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

The thought of either terrify me and I'm 31 weeks pregnant :(

I would have rather had forceps than CS precisely because one is presented as no big deal and the other is presented as major surgery...wondering if I have been slightly misled. I always hated the idea of a CS, well the spinal specifically.

MummyB2010 I was in exactly the same situation. My mum had a straightforward pregnancy followed by a long drawn out and forceps birth. For some reason I decided I would ahve the same experience - I didn't, have had 2 straightforward births. So please don't get worried that you will have the same birth experience as your mum.

I've had 1 EMCS and one forceps and would definitely prefer forceps in an emergency situation. It's not quite as safe for the baby, but kills fewer women, and fewer subsequent children. This latest thing, as I understand it, is calling for practitioners to be better trained with forceps for emergency situations, and that has to be a good thing.

I found my caesareans to be a total breeze tbh. No pain, easy peasy recovery, shorter stay in hospital than people with instrumental births and few complications. The spinal? Blimey, compared to contractions I didn't even notice it - seriously.

Labour, on the other hand, was seven kinds of sheer hell...

With DS1 I was taken to theatre for a forceps delivery but when examined there - they decided to go straight to emcs. I've then had 2 subsequent electives.

My c-sections were very positive and straight-forward and I recovered very quickly.

If I'd been given the choice I would have opted for a c-section over forceps.

I had a forceps delivery in July, resulting in a third degree tear. The women on my ward who'd had a c-section were without a doubt more mobile than me after the birth (had to be wheeled, crying, to have a shower). I'm pretty much healed now and am hugely grateful that my son was delivered safely, but I will definitely be having an elective section next time (consultant also recommended this route).

I do think budget has a lot to do with midwives/doctors portraying c-section as a last resort when giving birth.

I am interested to know if you had a forceps delivery first time around and have had subsequent births were they more straight forward or did you have assisted (forceps) deliveries or ECS for these too.

I had a forceps delivery for an OP positioned birth last time and apparently the chances of the baby being OP this time is 1 in 7 (I am 37 weeks). I have decided to go for a natural birth again however, my consultant advised if we were to end in a section this time she would prefer to decide with us at 4-5 cm dilated rather than 8-10 due to the associated risks - I guess we will see what position the baby is in at the time. I also suffered a primary PPH last time (which could happen again with both vaginal or section) so interested to hear how people got on 2nd time around.

I had Keillands forceps and had an horrendous recovery. I still can't contemplate a sex life one year on.

She was stuck in transverse arrest and the consultant had to yank with all his might to dislodge her. She was too malpositioned for a ventouse.

I was doubly incontinent for the first few weeks, couldn't hold anything in faecally, but the connection between brain and bladder seemed to have got lost so I had no idea of I needed a wee and needed to spend minutes just forcing my bladder to open and empty or risk an unexpected deluge Other than being reminded about doing pelvic floors, I was told they couldn't do anything until after my 6 week check. Thankfully it had subsided by then.

My episiotomy came half unstitched and when I expressed how I was suffering I was just repeatedly asked was I taking my pain killers. The pain was excruciating for the best part of 2 months. I still get aches one year on, especially during my period.

DD was horrendously bruised. She has a permanent scar beside her eye and "odd eyes" (one opens far more than the other).

I was in such a state my milk didn't come in until day 6, DD was readmitted to hospital to be tube fed and I had to see a bf counsellor for 8 weeks to establish bf (so its not just cs that screw up bf).

I had no feelings for DD for the first month or so. No emotions at all in fact. I think the bf counselling appointments were actually partly to keep an eye on me for PND.

I made it clear i wanted a CS rather than forceps and basically wasn't allowed.

I was told I was lucky to have avoided a cs but can't see it myself. A cs recovery would have been much easier for trying to bf (sitting on an open wound is nauseously painful).

I'd like more children but I'm too afraid. Can't even think about talking about it. I WISH I'd have had a cs.

Sorry to hear that you had such an awful time hearandthere. I can quite understand why you feel as you do. Unfortunately for some people there are also horrendous implications from a CS as well. I think there will always be people on both sides who wish they had been able to have the alternative because of what they went through, and with something so powerful and important as childbirth, people will quite understandably go with their gut.

I had a forceps CS - worst of both worlds then!

A CS is ALWAYS a last resort. I realise many women have had horrendous experiences with forceps, but there are far more women who have had horrendous experiences with a CS.

Someone also posted that an episiotomy is ROUTINE with forceps...this is incorrect. Each case is [or should be] assessed on an individual basis.

Forgot to add...

Re the intercranial haemorrhage due to the bones of the skull overlapping...

The bones of the fetal skull are designed to overlap in order for the baby's head to navigate the birth canal, it is a physiological part of childbirth.

I'd actually dispute "far more women have had horrendous experiences with cs" [than forceps]

Where is the evidence for that Middymee? Sure, women can have horrendous experiences with cs. But "many more"? I think that's just not factually correct.

Just want to point out something from the NICE Guidelines on Intrapartum Care (2007).

Which are here - www.gserve.nice.org.uk/nicemedia/pdf/IntrapartumCareSeptember2007mainguideline.pdf

Pages 240-242 contain a comparison of instrumental vaginal birth with CS. They admit they are dealing with 'limited evidence'. On page 242, we get the following: -

"...babies born with CS were more likely to be admitted to a neonatal
unit, but less likely to have trauma, compared with assisted vaginal birth."

There are various risks associated with both forms of delivery. But the specific risk of physical trauma to babies is LOWER with a CS.

How this piece of info stays buried in the small print, I don't know.

On a separate note, I think the risks and effects of a forceps delivery on mothers are routinely downplayed. Obviously experiences vary (height of baby, different forceps etc) - but when I compare my recent elective CS experience to my friends' forceps experiences, I feel I've been very lucky. I just don't think pelvic floor injury is taken seriously enough.

Yes me!!!
I begged for my forceps delivery when they said they were going to give me EMCS.

I'm glad I did in the end as DS was born absolutely perfect, no marks on him.

and often forceps are used to turn a baby who is stuck the wrong way round not to just pull them out.

I had placenta previa with my son and had a planned section. I talked it through endlessly with my obstetrician and also got a second opinion, and both consultants were very clear that the burden of risk is on the mother, not the baby and planned section is very straightforward.
As it was, he was at a weird angle - he could never have engaged as the placenta was in the way - and they used forceps to fish him out. I was astonished when I was told, but the obs said he used them far more for c section than vb, but no one ever thinks about that! I had a very short scar which healed fine and Ds had a little mark over his eye which faded in a day or so. And it was totally pain free!

Not sure, DD was already very low so 2 tugs on the forceps and out she slid. No damage to me (bar a small epistiotomy) and none wahtsoever to her. I guess we were lucky. She was getting very distressed though and the surgeon said she wanted to try forceps for 1 min max and then she would move to EMCS. As it turned out I'm glad it went the way it did as I didn't have to recover from a CS, but having read more horror stories I don't know if I'd take the risk again.

I had no pelvic floor trauma.

I would agree that docs should be better trained in them regardless.

Yes, intercranial hemmorhage by design. Doesn't make it any more attractive. It does, however, make me question the the validity of:

by design = good thing

Well, I seem to have got my answer here. I wanted to know if, generally speaking, women prefer forceps to c-sections. It seems some do, but more have expressed a preference for a c-section.

So, again, I would like to know why woman were not consulted in this article. What ever happened to the patient have some say?

I have never had a forceps deliver, and for that I am thankful. I attempted a vaginal delivery once, but it didn't work out. It wasn't until after I had had a section that I though you know... that wasn't so bad. In fact, I think I'll have them all that way.

A section is not for everyone. And I appreciate that some people have a more difficult recovery than I have. But, I also know natural birthers who have had a horrible time, and some went home a cooked dinner that night. Whatever your preference, that point of starting this thread was to say that the women giving birth should be consulted. One size does not fitt all when it comes to childbirth.

Barkfox: "I just don't think pelvic floor injury is taken seriously enough."

Hallelujah; the long-term impact of birthing injuries are rarely talked about. Since midwives never deal with that aspect of post-natal care, they tend to down-play perineal damage.

I think men need to be educated about birthing injuries and their impact (alongside the impact of BFing and sleep deprivation) on a couples' relationship.

In ante-natal classes, watching a an instrumental birth, with damage, should be par for the course.

I had Kielland's forceps. It was terrible. Nine months of postnatal pain.

"But the specific risk of physical trauma to babies is LOWER with a CS"

But most trauma caused to babies during assisted deliveries is minor - a bit of bruising or swelling to the scalp.

I'd rather my baby had minor bruising than breathing difficulties requiring a trip to scbu.

Interesting regarding maternal recovery. I know with each of my c-sections I recovered very quickly and was in a lot less pain than friend's who had forceps/epiositimies at the same time.

DS2 did end up in NICU but he was 3 weeks early and his giant head wouldn't/couldn't come out the normal way.

With all the stuff about risks of c-sections - is there any research/stats that take into account that many high risk pregnancies result in a c-section - surely this skews the results. Just thinking about multiple births for example which are often delivered by section and are often early.

"With all the stuff about risks of c-sections - is there any research/stats that take into account that many high risk pregnancies result in a c-section - surely this skews the results"

Yes - there is research comparing outcomes for low risk mums having elective c/s with low risk mums trying for vaginal births (of which a percentage will end in emergency c/s)

Tittybangbang, I thought the breathing difficulties in cs related to the anaethetic? So if you are prepped for a trial of forceps and given a full spinal block, you are as likely to have a baby whisked to scbu in either circumstance?

The outcomes from Kiellands forceps make for frightening reading. I fully understand that in the situation I was in that, at the moemnt they chose to deliver my ds in that way, it was the safest way to go. However, I don't think it should be seen as automatically preferable to CS from the outset.

My ds had a low Apgar score and took some time to breathe. His bruising (two black eyes, burns on the front and back of his head and scarring to his eyes that still persists) may have technically minor but he was an angry, angry baby who was a nightmare to feed because he was too uncomfortable to cope with latching on, leading to poor weight gain etc etc..

I know the doctors did what they had to do.. but it took me a long, long time to recover from my delivery. My doctor told me at the 6 week check it would take 8-9 months before I felt "normal" in the pelvic region and, well, she was right. I still have pain there if I take too large a step/have some issues with continence etc and won't go into the rest of it.

I think you do what you can to deliver a healthy baby, though.