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

I had a forceps delivery without anaesthetic and it was horrific - sorry, but you asked! Was traumatised for a long time afterwards. Would rather have had a c-s.

I`m with you on that one Roobedoo

Just as a balance to all the dreadful stories I am sure you have been told, I had a ventouse delivery with no pain relief and there was nothing to it. I had a tens machine which kept the contractin pain manageable but tbh, I wasn't aware of extra pain because of the ventouse thingy. My dd was 8.6lb so no lightweight and I had very minor tearing. I refused to listen to anyone with a birth story before I had dd and went into it thinking I would get through it all ok and I did. I don't think that negative stories are at all helpful to someone about to give birth. Penny, don't be frightened, giving birth is a natural purpose for which we are designed and you will be fine.

Hey - just remember 70% of births are normal with no complications so pls remember that this is a big if.

Pain wise labour can be managed with diamorphine (if you are allergic to pethadine), entonox, TENS, water, massage, hypnotherapy etc.

If the worse really did become the worse there would most certainly be time to give a general anaesthetic if a local block ie spinal or epidural was not an option.

Stay positive and enjoy your birthing!!

ps another point - having an epidural increases your chances of having an instrumental delivery - so if you can't have one you're reducing the likelihood of such .

Sleepymum - I am not sure that hospitals (well in my area anyway) are more careful now. The woman who performed my forceps delivery pulled so hard that she fell over.

I also know 2 women that have recently had high forceps deliveries.

Willow2 - I was interested in your comment about prepping for a c-section prior to forceps, as I was not prepped at all for this.

Mears - I had a local block, but I can tell you this was not effective pain relief at all for me. I felt absolutely every excruciating pull. I felt like I was going to die by the 5th pull. I actually blacked out for just over an hour as I don't think my body could handle that level of pain. Not a great thing to miss the 1st hour of your baby's life.

Just thought I'd add a positive note here. My second child was born by forceps and I had no pain relief at all, not even gas and air. As I remember, I had some sort of injection to numb the area and was then given an episotomoy (which I had always feared but actually it was OK) and then they tried with a ventouse then forceps. I remember some tugging but honestly I cannot say I really remember much else, it really wasn't traumatic for me. I did concentrate on my breathing and also had hypnotherapy once about a month before my delivery. Took a bit of rescue remedy and that's really it. I had an emergency c-section under GA first time around and the thought of going through that healing again made me determined to try and not have a c-section again.
I honestly can say I preferred the forceps delivery, don't know if this helps?

Hi pennycat,

I had a c-section with my first dd under a general as my epdiural top-up failed and to be honest I did feel totally disappointed and robbed of the chance of hearing and seeing my baby cry on delivery. So with my second I was determined to try for a VBAC, if it meant forceps or ventose then so be it. WHAT AN IDIOT I WAS!!!! I was given a trial of labour which was about 6 hours, in which time the baby turned into a posterior position which was the reason for my first c-section. I then begged the consultant for a c-section who insisted I should try with forceps first. She had to manually push back my cervix as i wasnt fully dilated and then haul the baby out. Thankfully I did have an epidural in place which was working extremely well, but the pain afterwards was incredible. The stitches became infected, breastfeeding became really difficult because of the pain and the recovery for me was alot slower than with the section I had. Even now 6 months after the delivery I am still experiencing alot of pain. If I ever have another baby I would be for a c-section under a general.

I don't think you would be offered an elective C-section to save you from forceps unless there was a real medical need, as I am sure low platelets make an operation dangerous. And a general anaesthetic is dangerous too.

A caesarean is not the birth of choice, I've had 2 emergencies and I know the experience was a lot harder than my friends who managed a vaginal birth. However, if there is any doubt as to whether you can deliver vaginally then a c-section is preferable. My first was a very long labour, stuck baby, failed forceps, emergency section and a very sick baby. It took me years to get over. Mental trauma can last longer than physical trauma sometimes.

Word of warning you can get terrible adhesions from a previous c-section. Second baby was a planned section, but I went into labour early (due to my womb not stretching any more and too much fluid - and I had 5 weeks of agony in late pregnancy). I was offered the chance of a vbac but chose the section for lots of reasons. Good too, because she was unexpectedly breech this time and if I can't deliver head down I wouldn't have managed breech. I knew something was wrong when they got into me, and they told me later that it was tricky to find somewhere to cut my womb, because the adhesions could have bled out. My baby was a devil to deliver too, it took two grown men a few minutes to push and pull her out.

All down to a mismanaged first pregnancy (induction too early).

It took me 2-3 months to even be vaguely over the 2nd section. Even now at 4½ months I get days where I feel a bit better and realise how bad I have been.

Is there nothing they can do for your platelets? Can they not transfuse some to make the experience safer?

I hope you have a successful meeting and hope you are in the 70% who have a good birth experience.

I had an episiotomy with my first baby but managed to push the baby out before any forceps/ventouse equipment were brought out. The doctor did inject local anaesthetic before performing it, but I thought the local anaesthetic was rubbish as the episiotomy and the stitching of the wound afterwards hurt like hell! I also had G & A to inhale on throughout the whole process but G & A did squat for me with regards to pain relief. Instead, it just made me feel dizzy and sick while being aware all the time of the pain!

After that, the consultant inspected my wound and thought there was something wrong, so decided to order the doctor to have my stitches taken out to check for any problems in there. My doc then decided to put me under epidural while she took out the stitches, checked inside and redo the stitching... The epidural was like sweet heaven to me at that point - nothing compared to local anaesthetic. It really blocked out all the pain. Thing is, I could cope quite well with the pain of labour, but I really can't cope with the pain brought on by incisions/instruments. Maybe I'm just squeamish about these medical procedures.

From what I've heard, it seems most forceps/ventouse deliveries require an episiotomy to be performed beforehand anyway, but if I could turn back time I would definitely have gone for an epidural before the doctor made any sort of incision to me downstairs which required me to be fully conscious while the whole procedure was being done.

Hello everyone, Thanks again for all the comments.

Thought I'd let you know what they said yesterday. Saw anaethetist (sp? again) consultant and he was very nice. The plan is not perfect by any means but I don't have any choices now and as many of you have said this is the worse case scenario and hopefully not necessary for me.

No chance of epidural as platelets low (they cant transfuse them as it is not effective) but also they have decided that due to some other medical things I am likely to have enlarged veins in my epidural space and therefore too risky. They will give me a PCA (pain pump) of pethadine which gives a lower dose over a longer period if I want pain relief, even though it makes my BP drop and I feel really bad on it and it makes baby sleepy (they woud use naloxone if baby comes out sleepy to counteract effects).

If I need intervention they will not use forceps unless desperate and if so they would put me under a GA. They would like to use ventouse with no extra pain relief.

Its hard to take it all in really, I know its really not what I want, they won't allow me a pudendal block due to bleeding risk and meptid was not discussed. I have a strange other consultant who is a bit of a tease and he said..'this is going to be a very medical birth, I want you to push this baby out, it would be too easy for me to cut it out and so I'm going to make you push it out!' He said I would be strapped up to a continious monitor and pain pump, and as I get low BP from pethadine am unlikely to be able to move around. And no water or baths either. Bit gutted but as my mum says I'm having a baby not a 'birth'.

Sorry its a 'me post' but thought it would be interesting for all who kindly offered their experiences to see the outcome (so far) of the decisions made.

Thanks once again xx

One tip with G&A if you are on continuous monitoring I found that if I waited until I could feel a contraction before taking a breath of G&A it did diddly squat for me, but part of the monitoring machine featured a sort of contractionometer that had a number that would increase according to how strong a contraction was. For me the number generally hovered around 10 when I wasn't having a contraction (it got up to... um... lots (at least 80 or so) when I was) and after a while DH's job was to watch it and tell me if the number got up to 20 I found if I took a deep breath of G&A at that point (when I still couldn't feel anything) it kicked in properly for the painful part of the contraction. A few times he forgot or wasn't paying attention and I could really tell the difference.

good luck pennycat

pennycat, I had to be continuously monitored too for my second birth, first time around I wanted a water birth, little intervention etc but ended up having a c-section under ga, which leads to you being monitored next time around. What I found that helped was, staying at home as long as possible, I had baths etc, my sort of water birth!, went to hospital, already 10cms. At home I also used a tens machine which I thought was great, really helped, also did a really good breathing course which also really helped with pain relief, used rescue remedy, not sure on that one!, and finally I had hypnotherapy which I do think helped. This all made me feel like I still had control. BTW although continually monitored I didn't lay on bed for long as just didn't feel good, instead I stood beside it for most and then went on all fours on the bed. In then end rushed to theatre and given ventouse and finally forceps. I have to say second birth was miles better than first as I got to see my baby as she was born.
Really do wish you loads of luck.

thanks LeahE - thats a great tip - I've heard that timing is important with G and A so thats a greathelp - have told hubby thats his job already!
Katierocket thank you and janus - thanks for that, yes I'm looking forward to getting my TENS as I think that could help early on, also I will try and stay at home as long as possible but we live about 25miles from the hospital so don't want to leave it too long but I think the bath may get heavy use at home!!!

Thanks guys!
Pennycat

Really good luck Penny, you will be fine.

Hello pennycat, i'm new to this discussion. I have no opinion on forceps etc, but have you thought about addressing your fears about the delivery. Hypnobirthing is meant to be very good. I know you don't have much time... Its just that the calmer you are going into it then chances are the better it will go for you. I found the midwives to be great. I asked that they not cut the cord untill it had stopped pulsing (so that my boy would breathe on his own when he wanted to) and the midwife remembered even when i forgot! good luck girl!!

...Bit gutted but as my mum says I'm having a baby not a 'birth'.

Are you my sister? This is exactly what my mum told her!!!

Pennycat (welcome BTW - what a stonker of a first thread! ) most of this thread has been about what may happen if you need pain relief or assisted delivery. Of course you are very right to prepare for that, but I'm sure you're aware that you may need neither of these things, and that by concentrating on preparing for a fairly natural birth you will help yourself to achieve that.

When yuo give birth your body takes over and gets on with it. What your head needs to do is to help your body - just as what your birth partner needs to do is to help you. Prepare with birthing classes, TENS, Hypnotherapy even. Talk all the options through with your birth partner so that you are both confident that they understand your wishes and can be your advocate if you become inarticulate (which does happen, because you get so inside your own head).

Have confidence in your own ability to give birth. At the risk of sounding corny, welcome each contraction - each one brings you closer to meeting your child. Keep an open mind about what may help, and discount nothing - I didn't want to be touched, even by dh, during labour, and that was a mistake as I got very tense and everything slowed down horribly. The next birth I accepted his touch, and we tried different things until we found what helped me best, and the birth was utterly different that time.

I know thta this isn't what you asked for in the OP, but wanted to try and balance out the scariness of most of this thread, and remind you of alternative possibilities.

Hi All

Pretty candles - thanks for your support, I agree that this thread has been about worse case possibilities for this birth but I in no way have this planned. I will be using TENS and trying as much as possible to be as calm and natural as possible, its just scary talkng about the 'what ifs' but I also suppose its good cos as least I have some idea of what may happen. Both hubby and mum will be around at birth and no one messes with my mum and I feel confident that she will make my wishes known when I may not be able to!

This is an IVF baby so we are very blessed after 4 attempts and we're just so excited!

Thanks to purple duck I have had hypnotherapy before and its not for me but relaxing 'womb music' I find excellent so I will be using that if possible! Thanks for the ideas though! We've done our NCT classes too which were good.

Willow2 - Not sure if you are my long lost sister but would be strange if you were!!!! Hope you are well!

Pennycat

If you are you hid the pregnancy very well the week before last!

Hiya...
Im not sure but you will prob. have episiotomy with a local aneasthetic (?? sp) if you have forceps or ventouse. I had an episiotomy and ventouse but had an epidural, but they def. give a local if you havent had one. Remember they are experts and wouldnt want to use forceps or ventouse unless it was nessessary. Your so caught up in the moment anyway you'll barely think about what they are doing. My baby was in distress, which is why they used the ventouse - im not sure what would have happened if he wasnt born quickly. Also, forceps/ventouse are only used about 15-20% of the time (check birth choice uk for your hospitals %). Please trust the midwives and doctors and believe me - its not as scary as you think.

Sarah x

Hi Guys

I had a spinal with my first delivery which was a c/sec, and a ventouse with my 2nd,after being prepped for a poss 2nd section. 2nd delivery much better, and although had episiostomy, recovery much quicker than with a section.

Hi Guys

I had a spinal with my first delivery which was a c/sec, and a ventouse with my 2nd,after being prepped for a poss 2nd section. 2nd delivery much better, and although had episiostomy, recovery much quicker than with a section.

Hi Guys

I had a spinal with my first delivery which was a c/sec, and a ventouse with my 2nd,after being prepped for a poss 2nd section. 2nd delivery much better, and although had episiostomy, recovery much quicker than with a section.