Can I refuse forceps?

[pennycat]

Hi a newbie here, can you help me please as have appointment tomorrow at hospital to talk to an anaethetist (sp?) re my birth. I'm 35 weeks with first baby, have low platelet count so can't have an epidural which was something that I may have wanted to consider. Also can't use pethadine as allergic to it. If necessary can I refuse forceps/ventouse as I don't think I will have enough pain relief with G&A to cope and I am terrified of that outcome. Obviously I'm not thrilled about idea if C-section under general too but think it frightens me less.

Sorry to waffle on but can anyone tell me if you are allowed to refuse and at what point I should do that?

Many thanks guys..this website is a godsend!
Pennycat

this is upsetting!
I had forceps 1st time and it wasn't a choice, apparentyl there was no time for a c/s, had to get him out!
forceps are horrid but, for me they weren't a choice but a necessary evil. And I'm now fine, thank you.

Willow, I had a forceps delivery and it was fairly brutal, but I can't - just can't imagine a C-section being preferable. For me.

I guess I am missing something. I find what you are saying interesting.

MissChief, what's upsetting you? You say you are fine now, why does this thread make you feel upset?

i am fine, that's the point. More to the point so is ds1, thanks to forceps! It was'n't a lifestyle choice to have forceps or "rejection" of a natural birth FGS, it was necessary and medically recommended. sorry not ranting at you, F& Z, just [cross] that some are naive enough to think that you can really "choose" whether or not to have forceps.
also i did not have a 4th degree tear and no no-one who has.

and ironically i'[d been trying for a homebirth (which i got with ds2) so it wasn't exactly to plan to have forceps!

I think willow is saying that forceps births are used too often / recommended too often by medical personnel, MissChief, not that we as mothers should have rejected forceps and laid there with our babies stuck in us

Or that's how I took it anyway

I am another homebirther who ended up with a forceps delivery, btw

Expat - you seemed to have missed Pennycat's main concern that it is forceps without any pain relief that she is concerned about, and is wondering whether she can ask for a cs rather than forceps-with-np-pain-relief.

And I didn't shout at you, but you replied with a ffs.

Can I just ask, who amongst thoise saying 'I had forceps, don't set yourself against it' had forceps WITH NO PAIN RELIEF? Just asking for clarification, because it isn't clear.

I decided to get that last comment but one deleted. Getting a bit hot and bothered over this and don't want thread to lose track of OP query and go off on massive tangent. Essentially, point I'm trying to make is that a nice, carefully managed c-section can be preferable to forceps. Most important thing with any birth is that mum and baby are ok at the end of it all. Think it is very easy to get caught up in the "perfect birth" myth and forget that fact - I know I did. Or - as my mum said to my sis' when it became clear that her desired home birth wasn't going to happen - 'you're having a baby, not a "birth" ". FWIW, Pennycat - I don't think they could give you forceps/ventouse if all you've had is G&A. But talk it over with your consultant. Whatever happens, I hope everything goes really well for you and look forward to seeing you posting in a month or so as a proud mum.

i had forceps with gas & air, not out of any heroic last stance but again because there wasn't time to give any other pain relief. It was ok as i was so out of it by then.

I had pain relief, and wasn't saying "I had forceps, don't set yourself against it", but was saying "try to keep an open mind". About as much as possible. Because I don't know many people who had the birth they wanted. And I think we'd all beat ourselves up about it a lot less if we went in with the aim of coming out with a baby, rather than achieving this that or the other in terms of the birth itself.

Don't know if that "naive" comment was aimed at me, but you most definitely can choose not to have forceps in as much as you can opt for a c-section if the labour fails to progress, rather than hanging around for days, waiting for something to happen. Obviously, you can't make that choice in some situations - and am by no means suggesting that anyone is wrong to have had a forceps delivery.

I chose an emergency CS over an attempt at assisted delivery. I was petrified at the idea of forceps or ventouse and and it was one thing I was keen to avoid from the outset. However, in my case, the consultant - when pressed to give us the odds of a successful assisted delivery - reckoned it was 25-30%. Had it been 90%, my decision would probably have been different.

i'm sure you can. In my case tho, my baby's heart rate suddenly plummeted tho so there was no time to prep me for a c/s. that's why i was a little upset by some comments on here.

that was to willow btw. we're all getting rather heated I guess, lots of crossed (and cross) posts!

sorry, i think that i have missed out a critical chunk of discussion whilst composing my post. hopefully, pennycat, your anaesthetist will come up with some sensible strategies for pain relief, whatever the scenario. i hope it goes well for you tommorrow

pennycat - if you cannot have an epidural, but needed a forcep/ventouse delivery, you would be given what is called a pudendal block. That means local anaesthetic is injected into an area that blocks the transmission of pain for the use of the forceps/ventouse.

Please be reassured that if there was any question that more pain relief was required for delivery, it is highly unlikely that this type of delivery would be attempted.

Are you allergic to only pethidine or all opiated? We do not use pethidine at all, we use Morphine. There is another alternative pain relief injection called Meptid which you might want to look into.

You certainly can refuse forceps/ventouse but that may not be the right decision as the only recourse then is C/S which is not necessarily a good option with low platelets unless absolutely necessary.

It would be a good idea to research how to enhance the chances of a normal delivery with mobility, avoiding induction if possible etc. As well as speaking to anaesthetist, it would be a good idea to speak to the senior midwife in labour ward too.

That is a wonderful and re-assuring post, Mears.
Pennycat - as I think you are new to MN (and welccome, by the way!) you may not know that mears is an experienced midwife.

Hope your appointment with your aneasthetist is re-assuring. Good luck.

Wow thanks so much for all the opinions and replys, I think the heat has made people very expressive about this! Expat hope you are ok and not feeling like everyone was mean to you (hugs!) Thankyou for your comments.

Its great reading others views, I just want to clarify, I do not have a birth plan and I do not think my birth will be 'perfect' far from it, Blu was right, I am simply scared silly of forceps with minimal pain relief, if I had an epidural I'd go with the flow. I also respect all those who have had forceps and agree that at times medically you need to accept these things, but whats really helped is Mears actually pointing out many of my points going round in my head. I had read about a pudendal block and meptid (was once a nurse) and will mention it tomorrow to see how they feel about these things. I agree a section under GA is maybe not great either, and I agree that induction is preferably off my list if I can avoid it.

Can't thanks all you ladies enough for taking time on this hot sticky day to reply.

Pennycat

Wow thanks so much for all the opinions and replys, I think the heat has made people very expressive about this! Expat hope you are ok and not feeling like everyone was mean to you (hugs!) Thankyou for your comments.

Its great reading others views, I just want to clarify, I do not have a birth plan and I do not think my birth will be 'perfect' far from it, Blu was right, I am simply scared silly of forceps with minimal pain relief, if I had an epidural I'd go with the flow. I also respect all those who have had forceps and agree that at times medically you need to accept these things, but whats really helped is Mears actually pointing out many of my points going round in my head. I had read about a pudendal block and meptid (was once a nurse) and will mention it tomorrow to see how they feel about these things. I agree a section under GA is maybe not great either, and I agree that induction is preferably off my list if I can avoid it.

Can't thanks all you ladies enough for taking time on this hot sticky day to reply.

Pennycat

'expressive' . Pennycat - you are going to be a top Mumsnetter!

Are you now in the Diplomatic Service Pennycat ? Welcome to Mumsnet and keep us posted as to how you fare Best of luck with the birth.
Meptid was readily available at our hospital as the preferred alternative to pethidine.

Coming to this very late, but I had forceps with my first. It was an emergency and although I'd been on gas and air the cannister had run out when they needed to get her out so I had the delivery with no pain relief at all. It was not what I'd hoped for but the most important thing was a live birth, and I did get that There was not time for any other options. The pain of delivery was intense but transient. The pain of the episiotomy and tear lasted a few months, but it also faded. I wouldn't do too much worrying in advance - you might have a great labour and birth and if you don't tbh if your baby is born alive and well you really won't care how that happened, and pain does fade.

Hi

I ahve not read all of this so apologies if I am repeating.

I ahd rotational forceps with my DS. They were actually used with a spinal in theatre as a last attempt to unstick him before resorting to a caesarian. I am really glad this was pursued and I ended up without a c section.

I hated the idea of intervention in advance but to be honest, by the point at which forceps are being suggested you will just want your baby out!

Lots of luck xx

Hi Pennycat,
I had a rotational forceps 14 years ago and many complications following-including a 3rd degree tear. Since had 3 operations to help with bowel incontinence and my flower refashioned ! Ds1 born 3 years ago and i wrote one thing only on my birthplan-i do not consent to the use of forceps. We have the right to give or not give consent as long as it is an informed decision.I know not everyone has such complications following forceps and there must been a majority that have a good outcome.Also im certain there are even more risks with c section.However i didnt want my baby helped out in that particular way .I think hospitals are a lot more careful nowadays and will only attempt forceps with a certain amount of pull.I also think (but may be wrong as i pften am ) that the type of high cavity forceps i had are no longer used anyway and a c section is the prefferred option to that now. Hope you make the right decision for you.