Would anyone mind sharing their knowledge / experience of forceps ?

[howardsway]

This evening I have been filling in the NHS birth plan in my notes. I've never bothered with this in previous pregancies (this is no 3) but having had 2 very different births so far I have a few specifics this time.

I found myself writing that I was open to ventouse and CS (in an emergency) but would not agree to the use of forceps.

As I wrote it I realised I am basing this on 2 friends experiences, both of whom have ended up sustaining prolonged damage to themselves following forceps birth. Is this a reasonable request or is it just ignorant, are there ocassions that forceps are the best course of action ?

There's no reason to think there will be a problem - its a 3rd birth and the last didnt require any intervention but have to say I am obsessing and worrying about this birth FAR more than either of the others.

Hi I had a forceps delivery. After 2 hours of pushing and a king labour I was exhausted and needed help. Doctors attempted a ventouse delivery which failed, they then used forceps. I needed an episotmy which I assume they gave me a local anasthetic for. I didn't feel any worse pain and was.just glad.to finally deliver.

Baby was born with a cone head which returned to normal shape within a day and some.bruising which eased quickly. I had stitches which healed nicely and.no last damage so not a horrific experience.

Congratulations on DC3!

In my case, without them I would have required an EMCS. Baby had been stuck for an hour, was beginning to get distressed and the ventouse attempt resulted in the cap pinging back out and covering my consultant and an amount of wall with blood in a comedic manner .
Did have quite a few stitches, but not necessarily due to forceps use. No exceptional damage and no marks on the baby either.

I think, like everything else, it depends on the circumstances and the expertise of the person using them.

I know this is just one experience of many differing ones out there, but hope it helps a bit with putting your mind at rest that they are not always horrific.

I had a forceps delivery with DS - his heart rate had dropped to about 60, I had been pushing for about 2 hours and he needed to come out quickly.

He was fine - had a couple of bruises on his head but no problems. I had a PPH of about 1500 ml and a second degree internal tear. (I lost about 450 ml with DD a couple of years later in a much more straight forward birth so think I do tend to bleed a bit but do wonder if the forceps influenced my internal tear at all).

Then sewn up in theatre for a couple of hours but can't kniw whether that was at all related to rhe forceps or not.

Not sure how DS would have got out without forceps as I think too far down for a CS and don't know whether ventouse would have worked.

I had a forceps delivery two weeks ago. Tbh I felt the same as you & wanted a section rather than forceps which they wouldn't give me without trying forceps or ventouse first. This obviously involved having an episiotomy as part of the process.

I felt a bit traumatised initially about the forceps but now a bit of time has past I feel fine about it. My baby was back to back & for various reasons distressed so they used forceps to turn him & I pushed him out myself. He had barely a mark on him & I've made a pretty quick recovery.

A friend of mine had her baby by c-section on the same day & is struggling much more recovery wise. It also won't impact on any future births I may have, unlike a section.

I wish I'd understood the benefits of forceps before hand so I wouldn't have felt to terrified. It's obviously not how I planned it but was totally fine.

i had forceps to get DS out 2.5 years ago. the upside was he was out pretty quickly and so i avoided a section but it meant i needed an episiotomy which i had to take painkillers for 8 weeks for, was quite bruised and couldn't lift my left leg for 2 days, and have quite a weak pelvic floor now (although not majorly damaged and never noticed any difference having s*x or anything). it doesn't hurt but i am sometimes still aware of my episiotomy and i really don't want another one.

i have decided not to consent to forceps this time, unless it is an absolute emergency. the last time it was coz i just couldn't get DS out, despite nearly 2 hours of pushing. he wasn't in distress, just stuck. i think in the same situation i would prefer a c-section, although i know that's not an easy route. each to their own but i feel i would prefer to recover from a section scar than another episiotomy, i found it very painful the last time, even weeks later. i do think that a 2nd or 3rd baby won't get stuck in the same way though.

i've yet to discuss all this with my doctor and i have certain questions which may change my mind but at the moment that's what i'm thinking.

PS just wanted to add that nearly everyone i know who has had a baby has had forceps and only one has had any issues beyond the first couple of weeks and that was coz her stitches got infected.

also, keilland's forceps (used when baby is still quite high up) are not used here in ireland or in most countries anymore and seem to cause the most damage so you could say you won't consent to them but will to neville barnes forceps for example.

I had forceps delivery 6 months ago. I personally would never ever let anyone use forceps ever again. I had an episiotomy, a 4th degree tear, and my baby had shoulder dystocia (and they let my epidural run out so I felt everything). Not a pleasant experience & I'm about to start counselling for PTSD.

I noticed after a few weeks that my DS wasnt turning his head easily one way so after a few discussions and going on my new mum instinct I took him to a chiropractor and it was confirmed 3 neck vertabrae were out of line. The chiropractor couldnt say for legal reasons definite that this was due to the pulling/forceps but he said that it is almost definitely the case. Its long term damage that will require treatments throughout his life. He also was quite bruised and one of his ears was 'squished'.

I am so far very very lucky with my injury's in that I have not had any incontence(sp?) issues. Its hard to say if it was the forceps or the combination of that with shoulder dystocia that caused my tear. I had to go for physio for about 4 months, I am only now back up to walking at normal pace again and if I overdo it on the exercise then my scars do hurt. I was on painkillers for about a month and had to have two lots of antibiotics. I've also had to see a consultant and have it in writing that its recommended for me that any future babies are by ELCS as they cant tell if it will happen again, and that even if I had a straightforward birth next time the damage caused already to my pelvic floor could be made a lot worse.

Sorry for the essay but HTH.

Sorry to hear about others' bad experiences. I had an emergency CS with DD after pushing for too long, she was in a funny position and an attempt to turn her with ventouse did not work. With DS, almost exactly the same thing happened in labour, was pushing for ages but he was stuck because head at strange angle. Was prepped for a CS but had episiotomy and forceps delivery. DS had red marks for a few days but was fine. I was really bruised for about a week but after that recovered much better than from my CS with DD. Hope things go well for you,

I requested help as after 3 days of prolonged slow labour and 3 hours of pushing I was knackered and spent and DS's hearbeat was dipping.

Was cut under local anaesthetic, didn't feel a thing and then DS yanked out by a tiny doctor with a surprising degree of force - have to say I was quite shocked to see her bracing herself against the foot of the bed and pulling with all her might like she was in a tug of war. Felt like my son was being ripped from me. I did not think my bits would come out of it at all well.

But I was stitched up whilst I blissfully cuddled my new son totally oblivious to what was going on, was sore for a few days and fully healed in two weeks and no long term effects whatsoever.

DS was completely unmarked!

I hope your birth is completely normal.

I had a forceps delivery after DS's heartrate dipped during a long back to back labour. It was done in theatre in case they needed to quickly perform an EMCS.

I had an episiotomy which healed in a few weeks with no problems at all. DS was very battered and bruised around the face and head, lethargic for a few days and we struggled with breast feeding because of it. But he is now 3 years old and there have been no lasting effects.

My own recovery was quick and problem free. I'm now 40+3 with DC2 and I'm a bit panicked at the thought of being in the same situation again. I have probably armed myself with too much information this time and have scared myself silly reading about the risks associated with every possible way of giving birth. I think I will just have to put my trust and faith in whoever is looking after me at the hospital and go with what is recommended in whatever situation may arise.

my consultant has told me that high/Keilland's forceps, the ones that struck fear into the hearts of women 20 years ago, are now very very rarely in use.

basically the types of problems that high forceps were used for back then, are now resolved with a CS. she says this is because a) many OBs are now women, and simply don't have the upper body strength to yank a baby out from high up, b) high forceps are pretty brutal in terms of tears and so on, c) they are difficult to use properly, and d) they can do a lot of damage not just to mum but also baby if they're not used correctly.

she told me that in her practice certainly, low forceps are what she uses, and even then it's usually to help turn a poorly presented baby or adjust baby's descent.

my mum had two high forceps deliveries (one of which was me - i certainly had no damage and neither did my sister) and has told me to have a CS rather than a VB. poor woman.

and also, fwiw, according to everything i've read, the best thing to do to avoid a forceps delivery is to keep moving throughout baby's descent. hip rolls, belly dancing moves, changing positions with each contraction, and so on.

Thanks everyone. Really helpful. I'm going to add the bit about high forceps and will amend so I'm not being quite so black and white.

Scarletfingernail - you've hit the nail on the head. I have also armed myself with too much information. Was far calmer about DCs 1 & 2. Ignorance was bliss first time round. Good luck!! My 2nd birth was much much more straightforward than first - hope yours is too.

OP have just looked it up and according to this

en.wikipedia.org/wiki/Forceps_in_childbirth

...high forceps are no longer in use in the UK (or the US fwiw). only short/low forceps are used now. and you can only use short/low forceps when the baby is wayyyyy more descended in the pelvis (compared to high forceps), or to rotate the baby a bit.

maybe your birth plan should just say, i don't consent to forceps use, but am open to discuss their use should the baby need to be rotated slightly. something like that?

With DD, I had forceps in theatre at my insistence whilst being prepped for a CS due to pushing for 2.5 hours and her getting more & more distressed. I was already on an epidural so that was topped up, I had an episiotomy & DD was yanked out on first attempt & taken straight to resus bed where she came to quite quickly (APGAR of 10 within 10 minutes). DD had a couple of marks on her cheeks but they had faded within 24 hours, I obviously had stitches & so had those/the episiotomy to recover from but just kept dosed up on codeine for the first 48 hours & then paracetamol & nurofen for the next 5 days and was then absolutely fine. I've never noticed any after effects for either DD or I.

DC2 is due in 3 weeks &, given how many horror stories v the number of easy recovery from CS I've read on here (as well as the fact that one of the other children in our NCT group has on-going neck issues from a forceps delivery), I'm not sure I'd make the same decision again... but maybe I would. For me, the post CS driving restriction would mean I'd either be housebound or have to have parents/in-laws to stay for weeks & I'm expecting DD to be very clingy so not being able to lift her would also cause problems. Neither of these should be issues (or not for so long) if I have forceps again. And there's the overriding fact that, IME, forceps were fine. Of course, I'm hoping DC2 will just pop out with no intervention at all!

I guess if it comes down to it I'll just ask why they are recommending one particular course of action over another. After all, they are (hopefully!) the ones with experience whereas my knowledge is mostly based on anecdotes!

First birth - forceps, vowed never to have them again. Episiotomy to allow access extended into 3a tear, DD had a black eye, it was bloodshot and had a squint for a few weeks.

Second birth - in triage room after emergency transfer, told dr quite clearly no forceps. She wasn't happy but accepted it. I had a quick chat with DH and then said I'd allow one attempt with forceps, no more, then CS.

DS born shortly after with forceps. I have no further (known) issues - only a week ago! No tearing, just episiotomy. DS has slight palsy to one cheek from the forceps but should be 100% recovered in a couple of weeks. His bruising and moulding have gone.

I had a Kielland's forceps delivery and I would consent to them again.

They were brutal, don't get me wrong. It was not pleasant and I found the birth difficult and had some pelvic floor damage.

However, a lot of therapy later I realise it was less the actual impact of the forceps than the fear of what was happening when I didn't know what was going on after a calm seren labour/poor communication around what was happening that traumatised me.

They won't use Kielland's forceps unless they have to. There are probably still less risks from using it than an emcs, I guess. My son was fine, I was fine but sore, there were no long-term effects.

I am no massive fan of medical interventions, but to be honest, being induced for waters breaking/allowing the drip to be turned up and up after epidural even when there was no need as labour was progressing well/lying on my back for delivery were probably more of an issue leading to the use of the forceps (aka cascade of intervention) than the medic's decision/my birth wish list. I will be trying to avoid the things that led to this happening rather than stating I don't want a repeat of forceps.

Yet if it happens, it happens. If we both come out of birth alive and with no long term negative effects, I will be happy.

I had forceps after a long (43 hour) labour that failed to progress, with both ds1 and me going into distress.

I too, found it horrendous (and had "no forceps" all over my notes for DS2).

They "didn't realise" (?) DS was back to back. My ex says there was a lot of force going on (no idea how normal or not it was though) and DS came out horrendously battered and bruised with a cut on his face, a huge swelling on his cheekbone, a swollen ear, etc. We were advised to keep holding him to the very minimum (feeds only) because of the wounds.

I had an episiotomy. I ended up with both episiotomy and internal stitches too, quite high up in my vagina. For over a year afterwards I would ache beyond belief if I stood up for more than a couple of minutes. Apparently I had a lot of internal scarring. It got better around 18 months after the birth, but during my pregnancy with DS2 it flared back up and was at times unbearable.

Aside from the physical damage, the mental trauma was awful. I had pnd and real problems bonding with DS1, as well as issues with breastfeeding. I don't think I realised how bad it was until I had DS2 with our post-birth cuddles, immediate feeding and the satisfied glow I carried. It did, however, also cause problems in my second labour as, once contractions began and the midwife gave me an internal I had a massive panic attack because everything suddenly came rushing back. I don't think she quite understood my reaction until DH showed her pics of newborn DS1 - she admitted she had not seen forceps damage like his before.

I realise this is individual experiences, not data, but my dc1 needed forceps to make his appearance, and he was fine. No issues at all. I was very glad they were there and able to ensure he was safely delivered when he got stuck.

I had a Keillands forceps delivery 2.5 years ago in a top London teaching hospital (St Thomas's). It was hideous and DD is scarred on her face (search for my posts in childbirth, I've told the sorry story lots of times).

Just had an ELCS with DD2 which has been positively pleasant by comparison.

Make your own mind up about whether you'd consent to them but it isn't true that Keillands aren't used anymore here in England (if that's where you're based.)

Both my births involved forceps and I have to say, two different experiences...

DD got stuck for a long time and I had a large bleed foolowing the intervention but this was due to a knackered uterus, not the forceps. I expected not to need them next birth, as it fairly unusual...

However, DS born 4 months ago also got stuck, had the cord around his neck and had dipping heart beat.. I just wanted help if I am honest and almost cheered when they pulled them out. I bounced back soooo much quicker as no other complications and no bleed so was up and about that night (he was born mid morning!)

Sooo - in brief, both my children may not have been here without their use and with a weakened pelvic floor the only real aftermath for me, I wouldn't rule them out!

There are three different types of forceps (I did a lot of internet searching after DD1).

-Wigleys which are basically used to help the baby out

-Neville Barnes which are used if the baby is further up the canal and needs to be pulled straight out

-Kiellands which are used when the baby is still high up in the canal and often is facing the wrong way so needs to be turned before being pulled out.

The first (and maybe the second) is interchangable with a ventouse and does not need an operating theatre. The Kiellands are always done in an operating theatre and are used less and less these days. You need skill to use them and I think less doctors are confident in using them. Often as the baby is still high up they can opt for a c-section instead. I think they might be more used in teaching hospitals as the constultants are more experienced and the junior doctors need to learn.

I had kiellands forceps for my DD 4 years ago (Ninewells hospital in Dundee). It was a pretty horrific experience and I had a 3rd degree tear. However DD is fine an I have healed and without them DD would not be here. She was looking over her shoulder and completely stuck. It was not unlike the One Born Every Minute episode a few months ago. I think if they need to use kiellands there is not much choice.

Congratulations on DC3. Try not to overthink it and fingers crossed for a couple of big breaths and hey presto, a baby type labour!

Yes, this is the key thing... They won't use Kiellands lightly. It wasn't fun for me or baby but the alternative would have been less so. I used to think I would refuse them if in same position again but with time and distance, no. I would take steps to reduce likelihood of them being needed long before then.. Optimal foetal positioning, avoid unnecessary induction, avoid epidural. These things are more in your control. By the time forceps are in question a healthy outcome is most important.

I had forceps (no idea what type) after a long labour, where I'd finally had an epidural for pain relief. That turned out to be a good thing, as DD's heart rate started slowing with each contraction, and she needed to come out fast. I was wheeled off to theatre in a rush, had the epidural topped up, was told to push like I had 20 years of constipation, and DD was out on the 1st try. (I didn't want a C section, so I was quite determined at this point.)

So far so good - and it is good, because we're both alive, but...she was badly bruised over her eye and the cut on her forehead has left a scar, still visible at 13 months. She also had a 'tumour of infancy' where the muscle in her neck bunched, from the pulling and twisting. She's lucky, we did physio very early (around 8-10 weeks), and that's no longer a problem. Her scar, well, it's about 1cm long and 2mm wide - not much really. I hope she'll come to love it, as we think it makes her, somehow.

My bits. Never really recovered, and I'm about to finally book a GP appointment to get them looked at. Strongly suspect I have a minor prolapse. Have endless problems with feeling constipated or like I haven't been properly. Sex has changed, little sensation somehow. Whether that's my pelvic floor or not, I don't know, but hoping GP will shed some light.

Would I have forceps again? Not given the option, but they were right at the time.

I had Neville Barnes forceps with DD 2.5yrs ago. I'd been pushing for well over an hour and she was well and truly stuck and I was knackered. In the end they realised she would never have come out on her own because I had a retained placenta (totally stuck took ages in theatres to get it out) which was right up at the fundus of the uterus and the umbilical cord was so short that it snapped on the way out.

The stiches healed quickly and altho I still have a minor/moderate cystocoele I'm pretty sure that's from the 2hrs of pushing not from the forceps. Was out and about and active miles mile faster than anyone I know who had a section. Hoping this time round I will just sneeze DC2 out but if I need forceps (of whatever sort) I'd happily have them as I totally trust the obs team at the hospital I'm booked at to make the right decision for me an my baby when the time comes