Is it possible to totally refuse forceps?

[RevoltingPeasant]

This is a musing rather than urgent Q, as not even pg yet! Am v organised

The Birthrights thread got me thinking: can you refuse in advance one specific procedure, or is this just really not possible?

In an ideal world I'd want a homebirth but would transfer to hospital if any probs. However, once there, would it be possible to say I simply don't want forceps under any circs, and to go straight to CS if it's tending that way?

Or will an NHS hospital not have that flexibility?

I ask because I've seen some forceps horror stories, and that + episiotomy is my real fear during birth!

[Lonecatwithkitten]

Even in very urgent situations a good PBS will explain the risks of all options. I never wanted forceps or episiotomy. However, when it came to it the risks of C-section were considerably greater than the forceps risk, so I took the forceps. We are both alive and well, but forceps was the least bad if a lot of very bad options. But then as a vet I am horribly aware that some positionings are very, very high risk whatever you do.

[propertyNIGHTmareBEFOREXMAS]

Agree entirely, Miaow. Well said [ smile]

[Flisspaps]

coconutty You don't need to understand why anyone would refuse, the point is that it is perfectly legal and within a woman's rights to do so. Take a look at the ragged bits thread over in Health if you want to have a small insight into why some women may consider declining forceps during birth.

YABVU (I know it's not AIBU but still) to use the word 'minnie'

[tilder]

What peoniesplease said.

Op of you are worried about intervention rates at your hospital, the stats are available to check. Unhelpfully I can't remember where. I'm sorry you know people who had a bad experience, but please don't think that happens to everyone.

[VinegarDrinker]

As everyone else has said, it's your body, your choice. However do be aware that it is sometimes the quickest and safest option for the baby.

I had in my mind that I didn't really want forceps if possible .... Ended up with forceps + episiotomy in theatre after 2.5 hours pushing. Tbh if the cleaner had said they wanted to Hoover him out at that point I think I would have agreed!

Very pleased I did consent to forceps though, I had no nasty tears, no pelvic floor issues and a pretty damn quick recovery all things considered. And DS was absolutely fine, couple of small forceps marks that disappeared within a day.

[Flisspaps]

Coconutty here.

Having had a 3rd degree tear myself where the episiotomy extended, followed by a PPH and manual removal of placenta (all things that are risks of intervention including forceps), for me, forceps WERE an issue. And DS had marks on his face and facial palsy for several weeks from the forceps, had that not healed then I would probably have been left regretting my decision to change my mind and consent a second time.

[Flisspaps]

I don't know anyone who would put their minnie before their baby though, and if the fastest way to get the baby out was with forceps why would anyone refuse?

I think ^ this has been construed as you suggesting some women woulld want to keep their 'vag nice and tight and shiny', rather than putting their physical and mental health and their baby first.

[TheChaoGoesMu]

You obviously can refuse, but I would do whatever it takes to get the baby out safely. I guess the best thing to do is educate yourself on the risks and alternatives.

[Lonecatwithkitten]

Being informed is the most important thing. In certain cases you really do have to weigh up the risks I had a tear and have ongoing problems due to the forceps delivery I was told these risks. However, in my case c-section had a considerably increased risk of anoxic brain injury or death to baby. So on balance in my mind I would rather take the risk and then accept the damage to myself rather than risk DD.

[BackforGood]

Thanks revolting for explaining
Do remember though, that people will complain when they've had a bad experience, but there will be loads more women who were very glad of the intervention, who you won't hear from, because they were perfectly happy with their care.

[BraveLilBear]

This is an interesting thread as I remember one fairly recently that said it was impossible to refuse consent, as they make you sign for a trial of forceps before c section. This is heartening to know there are choices available. The only hope is that there is enough time to be informed of the specific risks in any given scenario so you can make an informed decision - ie if forceps are considered likely to fail, then c section should be presented as the preferable choice. If c section would take too long, then that should also be made clear.

I think that my concern is that so much is made of the drive to try and avoid c sections that you may not be presented with the risks in a balanced way, ie you will be encouraged to try forceps even if not likely to work. Having watched OBEM and read plenty of threads on both sides of the debate on here, there is a certain endemic mistrust of the motivations of HCPs. Obviously not all HCPs will have stats at the forefront of their mind in these circumstances, but there is certainly an implication that some do.

How would you be able to tell in an emotionally distressing scenario whether your HCP genuinely had yours and baby's health at forefront, or whether they had half an eye on stats? I think that is a challenge, and one of the things that makes childbirth such a terrifying prospect to many women - especially with tales of shortstaffed midwives who you may not have been able to make a connection with and therefore trust up to that point.

[OneLittleToddleTerror]

I had an episiotomy, and trust me, by that time, all you want for the baby is to come out. All I had in my mind was, oh no, my baby is stuck in the birth canal. It actually didn't hurt, but I have been in labour for over 2 days.

[OneLittleToddleTerror]

And want to add to others that there are cases where the baby is too far down in the birth canal for a safe c-section. I had a horror story from my doctor friend about this. She was in delivery as a trainee with a woman where the baby was stuck for the c-section. They had many doctors and nurses in there all trying to pull the baby out from the top. I can't remember how long she said it took, but it was a long time. The baby had to be taken to SCBU afterwards. (She didn't say if they failed a forcep/ventouse, but I'm guessing it is).