Do women actually want a foceps delivery rather than a caesarean?

[Strix]

Yikes. I know I wouldn't. But, perhaps I'm in the minority. This article talks about how doctors should be better trained in forceps so they could use them more. And I just wonder why they have only asked doctors in this article and not mentioned whether this is what the women giving birth want.

I personally don't think it's a good idea to clamp some steel tongs on my baby and pull him/her by the head. And if the baby's head doesn't fit through my tunnel, how on earth are they going to get head and tongs through?

www.bbc.co.uk/news/health-11589284

'Diabetes: I wonder if this is because mothers with diabetes give birth by caesarean. So of course babies born by caesarean are more likely to have diabetes because they are more likely to have diabetic mothers.'

I am a tope one diabetic and dd had forceps delivery I wasn't even allowed an epidural, type one diabetes is not thought to be hereditary and my ob always pushed for vb. I didn't know that children born by cs were more likely to get it, it is an autoimmune disease though, very interedting

Forceps should be in museums IMO (and that of Michel Odent, interestingly. They are dangerous.

How forceps dramatically increase the risk of babies having a brain bleed which is potentially catastrophic

www.ncbi.nlm.nih.gov/pubmed/10580069

I had an EMCS and after what I hear about some assisted deliveries I think I got away lightly.

DD1 was born via forceps.

You do realise they are used in CS's as well?

I've had two instrumental deliveries.

I do not have pelvic floor issues or continence issues and my children were not affected.

I did get a fistula giving birth on all fours, no drugs to DD2, however, it was small and healed up itself.

DS was born using forceps as they had to get him out quick at that point. I nearly ended up with a CS and am so glad I didn't. I really didn't want major abdominal surgery and the forceps helped avoid that. I would go for forceps in those circumstances 1000 times over.

Duellingfanjo - epidural does increase the risk of instrumental birth.

Ingrid, the jury's out on that one. There is a correlation, but it is not at all certain if epidurals increase the risk of instrumental births, or if people with the kind of complex births that will end up with ventouse/forceps are more likely to be in pain and want/need an epidural. I think most doctors would prefer to use these instruments on people with an epidural

personally I would rather have any type of delivery instead of a CS.
Thats just my personal opinion which I admit is hugely skewed!

can i ask a question here? Is there a reason that ventouse is not being discussed here as an option?

The thing is forceps seem to be put into one catogory by most people but there are different types of forceps.

Most forceps deliveries are carried out when the baby would already be two low for a safe CS, as they would have to push the back up first causing more problems/taking longer. So in those cases a forceps delivery is much safer then a CS.

The other type of forceps used are keillands, which are longer and can be used to turn the baby before being pulled out. Often in these cases they could perfom a CS instead, they are known to be more dangerous and are being phased out in some hopitals as the consultant needs to be specialy train in order to use them safely. Most of the bad cases you hear about forceps deliveries seem to be when they have tried this approach rather then just opting for a CS. I think they are a bit like a vergainal breach birth in that they used to be safer as more staff where properly train, but as they have become less coman due to performing CS instead there are less staff who are trained to use them properly.

DD was born by forcepts but the docotor on duty should have tried to turn her first but didn't (don't know why) and she then got stuck at the shoulders as a results. Also resulting in a nasty tear for me.

I know that ventouse is tricky if the baby hasn't descended. I had ventouse (which normally shouldn't require an episiotomy) but my DD hadn't descended at all and they had to cut my almost along the whole length of my vagina and really haul me about to get the cup into her head, then turn her, and then get her out. I have poured my heart out many times on MN about the damage they caused to me. :(

I had a debrief of that delivery with the senior MW of a different hospital (while pregnant with DD2). The notes are quite clear that they knew that DD1 hadn't descended and therefore they must have known that the chances of ventouse working were low, but the risks of damage were high. And I was very clear that I wanted a CS rather than instrumental as long as it didn't endanger DD1. Mysogynist bastard OB went ahead anyway, and came close to destroying my marriage.

There seems to be an awful lot of info about the immediate costs of C section versus instrumental, and C section is obviously more expensive. But there doesn't seem to be much on the lifetime costs of dealing with the damage that instrumental can cause.

I had ventouse with DS, my third. He had descended but had cord wrapped round his neck.

From my understanding of the research, and what was in this article, a CS delivery does carry more risks then a forceps one in the balance of things. Which is why I didn't want a CS (I would have rather not had forceps and had breathed dd out with only incense and whale music....BUT!)

Yes, it was painful (no epidural....), but she was fine, and I was in the gym 3 weeks later. (although it took 2 1/2 months for pelvic floor not to feel like it wasn't going to fall out...)

I think they both have a place, but I am not sure that saying you don't want one because you don't like the idea/it is scary, when the medical evidence appears to contradict this is the most sensible approach. The Daily Mail loves to occasionally run appalling stories of children damamged, and yes - there are risks - but there are also appalling stories of mothers and children damaged or died as a result of CS.

The balance of pros/cons of forceps vs c-section deppends to some extent on whether the pregnancy is the mother's last or not. If it's her first and she wants a big family a c-section will carry a much greater risk for future fertility/pregnancies/births.

Apparently some women want to avoid a c-section so they dont have a scar, visable to future lovers, which will reveal that they have had a child.

Personally I'd choose a 'good' c-section over forceps but sometimes labour has progressed so far, unless you perform the risky procedure of pushing the baby back up, forceps are necessary.

I had a forceps delivery with a big posterior baby.

Yes, healing took some time. No, my pelvic floor has not been quite the same since.

Would I have preferred a c/s? NO WAY! My second birth was a home birth and one of the best experiences of my life. I don't think it would have happened had I been a VBAC, given that I also had gestational diabetes. I also felt a huge sense of triumph after my first birth - that I managed to get my baby out in such difficult circumstances. Was very pleased with myself.

I wish I'd had a c section rather than a forceps delivery for DS. I'd been led to believe it would be safer. Only afterwards, when reading up a bit more (I'd foolishly before thought it'd all be nice and natural), did I realise that although it was easier for my body to recover from a forceps delivery, the risks for DS were much higher.

There is no way I'll have a forceps delivery again.

Interesting quote:

' In recent years the Cesarean Section (CS) rate has risen....This may reflect a perception of the practitioner that caesarean section has less morbidity. However this has not been supported by evidence. Unfortunately, caesarean delivery as an alternative to instrumental delivery for fetal distress or dystocia in the second stage is not without serious complications either. Emergency caesarean section at full dilatation has very different implications from elective caesarean section in terms of morbidity and complication risks to the mother and the baby....The use of instrumental delivery is often a better alternative than emergency caesarean section when spontaneous vaginal delivery fails to progress in the second stage. The risk of severe obstetric morbidity quadruples with emergency CS as compared to vaginal delivery.'

From this article by two obstetricians.

I had Keillands forceps delivery for an OP baby. Not a mark on her, came out with one push in theatre, episiotomy site has never given me a second's bother. Had fab pain relief and wasn't remotely fussed by the whole thing. Staff were BRILLIANT.

I think that is probably the case for the majority of women and I admit to feeling a bit that people can be scared out of considering forceps as an option. Sometimes they're the only option.

In the US, hospitals with a higher CS rate saw a fall in major birth injuries to babies.

Interesting CCF - seems directly at odds with the research findings of that paper. Their statements are all refernced (I have to admit to not reading the referenced material though.)

I think there is a bit of sheer terror/sqeamishness attached to forceps because they look so medieval. The idea of being opened up and then the baby pulled from my tummy (sometimes via forceps again!) sounds pretty scary to me as well - and frankly worse! But I honestly think that for some people it is the fear factor rather than the science factor that influences their wishes.

That said, if they are so terrified of forceps, then they are probably not going to be releasing all the hormones that help with a vaginal delivery, so perhaps they are better off being able to rule them out.

"In the US, hospitals with a higher CS rate saw a fall in major birth injuries to babies"

But then the maternal mortality and morbidity statistics in the US are a bit of a disaster, especially considering the spend per head. I suppose that's one of the fall-outs from having such a high c/s rate. Probably high rate of birth injuries with babies born vaginally because of high induction/augmentation rates and supine births as well.

I wish I had had a CS instead of the induction and forceps I had. However I don't think DD was in the right place when they decided to use forceps to have been able to do a CS. I also doubt that the 3 nights of being induced in hospital were any cheaper than an ELCS. I don't think that the studies take into account the long term health effects on the mother of forceps and obstetricians don't see the aftermath - the just stitch you up and think that everything is ok. It it the same with midwives. The number who have said to me - lots of people who have had infected, open episiotomies following forceps and have gone on to have straight forward vaginal births next time. They never see the women who choose not to have any more babies due to the fear of further damage. There is no way that I will have a further vaginal birth following the damage I sustained.

I had forceps with my 1st as a last resort instead of having a cs, was in theatre prepared for a cesarian but they got him out with forceps instead, was glad to avoid cs & we did not suffer anything from the forceps no complications or anything. they do have their uses... in future would prob rather them again than a cs