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

Breathing problems following CS is (at least partly) related to the mode of delivery, as the baby doesnt get 'squeezed' on the way out.
Local anaesthetics eg a spinal or epidural wont affect the baby.

DP was on orders that if I was too out of it, he was to tell them that they were to take me in for a CS if they even thought of putting forceps near me I was terrified (and still am) at the thought of them.

Thankfully no assistance was needed, but I am surprised people would rather have forceps.

Oh right, I was told it was the anaesthetic .

tittybangbang - you say - "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."

Well, yes. Wouldn't we all?

Page 243 of the NICE document I linked to contains this: -

"More babies born via CS were admitted to a neonatal unit (OR 2.64 [95% CI 1.16 to 6.02]); but less babies with CS had
trauma from the birth (OR 0.37 [95% CI 0.20 to 0.70]; or serious trauma OR 0.34 [95% CI 0.08to 1.42]), compared with babies who had had an instrumental birth."

Babies born via CS are less likely to suffer trauma or SERIOUS trauma compared with babies who had an instrumental birth.

If you disagree, you could always take it up with NICE, I guess.

I'm happy to admit, I have more awareness of forceps damage than most as I have permanent nerve damage to my face (lazy eye and 'droop' around the eyebrow) as a result of my own instrumental birth. Not serious or life threatening, just minor disfigurement. Very noticeable, though. Didn't make life easy at school, and still draws attention in adult life.

"However, I don't think it should be seen as automatically preferable to CS from the outset".

I don't think it is.

I thought that was what the thread was about?

I had keillands and simpsons forceps in theatre to get my DS out, my episiotomy turned into a 3rd degree tear and two years on I still have faecal incontinence issues. I'm going to meet with the consultant on tuesday to beg for an ELCS as I'm 20 weeks pregnant now. My DS still has a scar below his eye and it took his head months to heal. There's no way I would ever consent to forceps again. I was in hospital longer than all the section patients. They put you on the section bay anyway as it's considered as serious a proceedure.

I think it's a bit silly of any of us who have had either forceps or CS to assume that the other route is easier.

I know people whose recoveries have been straight-forward and fast on both/excruciatingly painful and slow on both.

So many factors..

After a 49hr labour (and 55 hours without sleep)my DD was born by forceps and I wished I could have had a C section.

They broke my coccyx pulling her out ( she was on the large side 9lb 1). I lost a lot of blood but they didnt realise until 2 days later.

DP told me that the dr fell over the bucket in the delivery room spilling my blood everywhere. So they had to guess how much I had lost.
I had to have a large blood transfusion as my blood count was 6.9 and should be around 10.

My stitches came completely undone and had 2 infections and I had to heal naturally. For nearly 3 months I could barely walk, stand or lift my baby out of her moses basket or changing mat.

A C section would have been better for me.

Babies admitted to nicu following a c section could be there because their condition immediately prior to delivery was still present at birth. My 3rd daughter for example was born by crash c section, due to not tolerating the induction due to the fact that she had an infection caused by prolonged rupture of membranes (due to cord entanglement). So although she appears in the stats as a c section who then went to nicu, she didn't go to nicu because she came out by c section but the other way around. I refuse to believe that c section is so routinely deployed that babies end up in nicu because of the way they were born (although there are obviously some physiological advantages to a vaginal delivery), it is on the whole better to come out by c section that to emerge dead.

I would still have a CS any day over instrumental delivery. Have always put that in my birth plan. The potential for absolute disaster if instrumental delivery is done by the wrong hands is too great for my liking. It should only ever be done by a very well qualified and trained person, and never on a have a go basis. Until they produce some serious and credible stats on birth injury to both mothers and babies I will not be convinced otherwise.

wow, reading this makes me think i've been very lucky. my OP 8lb13oz DS was delivered by kiellands forceps in july. i had a full spinal block as the epidural didn't work and it was a trial of forceps, they thought it likely it would become an EMCS. for me it was fine - they turned the baby and then he was out in 2 pushes. didn't feel the cutting or stitching at all. not a mark on ds. i have recovered well from the episiotomy - was having sex at 6 weeks, now at 14 weeks it is pain free. would rather have had episiotomy, expertly stitched under a spinal by a surgeon, than unpredictable tearing.

am glad i didn't have a cs - i recovered much faster. but am glad i hadn't read the scare stories of kiellands forceps at the time.

my milk didn't come in till day 6 which caused some problems - don't know if that was connected.

"I think I prefer the risk of minor breathing difficulties, personally."

Ds was born by elcs at 39 weeks, and was admitted to nicu within 4 hours of birth due to severe respiritory distress, he was grunting, had deep chest recession and couldn't feed (breast or bottle), he also had jaundice and a heart murmur.He was put on cpap, and tube fed. He was in scbu for 8 days. He is under consultants care atm, because of his chest and because he has severe reflux.

The consultant said that it is likely that my dates were wrong, possibly only by a couple of weeks, but that was enough time for his lungs to have not developed properly, and for him to show other signs of prematurity. She said that this, combined with the fact that the lungs don't get squeezed through the birth canal is the reason why elcs carry a higher risk of repiritory distress for the baby.

I know that there are risks associated with all modes of delivery. But I think sometimes the risks of an elective cs are wrongly dismissed as minor. Obviously if the dates are 100% accurate then these risks are reduced, but my dates were considered to be 100% accurate and things still went wrong.

What this thread tells me is that there are arguments for and against. Given that the science is mixed, I think women should have much more freedom to choose and state their wishes in advance. And doctors need to lose a lot of the 'dr knows best' mentality that so many suffer from.

"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."

Statistically rates of maternal morbidity and mortality are higher in caesarean section than instrumental delivery.

I've seen more readmissions for uterine and abdo wound infections following a caesarean than for perineal trauma. Although this is merely personal experience.

What is not being mentioned (as far as I can see) is the reason for using forceps in the first place. I am aware of one birth in my circle of friends very recently where the consultant decided the mother to be "just didn't look like she was able to push the baby out". There was no maternal or foetal distress on any monitor, she had specifically stated she felt fine, she had not had any pain relief, so I am at a bit of a loss. My own very bitchy opinion is that those golf balls are not going to hit themselves now, are they?
I know a midwife who works there as well and another consultant, when checking on mothers during the pushing stage, instructs the midwives to place the forceps trolley outside the delivery room before he goes in to examine them, he routinely gives them 15 minutes to push and then announces they need help and in with the trolley.

at Notwoozy. That's terrifying.

As a 1st time mum, it took me 2 hrs of pushing during my HB, with lots of position changes and support from DH and 2 experienced HB MWs but DS and I both came out of it healthy and undamaged in any way. Really awful to think it could have been so different just because the consultant has a game of golf to get to.

Notwhoozy

Has your midwife friend reported the consultant in question for this?

Eviscerate, she's not a midwife, and no she hasn't reported him. For what exactly? All the notes will doubtless back up his story, and it will be his word against hers.

I thought that your post said that you knew a midwife who worked there too?

A consultant who routinely uses forceps after 15 minutes of pushing must be well known for doing so, regardless of what the notes say. I think that it is concerning that this might happen and also that midwives would routinely see this happening and not report it.

Forceps for me with DD1, against my will, I did not consent or have adequate pain relief.

ELCS for me with DD2 - never, ever would I consent to another forceps delivery (but didn't trust them not to do it again, hence ELCS).

Sorry eviscerate, I thought you meant the mother who just had a forceps delivery. My friend no longer works there and if she did report him would face the same problem anyway, of his word against hers.

I would choose a caesarean over forceps.

My dd1 was delivered by keilland forceps, they had to turn her then deliver her. Had I known then what I know now I would never have agreed to it in fact I don't actually remember agreeing to it, I was told they were going to try forceps. It wasn't until dd1 was 9 that I found out that forceps are usually used in the delivery room,I was prepped and rushed off to theatre so they obviously didn't think they were going to work and were prepared to do a section if need be.
Recovery for me seemed to take forever,but I did recover and dd1 was fine which was the main thing. but it all seemed so brutal and it took a long time before I could consider having more children.

When I was having dd2 I had in my birth plan and told my consultant explicitly that under no circumstances were they to deliver her with forceps if it came to things not going smoothly I wanted a section. Luckily I managed a completely natural birth the second time.

My poor sister was very badly damaged by the forceps delivery of her first child,so much so that she will never be properly healed. Her second child was delivered by elective c-section.

Personally I'd be happy for 'lift out' or low cavity forceps or a ventouse delivery.

By the time you get to this point pushing your baby back up your vagina to be delivered by LSCS is very risky.

I would NOT be happy to have a high cavity or Kiellands forcep delivery and would push aggressively for a LSCS.

The risks between the two are very different.

I have experienced both.
CS - three days in bed, some major painkillers, six weeks no driving, PITA.
Forceps - home within six hours, driving the next morning, at a singing rehearsal within two days.
no contest

My ds was delivered by forceps in the operating theatre - last ditch attempt before c-section.

Beforehand I'd thought I'd rather a c-section than forceps, but when it came to it I was glad it was only forceps tbh. My recovery was very quick, episiotomy healed well and I felt recovered (other than a bruised coccyx) within 4 or 5 days. My ds was quite bruised and battered though, and suffered some facial nerve damage - which thankfully resolved itself within a couple of weeks.