One Born Every Minute - Who's had a Forceps delivery?

[Treadmillmom]

Mum of 3 fortunately all text book natural un aided deliveries.
I've just watched tonights One Born Every Minute and the forceps delivery, I am stunned!
The midwife seems to be putting her back into it, dragging the baby out, is that okay for the baby? How is it possible the baby isn't born with neck injuries?
Also mom, doesn't having 2 metal tongs inside you not shred and bruise you?
Tell me please, I was totally grimacing as if I were there.

[bronya]

My DS got stuck early on, and MW told me he was already too low for a CS so it was the big scary forceps only. When the consultant came in, I'd managed to shift him a bit, and was adamant they weren't coming anywhere near me with those things. I got him almost all the way out, but as he was crowning, he kept pushing himself back in with his hand, that was stretched out by his head. I ended up with an epi and forceps - they didn't pull at all, just held his head so he couldn't push himself back in between contractions. He was out in one big push and was fine. Wasn't very keen on the MW but the consultant was fantastic, and did a really good job.

[lunalovegood84]

I gave birth 2.5 weeks ago and insisted on a c section instead of Kielland's forceps. I was induced at 14 days overdue. I got to fully dilated without much trouble, but baby was still high up in my pelvis and back to back. My contractions weren't succeeding in moving him much and the pain was constant and unbearable. It felt like my pelvis was splitting. After 20 hours of active labour, I was told it would have to be an assisted delivery and only when I asked was I told this meant Kielland's rotational forceps to turn him.

I had read about these forceps due to a terribly sad case where a baby girl had died after botched use during delivery. I refused consent and asked for a c section, which was granted. The emcs went well and recovery has been very straightforward.

I have wondered since whether I did the right thing - going against medical advice based on a tragic story in the media and a bit of googling. It turned out that against expectations, baby was massive - 11 pounds 9 ounces. It seems likely that this would have decreased the chance of successful use of the forceps and increased the possibility of trauma to baby. In any case, I would much rather have an abdominal scar which is healing well and has been mostly painfree, to risking my bladder, bowel and vaginal function with these forceps. Some of the stories on this thread are awful, and I'm counting myself lucky that this didn't happen to me.

[GalaxyInMyPants]

Samarcanda. I have no idea if you're a Dr or not but I'm 100% sure you're not an obstetrician. So you did what four weeks obs and gynae placement in your 4th year at med school? One week of which was spent on labour ward.

As someone who does work on a busy labour ward and has done for ten years and has taught numerous Drs how to conduct forceps deliveries I can promise you you're talking utter bollocks.

And a lscs is major abdominal surgery.

[lady1980]

My second Cs last April , was delivered by forceps , her poor little face was so out of shape , the surgeon explained she was in a funny position,

[Memphisbelly]

I had forceps, I had black bruising on my inner thighs down to my knees, the woman doing it had one leg up on the bed and a nurse standing behind her and she shook he was tugging so much, the pressure was unreal (no pain due to mobile epidural) and I screamed 'your going to break my pelvis'

My mum has had 3 children and been at all her grandchildrens births but the trauma of seeing forceps made her so upset for so long after she needed some councelling.

I am glad I had it done and no lasting effects, My only problem was we went from pushing stage to 10 people in room and no one told me what was happening, they didn't have time to get me to theatre and did it in delivery room. They

[sofiashewolfe]

Forceps are a good thing and there is a place for them in modern obstetrics , I had a very traumatic delivery with my first baby , and spent 31 hours in labour , as I had preeclampsia in the last three weeks of my labour , an induction was planned at 39 weeks , I was taken into hospital a day before labour was due to be induced on christmas eve , and promptly went into early labour on the morning of the 23rd December,
The first 12 hours was basically just spent walking around with the pain in my back peaking every five minutes , this set the pattern of the entire labour terrible back ache and no stomach pain at all !
About nine hours before the birth my waters went , and the whole labour changed metre from then onwards , the staff realised from the looking at the waters , they were a dark green colour , that my baby was distressed so a drip was set up to increase the contractions and about an hour before birth whilst nearly fully dilated a pudential nerve block was set up , forceps were used for the entire length of second stage and Ben was born 12. 47 pm on Christmas eve weighing 4,5 kilos nearly ten pounds , he was bruised heavily around the cheeks but over wise no problems at all , very glad I was spared the pain of pushing to safe guard both my blood pressure and a distressed baby .it was a mid cavity delivery i found out later.

[atrcts]

I had forceps delivery and it was brutal. I was shoved so hard up the bed that they had to pull me back down to continue!

Baby came out with purple rings on his eyes and was cut and bruised for weeks after. He was desperate to suck constantly and I think he must've had one heck of a earache poor little mite. I took him to a baby cranial chiropractor to help realign his spine.

It twisted my pelvis so much that it hurt to stand and took 2 years to heal. I also needed Physio to help tone up the anal sphincter and although it improved, it's never been the same since.

I have a medical condition (multiple sclerosis) which studies show increase the likelihood of an assisted delivery. For this reason, and because of the MS fatigue, I want a c section next time. I'd rather repair for 6 week than 2 years!

[brettgirl2]

Rather than banning forceps why not just discuss the risks of different approaches with women prior to the birth? Instead of ramming the 'natural is best' down their throats and refusing to discuss anything else in case it scares them. Then they can make their own decision ahead of time, isn't it called 'patient centred care', which is seemingly considered best practice in everything apart from childbirth?

I was delivered by forceps, gash in the head mum lots of stitches by a junior doctor doing their first forceps in 1977. I suppose someone has to be the unlucky victim but mum went private with my brother so she knew he would be delivered by a consultant. She still thinks it was better than a section (my dad didn't drive at that point for one thing). Me I was lucky and had 2 natural births with no intervention.

[cravingcake]

Not read whole thread but my DS was forceps delivery 15 months ago.

I had a 4th degree tear, pph, episiotomy which tore also. I felt every second of it and can honestly say it was the worst experience of my life. I felt like I was being torn in half (which basically I was).

The forceps bruised my DS face and ear, but worse, he had 3 neck vertebrae out of line that a chiropractor had to fix and he will have to see for the rest of his life to keep things lined up.

My insides are torn to bits and I'm waiting for surgery to fix things before I can have another child. I am still in pain daily, from a direct result of forceps. They may have saved my son's life (he needed resus immediately) but a C-section would have as well, with perhaps less damage to both of us.

I have been told since by 2 different gynae consultants that I should never ever give birth naturally again and that I am promised a ELCS and have this in writing.

So injuries do happen.

[VodkaJelly]

I totally disagree Karasmummy. My DD was stuck during delivery and the consultant used forceps to turn her and I pushed her out. Yes the episiotomy was painful and I still have some pain from the scar 4 weeks later, but if they hadnt have used forceps to turn her I would have had an emergency c section. In my opinion the forceps were better than major surgery.

[Karasmummy]

I had forceps and episiotomy, it was horrendous and left me fecally incontinent and my bits look like something from a horror film, forceps should be banned i now know they are notorious for causing incontinence etc. I am making a formal complaint to the hospital, the big male doctor was less than gentle and my lo looked like she'd been in the ring with tyson, luckily she is fine now unlike myself. I will never have another baby!!! If id have known the lasting affects i wouldn't have had one.

[gloyw]

cleo - The NHS public patient info on forceps deliveries is here - www.nhs.uk/Planners/pregnancycareplanner/Pages/Instrumentaldelivery.aspx

All it says about risks to babies is "Forceps can leave small marks on your baby's face, but these will disappear with time." This thread alone proves there is often a lot more damage than this to babies, myself included.

And there is no mention at all of pelvic floor damage to mothers. If that's not playing down the risks, I don't know what is.

All the more surprising when this NICE document, p 242 - www.gserve.nice.org.uk/nicemedia/pdf/IntrapartumCareSeptember2007mainguideline.pdf

• finds that babies born by assisted vaginal birth (forceps or ventouse) are MORE LIKELY to have trauma (physical damage) than those born by CS.
  

Of course mothers who have had CS's can have incontinence issues too. They are just much less likely to have them. See here - www.nice.org.uk/nicemedia/live/10940/29336/29336.pdf - page 49.

And really, common sense kicks in here. Childbirth is the main cause of female incontinence. The greater the pelvic floor trauma, the more likely longterm damage is. CSections avoid this trauma.

Of course, the huge problem with ALL info about CSections is that emergency CS's and elective CS's get lumped in together. The vast majority of Csections are emergencies - carried out because the mother or most commonly the baby is in serious danger. They are therefore much more likely to suffer all kinds of complications after birth than a healthy mother and baby.

NICE stats also make no allowance for the fact that some poor women will have CS's after instrumental intervention has failed. There is going to be pelvic floor damage for those CS mothers that is never an issue for planned Csection mothers like me.

This is where people's habitual inability to distinguish between association and cause comes in. Are mothers more likely to die after a CS than a vaginal birth? Yes. Mothers will be having emrgency CS's because they have a life threatening condition in the first place.

To illustrate - heart operations have much greater post-op mortality rates than operations for ingrowing toenails. However, stopping all heart operations in the expectation that cardiac patients would stop dying would obviously be stupid.

Poor information about childbirth is rife. It's appalling. It disempowers women and contributes to post birth trauma. The NHS patient info about forceps delivery is woefully inadequate.

[Chynah]

Prettybird - Sad article yes but don't think the CS actually killed her. The article talks about obesity etc and the health of the mother being a primary factor in US death rates and you can see from the piture that the poor woman was clearly very overweight.

[eviscerateyourmemory]

samarcanda

Please stop claiming to be a doctor. Or if by some bizarre chance that is what you are, please discuss your ideas around this topic to a colleague so that they can explain things to you.

[prettybird]

Damage following a forceps delivery is very sad.

Even more sad is death following a cesarean section Jim Scythes speaks speaks after wife's death in childbirth :(

[Cleofartra]

gloyw - incontinence is also a problem for mothers who've had c/s too!


And where is your evidence that the risks of forceps are 'hugely downplayed' or that the risks of c/s are 'often exaggerated'. And by whom?

[prettybird]

How about all the mothers in this thread who have talked about having had forceps deliveries that were OK?

It's the usual thing: you only know about those people who complain or have issues with the birth. I don't go about telling people that ds was delivered using forceps because to me it wasn't a big trauma.

In fact, when I went to see a physio about some (minor) problems I was having, I told her initially that I had had a natural birth (becuase it was vaginal and not a CS). It was only having gone through other infomration that I said "oh, it was forceps," "oh, I was induced" (waters had broken more than 24 hours beforehand). I thereofre had 3 out of the 3 risk facotrs for damage (the 3rd being the fact that ds was over 4kg - even though they had predicted a small baby as my bump was small and neat).

[gloyw]

I was a forceps baby, and have permanent nerve damage to my face - nothing major or disabling, but a lazy eye and a bit of a droop on one side of my face. Forceps can damage babies beyond a 'few marks' and mild bruising.

I had a CS for my 1st, and it was a wonderful experience, from which I recovered very quickly. Without exception, every other mother I know who had a forceps delivery found it brutal and traumatising and had difficult recoveries. Some of them are still having pelvic floor and continence issues over a year later, not to mention pain from episiotomy scars.

People are right to point out there are different kinds of forceps, and different kinds of forceps delivery. Right too to point out there are a few circumstances where forceps are the only option.

However, I feel that while the risks of a CS are widely circulated (and sometimes exaggerated, in fact), the risks of a forceps delivery to mother and child are hugely downplayed.

Pelvic floor damage to women is simply not taken seriously enough. Some of my friends have been left shocked at the level of pain and damage caused to them which is considered to be fairly normal during a forceps delivery. Many of them had longer stays in hospital than I did after my CS due to the severity of their injuries, and the fact they needed catheters to be kept in for days.

Yes, a forceps delivery is a bit cheaper than a CS on the day. But we never factor in the aftercare or the effects of a forceps delivery. If a baby is left bruised and in pain for the first few days of its life, if it makes successful BF-ing hard to establish, if the mother takes months to heal and is left scarred and traumatised - if they need physio or surgery to deal with incontinence - well, let's hope saving that few hundred pounds on the day was worth it.

[Cleofartra]

I'm incredibly glad that forceps are often used instead of abdominal surgery.

There's NO WAY I'd have wanted a C/S with my first child.

None of the many women I know who've had a forceps delivery would have preferred a c/s.


"Looking at the single case with your experience as a professional doctor is what will give you the real risk/reward ratio".

Were you being sarcastic samarcanda?


You only have to look at the shameful history of obstetrics in the US and Europe to know that a huge amount of obstetric practice has been incredibly damaging to women and babies - routine episiotomy, scopolamine births, routine use of forceps, restraints and lithotomy. And all done by individual doctors delivering babies year in year out, utterly convinced that their way was the 'right' way.

If doctors spent more time watching and listening to mothers in labour and let it inform their practice they'd do far less damage and far more good.

[prettybird]

Waht I object to about Samarcanda is her desire to ban forceps - despite the fact the the evidence does not support it. These are research studies done by doctors, not accountants. (In fact, one of them, an 18 year follow-up study, did find that there was an improved IQ for boys extracted by forceps rather than ventouse - but it didn't try to impose the use of either - rather just the need for experinece use. And no, it wasn't dones in Turkey - it was doen in the UK).

It is a Catch 22 situtation - forceps are a safe alternative in practiced hands - but if you don't allow people to use them, then no-one can get the experience or to maintain their expertise. And part of that is observing forceps being used (which is why I am glad that my own birth expereince helped a trainee)

The other very sad thing I have found (which my father often reminds me) is that the US's maternal and neonatal morbidity rates are far higher than they should be, given the US's relative wealth. Not a model we really want to follow.

Mistakes do get made in medicine - doctors are human beings and not infallible. I have a friend whose daughter was born profoundly handicapped and with a life expectacvny of less than a year following a uterine rupture which was not diagnosed. However, I am not going to exptrapolate from that that everyone should have a ELCS.

Ds' own birth was apparently stragihtofrward - so aboslutely no indicactions of the need for a CS (quite apart from my strong desire not to have one). (With hindsight) the midwife made a mistake in getting me to push while I was in transition (first time labour, I didn't know any better so did I was told) resulting in maternal exhaustion - and a baby stuck half way down/up the birth canal. Ventouse was not an option. How else was he going to get out?

Smamrcanda's logic of banning forceps would either mean that all births would have to be ELCS (as you can't always predict which ones will cause problems) or that babies like ds would die or risk sever damage because he would remain stuck - becasue even if I had had an emergenecy CS, forceps would still have had to be used to get him back up the birth canal - either that, or hack me to bits .

As it was, I have a gorgeous ds - and if I had been able to get pregnant again, was told that subsequent births would have been a doddle (OK, not quite in those words )

[Margles]

(there's a reason why women die MUCH less of childbirth now than in Victorian times, it is because they GO TO THE HOSPITAL to give birth !!!,

Er no - you only have to look at the US maternal mortality rates to know that this isn't so. In Victorian times hospitals had much higher mortality rates because the Drs went from handling cadavers to attending pregnant woment. Semmelweiss pointed this out, and was ridiculed; his work was only accepted after his death. Coming back to today: where is MRSA a problem? At home? I don't think so. In hospital - yes.

The major reason for improved rates of maternal mortality now are more likely to be better health in the woman, better ante-natal care, better public health e.g. clean water & sewerage, plus anti-biotics to fight infection.

[samarcanda]

because i am in the medical profession i know that i can pull out every sort of studies... i'm sure i can get some turkish based clinical studies that prove that forceps are actually good for the baby's brain development.

Looking at the single case with your experience as a professional doctor is what will give you the real risk/reward ratio.

You continue being sarcastic and annoying , i really don't mind if you want to go through forceps deliveries for all your babies... infact, good luck with it !!
however as i feel sorry for you and whoever else gets brain washed by the tons of CHILDBIRTH politics going on...and being the aromatherapy doctor that you say I am, i will now provide my experience in the backstage of a hospital (of course gathered watching House and ER on TV!):

first of all there are very few cases that medical professionals cannot forecast in terms of outcome for something like childbirth, we are not talking about some experimental organ transplant, if you have done a repetitive job every day for 20 years, you know that the situations where you are really caught by surprise are minimal.

Furthermore, somebody in the numbers rooms make tons of fancy spreadsheets with all the reports of single patients outcomes... this is the reason why the whole healthcare system these days is based on probability based PROTOCOLS...that are decided NOT by medical professionals but by Accountants on the basis of the budget that they are given

probabilities.. if you have ever gambled in the stockmarket or at a casino, you will know they mean NOTHING and are a recipe for disaster.

The pre-assesment of a patient (in phase 1 of labour and during antenatal care) will allow the medical professionals to allocate the patient to a certain probability based protocol. If your baby is back to back, you do not have much fluid, you have failure to progress, your anatomy is slightly odd for a certain size baby, you will fall in a score of X%... this is the probability that with the that specific hospital protocol you and your baby will have X% probability of complications, morbidity, mortality etc....
accountants have these tables... they meet every year and look at their money and decide... can we afford to reduce that x% of patient distress, risk, discomfort etc ?

now if you are in a well funded hospital, or in private care, or in a country where the healthcare system is actually well managed (not the case of the UK unfortunately) they might say YES... but if you are in your average NHS hospital... where understaffing is a routine and cost pressure always a must, then their answer is gonna be WE ACCEPT THAT X% RISK.

This is unfortunately the reason why there are less c sections in UK hospitals and more forceps deliveries than anywhere else in the civilized world. THis is also the reason why there are LESS EPIDURALS and more emphasis on how natural the birth has to be.... if we can cut costs on pain relief for women in labour, WHY NOT? there are many other areas that require more urgent funding. after all isn't it written somewhere : "woman, you will give birth in pain???" .

THEY KNOW these practices are more risky and quite barbarians for the women and can be avoided, BUT the accountants prefer to allocate money elsewhere.

a lot of doctors within the NHS have been fighting these practices (which by the way come from USA where healthcare is managed as a business!) quite strongly within hospital politics because although they provide a great way to meet ends, they are really often NOT in the best interest of the patient.

there is however little a doctor can do, patients can and should do more to be their own advocates instead of falling in the traps of ideology... where everyone fight because homebirths are cool (there's a reason why women die MUCH less of childbirth now than in Victorian times, it is because they GO TO THE HOSPITAL to give birth !!!, not because of forceps, cause those were already used in the middle ages!)

sadly patients are often caught in the politics and are misinformed ....

USHY, good point about the comparison... of course an easy vaginal birth is much better and a c section ! :D I'd sign up to it anytime.... the difference is that one is an uncertain event, the other one is quite liekly togo as planned.

[prettybird]

Interesting that when asked to supply evidence, Sam supplies quotes the Daily Mail

As a trained medic, I thought she might have been able to provide more reserach based evidence, such as this. In particular, I like the intorduction

In recent years the Cesarean Section (CS) rate has risen and there has been a gradual decline in instrumental delivery. This trend is seen in many countries, possibly due to concerns over neonatal and maternal safety, medico-legal issues as well as fewer clinicians skilled in forceps use 1 . This may reflect a perception of the practitioner that caesarean section has less morbidity. However this has not been supported by evidence 2 .

It does go on to disucss the need for trained practioners.

I am really sorry that Sam's cousin was brain damaged. I don't now if there was negligence involved or the doctor was not sufficeintly experience - or if the alterantive might have been that he would have died if they had waited to do an emergecny caesarain. Things do go wrong :(

However, research suggests that the alternative of more caesarians is more dangerous across all births than use of forceps by appropriately trained doctors.

In my case, ventouse couldn't be used because ds was still too high (I was aware enough to ask). I did not want a caesarian. What alternative was there??? (and ironically enough, from what I have since learnt, they wo uld probably have had to to use forceps to get him out even if I had goen for a caesarian as he was mid-cavity )

As an aside re training - I am also glad i was able to offer a "training" opportunity to an SHO, who was observing that day, so she was able to watch a successful forceps delivery being carried out :)

[kensworth]

Mean stiches !!!!!!!

[kensworth]

I had forceps with ds2 and no tears or stocked!!!!!!!!! Not sure what that says about me. Also had vontous ( no idea how to spell it) with ds1and again nothing black well tunnel must spring to mind !!!!!! Lol what else can I do :)