it’s womens health and well being we are talking about.

*Because DS was back to back and brow presentation. He’s lucky his neck wasn’t snapped with the force of me pushing for 4 hours. He’s lucky the Doctor was able to move his head properly without snapping his neck. He was barely into the birth canal so a c sec would have been far easier than forceps, but the midwife absolutely failed in her job that day. We were 2 minutes away from a crash c section in which my mother was warned that we/one of us would probably die.

If they continue to be used there ought to be a shit load more guidance etc.