Avoiding forceps / ventouse

[MrsVidic]

Hi I'm 22 weeks with dd 2. Dd 1 was born straight forward, no intervention with only 2 stitches. Yet I am really scared about intervention, is there anyway you can ask to go straight for section if they want to intervene? My sister is a journalist and put the fear of god into me with horrific injuries some babies suffer.

i had a section with my first and then a vbac with second vbac was assisted a little with forceps. It was all fine i was also a forseps baby and although my mum sayd i had some bruising around my head it did not affect me at all and im fine now!
The thing with the papers is that only the small percentage of 'gone wrong' assisted births get reported in the papers and all the ones that go absolutley fine don't get a look in!
Having said that i had written down in my birth plan that if i needed intervention i wanted forceps and not vontuse cos of horror stories id heard!!
You can request a section but bear in mind that depending on how far along the birth canal baby is then you might not be able to.
With ds1 he jsut got stuck at the top as he wouldn't/could't turn his head(9lb 7.5oz!) so i didn't even get as far as pushing.
with ds2 i had an epidural just in case i needed a section again as i didn't want it all to have to be too 'rushed' if i neede another one.
I would suggest discussing your fears with your midwife.
Also although i know no two births are the same seen as you had such a straight forward one with your first there's nothing to suggest that your second could.t be the same.

Not sure how to avoid intervention but if you do end up needing ventouse or forceps I'd strongly recommend seeing a cranial osteopath who specialises in newborns as soon as you can after the birth. Did wonders for my DS and I'd definitely see one again if I was in the same position again. Hopefully all will be fine though and you won't need any intervention.

my baby was born 7 weeks ago: failed ventouse, successful with forceps. he was stuck and they would have had extreme difficulty getting him out with a cs. i'm very lucky he's alive and well and that's thanks to a great MW and doctor who made the right decisions for my baby.

i say, trust the professionals to do the jobs they've trained to do.

you can discuss your birth plan and wishes with them in advance (unless it all happens too quickly), but when your considering your ideal birth - that's all it can be is "ideal". My MW said to me write out preferences, but be prepared to accept other possibilities.

CS is major surgery - have you considered the risks of that to you and your baby? or the impact of your ability to care for your baby after he/she's born when you have had major surgery?

try and weigh up the possibilities in a more balanced way than being terrified by some articles from your sister (!) and talk to your MW about your concerns too.

How to avoid an instrumental delivery?? Don't have an epidural.

Have a homebirth.
If you are low risk, evidence shows similar outcomes for planned home and hospital births in terms of safety, but with much less intervention, lower reported pain and greater maternal satisfaction in homebirths.

A lovely website. I think the woman who wrote is is a living saint!

spinningbabies.com/techniques/during-labor/labor-progress

I was almost taken to theatre for this but when the consultant checked my DS was in the wrong position and was too distressed so was taken for EMCS instead.
I am not sure it is possible to avoid instrument delivery if it is needed to be honest. In my case after 3 and half hours of pushing I just wanted him out safely.

I agree with BooBearBoo. Don't have an epidural, much less risk of needing intervention that way. That also implies avoiding induction if you possibly can and especially not having your waters broken. Do you have a birth plan? Talk to your midwife about strategies for avoiding intervention such as using a birth pool, being upright and active, eating and drinking in labour. Maybe consider hiring a doula. Also what a lot of people don't realise is that when cesarians are done sometimes they use forceps anyway especially if labour was quite advanced and baby had already descended down the birth canal.

I mean they use forceps to pull the baby back up the other way.

By the way if your first was straightforward there is every chance this one will be too so try not to worry! The vast majority of births go well.

I had a forceps with DS1. And both of us are fine. Yes he had bruising - but was such an easy baby (def no need for cranial osteopathy) and I had episotomy, but no long term effects.

I was just delighted that labour was coming to an end. It was almost an emergency CS, but I am thankful that it wasn't.

Perhaps it is related to the fact I had an epidural, but to be honest I was in such a state that I needed it. No regrets on that front.

I asked and asked for an epidural for DS2, didn't get it, but actually didn't need it. No forceps for him either. But perhaps DS1 had sorted my "funny shaped cervix"?

I would avoid an epidural if you want the best chance of avoiding interventions. That way, you stay in control, stay mobile and feel what is going on in your labour. The fact that you delivered your first baby (and first labours are notorious for being the toughest) without intervention is probably the biggest factor in ensuring you will be fine this time

Cheers, I didn't have an epidural last time ( was only in labour 6 hours) but I really wish my sister had kept her mouth shut.
I can't have a hb as I am a strep b carrier, so have to go to hospital asap for anti biotics. I'm a bit gutted about the hb thing to be honest.

I just had a long meeting about a VBAC with the consultant midwife and amongst other things asked about this. She said it really depends on exactly what the issue is as to whether you can "skip" forceps and go to CS but that the sort of "high forceps" nightmares you hear about are very very rare. I did get it written into my care plan that I was very "unkeen" on instrumental delivery, especially as I healed so well from the CS and have friends who really didn't recover speedily from forceps.

DD was born by ventouse. She did develop jaundice though - apparently there may be a link between the two. We also saw a cranial osteopath as we thought that she had feeding difficulties (later it turned out that the midwife's scales were wrong ...). The cranial osteopath was appalling. She told me that she could only treat my dd if I was also treated because apparently there was something totally wrong with my hips etc (I did not feel a thing wrong at all, no pain nothing). Of course it did result in double charges. So I had treatment once and thought it was simply hocus pocus. She told us that dd was extremely ill and that her meninghe had been pulled apart by the ventouse and dd suffered terrible headaches. She made me feel terribly guilty before I finally realised that she was a fraudster (she is a well known London based cranial osteopath by the way). Independent top paediatricians fully checked my dd and found nothing wrong whatsoever. So don't worry too much about intervention - if it is necessary it will be to save your child. Afterwards, if there are feeding difficulties, lot of crying, seek help from real professionals like paediatricians, midwives, etc. but not quacks. Good luck!

Here is a website that may help you become more informed of your rights and choices re homebirthing after a positive strep B test, if interested.

www.homebirth.org.uk/

Click on the "Can I have a homebirth if..?" link for some info about the subject. They have published loads of stats and interesting info. I think there are also some GBS birth stories that you may wish to investigate.

Good luck.

Avoid an epidural.

And you can have a HB with Strep B, and even if you have a hospital birth, you don't have to have ABs - it's your choice.

I had forceps with a CS as DD was so high. CS doesn't take away the risks to LO of forceps.

Forceps CAN be used in a CS birth. However, MOSTLY they are NOT. The risk of a baby being delivered by forceps is less with a CS than a VB where intervention takes place.

Overall, there is less risk of trauma to a baby during a CS birth than during an instrumental vaginal birth.

Have a look at these NICE guidelines and research, esp pages 240 tp 243, which compare instrumental VBs to CS's. www.gserve.nice.org.uk/nicemedia/pdf/IntrapartumCareSeptember2007mainguideline.pdf

In particular, the statement on p, 243 - "....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."

Also: - "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 0.08
to 1.42]), compared with babies who had had an instrumental birth."

It's a complex picture - not helped because with CS data, they make no distinction between emergency C sections, and planned C sections. It's basic common sense, but still worth pointing out - the vast majority of emergency CS's are carried out because the baby is in serious danger. Of course those babies are more likely to spend time in a SCBU. They have problems before they are born.

Yes, there is some evidence that babies born by any kind of CS are more likely to suffer some breathing difficulties. However, purely in terms of physical trauma - SLIGHT AND SERIOUS - babies born via CS are LESS LIKELY to be injured than those delivered instrumentally during a VB.

We do women and babies no favours by hiding this information.

Agreed, but you do have to look at the overall risks. Having had DD in SCBU with breathing and feeding difficulties after our forceps CS, I would have preferred her forceps mark to be worse and not needed SCBU!

It isn't just about avoiding an epidural. Practise OFP and make sure you labour upright and forward.

Yes, japhrimel - I take your point, and I don't think anyone would take a stay in SCBU over a few forceps 'marks' on their baby.

However, women whose babies suffered worse and longer lasting damage than 'marks', and who suffered significant pelvic floor damage themselves after forceps might well take on the risks of a CS, in as far as they can be aware of them.

None of us have a crystal ball, each mother's circumstances are different, and all we can do is be as informed as we can be.

I have permanent facial nerve damage (lazy eye, face droop) as a result of being delivered by forceps. I'm sorry, but it's so frustrating when people talk as if the only possible consequence to babies from a forceps delivery are a few little marks.

I had a forceps delivery with DS 12 weeks ago. Am now pretty much recovered. After 3 and a half hours of pushing and getting nowhere, I was jsut relieved to get DS out safely to be honest. I didn't have an epidural until right at the last minute in theatre, as the next option if forceps didn't work was EMCS.

Am so glad I didn't have to have EMCS - it's major surgery!

After labouring (and remaining active, upright, etc...) for 18 hours (established), pushing and pushing and pushing, I really really didn't care, just wanted him out safely.

As for pain afterwards, the piles from pushing for that long were far, far worse than the stitches .

Yes, there are horror stories, of course, but there are horror stories with everything in life if you look hard enough!

Sorry, should also add that DS didn't have a mark on him except for one tiny red mark on his scalp, wouldn't have even known it was there if the MW hadn't pointed it out. He is a very happy, contented little thing.