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]

Revolting often forceps are used when a birth had been progressing in a normal manner and goes straightforward at the very, very end. So no often there aren't any signs earlier that you should stop and do a c-section.
Yes in my case there were some pointers, but I think these are very rare. My DD was breech till 37.5 when she some how managed to turn, she then failed to engage at any point prior to or during labour. The only time she actually engaged was when she was completely stuck in a lateral oblique presentation too low for a c-section. Once born she was little for her dates and had clearly had too much room to party in there hence all the activities. With hindsight yes I probably should have had a planned section, but this scenario is very, very rare.

[Lonecatwithkitten]

Sorry meant to say the birth goes pear shaped at the very very end.

[OneLittleToddleTerror]

RevoltingPeasant is there a birth centre or a midwife led unit around you? They might be a good choice for you when you become a first time mum. Tbh, after what you said, I wouldn't trust that hospital either. I think from all the posts here, you can see there are many who had foreceps and haven't had any problems. Also that sometimes an instrumental birth is needed and the best option. But I think the main issue is trust. That you have to trust the HCP knows what they are doing, and that they know what is the best options for you and the baby. And it doens't seem to be the case in that particular hospital. If you need a hospital birth, I would seriously consider an alternative. (Or the birth centre or midwife led unit).

[BlueFishWonder]

I am currently 32 weeks pregnant with DC2. After a horrendous birth with DC1 involving forceps which left permanent damage to me and DC1 in a terrible state I will not consent to the use of them unless it really is life or death. I would rather a CS than put myself through that or my unborn child through that again.

[higgle]

Wish I hadn't posted now, just sharing my experience with no spin or criticism of anyone else. The very experienced famale obstetrician at The Garden ( subsequently Lizzie and john) told me she often used this approach when the mother seemed tired and despondent. It was a bit like a bootcamp instructor getting you to the end of the class. They were beginning to be getting a bit cncerend about DS and there was no obstruction or question of difficult presentation, I'd just been in labour for nearly 19 hours.

I had just assumed I'd have a regular straightforward delivery and it didn't cross my mind I'd be stuck there for so long, tired and in pain ( of my chosing) It brought home to me the reality of what would happen if I didn't get on with it and I was pleased she did. That is my experience and my experience only. This lady has probably retired now but was lauded in her field and had lots of grateful patients, the fact that with my telling off I was able to be the first to look into my son's eyes is something I am very happy about.

[MajaBiene]

Some countries don't use forceps at all though do they? So there must be some alternatives.

In my case forceps were a last attempt to avoid a c-section. If it came to that again I'd say forget it - go straight to the c-section.

[strawberrypenguin]

As others have said yes you can but it does depend what's best at the time. If I had refused forceps/they had failed I would have needed a really brutal c section where DS would have been pulled from the section and pushed back up birth canal at the same time very distressing for him and dangerous so I'm always grateful for the forceps delivery he had it could have been much much worse.

[MyNameIsAnAnagram]

the thing is Higgle in your situation there was no need for an instrumental delivery so they did the right thing. In most cases an instumental delivery is needed becauase the baby is stuck - I was pushing for 3 hours, I wasn't being lazy, I didn't need a pep talk, DS was just stuck because of was back to back, hadn't turned and his head was at a funny angle. I was never going to get him out on my own. I had a ventouse which worked really well for us.

OP I would rather avoid forceps too, had that on my birth plan. I notice that you also mention you are also scared of an episiotomy, I had one becasue of the ventouse and can reassure you that it was fine. Local anasthetic so didn't feel it being done (as an added bonus you don't feel the dreaded crowning!) and also didn't feel it being stitched. It healed really fast with no issues at all - I didn't even need pain killers after the birth.

[higgle]

Correct, he wasn't stuck I was just dog tired and wasn't having strong cntractis anymore. i onl mentioned it as obstetrician said they wuld nothave let it go on for so long in NHS hospital and I'd have had an intervention at an earlier stage. i think at that time you had to be transferred to another hospital if you needed a CS so they tried very hard to avoid them.

[thing1andthing2]

Hi Revolting,
I had a birth plan just like your intended one for dc2. It was a homebirth, and I had a mild prolapse from the first birth so there was no way I was consenting to instrumental delivery for the second. My plan said homebirth, and at the first sign of lack of progress or malpresentation, please go straight to c-section. No instrumental delivery.
In the end I had a very straightforward homebirth so it didn't matter, but no eyebrows were raised regarding the plan. I think having the prolapse meant that they were understanding of my reasons, at least.

[BlueFishWonder]

Thinking about it myname my experience was exactly the way you described yours, so though I would love to avoid forceps this time around I don't know if I would be able too or if there was any alternative. the experience left me traumatised as I had lost so much blood needed a transfusion, didn't see DS for nearly 4 hours and was kept in hospital for a week but not sure I am fair in blaming this on the forceps as they were probably the thing that saved us....

[strawberrypenguin]

Yep myname my DS so so wedged DH said they almost pulled me off the table trying to get him out! (I was a bit out of it at the time, I'll take his work for it!)

[LovesBeingWokenEveryNight]

I did, when my midwife asked about my birthplam I said I only wanted to write in capitals letters across the page NO FORCEPS, she replied that she didn't blame me!

[LovesBeingWokenEveryNight]

I surprise that statistically there must be women who don't 'try' hard enough

[LauraSmurf]

Yes you can. I have a clotting disorder and it was possible that my baby would have the same one.

So I was told in no uncertain circumstances that forceps or ventouse we to be used for mine and baby's health.

They said if failure to progress they would prefer to push baby back up!! And do CS.

Just make it really really clear what you will and will not do. It was easy for me. I didn't have a choice, but they did say that pushing baby back up would be very VERY painful if that did happen!

[RevoltingPeasant]

thing1 thanks for that. Yeah, that's kind of how I feel. I really want a natural home birth but if it doesn't happen I'd rather be in a controlled environment.

I forget the PP who mentioned looking on the internet for stats on the hospital, but I did, so thanks :) and the hosp I am talking about has below national avg for CS but above for instrumental delivery, which makes me think they go for instrumentals over CS, possibly on cost grounds. It also has a higher number of complaints than other hospitals in the area and is rated as the least well performing in the area on one site.

Thanks, all. I know birth is a big adventure and what happens, happens, but this has at least helped me clarify thoughts. Now I just need to get pg - easy!!!

[MyNameIsAnAnagram]

Bluefish when I saw the cons this time to go over previous birth she said that instrumental deliveries were much less likely second time round even if you've had one before. Fingers crossed!

[Bibs123]

I had forceps and episiotomy, i was begging for a c section but they managedto talk sense into me as a section carries alot more risk to mum and babyand a much longer recovery. People should not refuse procedures unless properly educated about it, we are in the hands of trained professionals with years of training behind them who know more than we could ever know. I am glad i trusted my fantastic consultant as I was back to normal within 2 weeks. people can be a little arrogant to thinm they know better than a hospital consulatant about matters they are trained in.

[SchroSawMargeryDaw]

I had it in my notes, no forceps and no episiotomy.

They will ask you if the time comes though and you are not usually thinking the way you were when you wrote it and could give a completely different answer.

I ended up with both, I actually begged for them as had already been begging for an already promised c-section and was getting no where.

Btw, can anyone tell me why I keep reading about people going to theatre for forceps?

[SchroSawMargeryDaw]

Bibs That's not always the case, just because you aren't sure about the best option for you, does not mean that others don't for their own circumstances.

[mercibucket]

I always thought we were unusual in doing high forceps deliveries? Anyway, I put down a big 'no' to that on my form

And as an aside, sorry to be naïve, but why would pushing the baby up be v painful? Can't they do generals, or at least epidurals?

[Flisspaps]

People should not refuse procedures unless properly educated about it

And I don't think we should blindly accept procedures we're not properly educated about either. Doctors are not some sort of God.

people can be a little arrogant to thinm they know better than a hospital consulatant about matters they are trained in

People could also be construed as arrogant in suggesting that perhaps women should put up, shut up, and do just let the doctors do as they please regardless of what the woman wants.

[SchroSawMargeryDaw]

Flisspaps Completely agree with everything you have just said.

[StarlightMcKenzie]

Not only did I make sure that the midwives understood no forceps, but I made it clear I would not consent to the mcroberts maneuver for shoulder dystocia either.

[MrsPnut]

Merci, pulling the baby back up is bad for the baby. It puts pressure on the neck as the baby is designed to move down the canal head first.

With dd2 I was pushing for about 2 hours to actually deliver her, I did two pushes laid on the bed because the midwives wanted me there and then moved to kneeling against the bed despite their protests. It seemed to go on forever but thankfully they didn't mention forceps. I just had a big headed baby that took forever to move, but if I had stayed on the bed I think she would have required help.