Birth plan - forceps/ventuose/c-section question.

[BreeVDKamp]

I am currently thinking about my birth plan. If it gets to the point where the midwives are suggesting either forceps or ventuose, can I refuse and ask them to go straight to a c section? Or is it likely that by that point I wouldn't be able to have a c section? Why would that be? Baby too far down the birth canal?
I haven't read anything good about forceps or ventuose deliveries.... tears, prolapses, incontinence etc...... O_O I would much rather that if it looks like I'm going to need assistance, just skip straight to a c section. Is that naive and impossible?
Am hoping for an active birth, and an epidural and not being able to walk around really scares me, but I would take that over long term health problems from forceps!

(Also, I only just realised what a spinal block is. I thought it was a sort of cuboid anaesthetic device that attached to your spine for the duration, and was wondering how you could lie down with one of those in place. Then I read about a pudendal block - you can imagine my horror!! Then I realised it was 'block' as in, blocking out the pain! HA ... So much to learn...!)

I want to know the answer

Fwiw DS got stuck on my hip and they were talking about ventouse and I threw an epic fit that they were not putting us through any more because stupid midwife wouldn't believe he was stuck on my hip during the 2hrs pushing she forced - I got an emergency C section

I don't actually know if a new energency presented or if it was due to me losing my shit. DS had a lot of bruising on his head where he'd been banging my hip

It's not impossible, but maybe naive. I think it's best not to have a concrete plan for this situation but be guided by the Dr. Tell them that you'd really prefer not to have an instrumental and that if it's safe you'd prefer a section.

Sometimes if a baby is so low down it will need to be pushed back up vaginally for a section to take place. This isn't without risks.

My dd was a ventouse delivery.
However that was the least of my worries. Trapped placenta leading to spinal block before manual removal. I did need a few stitches but was walking round town relatively comfortably when dd was 5 days old.
C section is much more drastic IMO and means you can't do very much for around 6 weeks. You can't drive, lift very much etc as it is major surgery. If possible I'd avoid a C section unless medically advised it is essential.

My ventouse was done in the room (not theatre) and was really hassle free. I had stitches but they healed easily. Had it been suggested that they try forceps in theatre I would have pushed for going straight to the section.

As far as I know, if you have an epidural, you cannot be walking around or have an 'active' birth.
I had an epidural during my induction and I was labouring on my back the whole time - I was pleading to be able to be on all fours but they just wouldn't let me.
And i am convinced that it was because of the epidural that I needed forceps to deliver DS.
If it makes you feel any better, I didn't have any major issues after having the forceps delivery-just the kind of things you would expect from giving birth!
But if you are worried, talk things through with your midwife, or have you considered ante natal classes?

I also had a hassle free, straightforward ventouse delivery in the room with no problems at all - would definitely take it over a c-section and, although I didn't need ventouse for my second birth, would have had no problems at all having it again.

I had to have the epidural after my dd was born because of the trapped placenta. I was really gutted.

My dd was a ventouse delivery as she had a shoulder dystocia (sp?). They didn't know that at the time, it was only evident once she came out with one hand up.

If I'd refused and pushed for a c-section there is a high possibility she would have died.

Just to put the 'birth experience' into perspective.

They will try to encourage you to have forceps/ventouse. I had failure to progress and they wanted to get me to 10cm then do forceps. I was very clear that I would not consent to forceps (at 8cm) and the dr was VERY forceful in how c-section was not necessarily the best option. Baby in birth canal etc. I ended up with a c-section anyway but I think my very clear line on the forceps was part of what decided her to go for the section.

You're more likely to end up with interventions from an epidural - cascade of interventions - so think about that a bit now. I wish I'd been able to think about asking for a csection at the point that I'd been at 5cm for four hours instead of much later but it was ok.

My first DC was a Ventouse delivery, after a long stop/start labour and I was very tired and her heart rate was beginning to cause concern. I'd had an epidural put in a few hours previously as I was on my knees with exhaustion (none of that had been in my birth plan!!) so they topped that up ready for episiotomy, I felt nothing, the stitching healed well afterwards. A bit sore for a few days but nothing too bad and I was relieved not to be looking at the recovery after a c-section. The doctors and midwife just said, we need to get your baby out, if Ventouse doesn't help, we'll be looking at a section. So I don't know if that answers your query about timings?
The midwife helped me shuffle around and produce the biggest pushes ever and the Ventouse pulled and she came out after two sucks...
She then slept all night as she was exhausted!! Lucky for me, as I was exhausted too!
Subsequently her sister and brother were much easier deliveries and didn't sleep for their first nights!
Good luck and try not to worry. I was very nervous of all things medical as I'd never had any hospital proceedures before. I started off in midwife led unit which was lovely and in my plan, but the labour just took a different course, sometimes it does, but I felt very well informed and looked after x

OMG it all sounds horrific. I am scared now and desperately clutching my hypnobirthing book. Oh God I am deluded!

Except lentil's story. That's a good one.

I started antenatal classes on Friday Grey, I think they will be very helpful :) Really enjoyed learning about what the body does at each stage etc, I think that will help me.

Shoot wow, well done for losing your shit! Sometimes necessary I think!

Viva I think I've read before that you are a midwife? :) Thanks for replying. I am definitely trying to keep an open mind and keep my options open. But ventuose/forceps seem like the scariest option!

Jane good to know a quick recovery is possible! Oh no, I don't like not knowing what is going to happen...

Lots of X posts!

Kitty how come a c-section would have been so dangerous? Because it would have taken way longer to sort everything out, whereas they could do a ventuose there and then? Sorry for your scary experience.

As PP have advised, go in with an open mind re your birth plan but also make sure your birthing partner is well aware if your wishes as you may not be in a position to effectively state your case if it comes to emergency intervention. Make your preferences clear verbally early on as I found that my midwife didn't even look over my carefully written birth plan.

I was terrified of forceps but ended up with them anyway. I do have to say I had no ill effects at all, DS was out quickly and unharmed and I had a very quick recovery considering the intervention- I know every case is different and I was obviously lucky in that respect but I just wanted to put over a positive experience and say that at the time I felt very confident that the medical team working with me had my son and my best interests at heart and were acting professionally.

Good luck.

If I can be honest , imo a c section is to be most avoided.
I was induced and still didn't have my dd for three days. I had forcep delivery, epidiotomy and then had a haemorrhage and had an epidural.
I actually healed very very well and really quickly- much quicker than I ever would have with a c sec and have had no issues at all.
Many have long term problems from c sec so I don't think a forcep or ventouse delivery is anything more to be concerned about. It is also a quicker way to deliver the baby so would think it is safer for them from that point also.
I couldnt have a c sec as she was too far down the birth canal but an soooooo glad I didn't need one. I would have the same delivery all over again if it meant i avoided a c sec.

Be open minded. The hospital will always guide what is best for you and baby and ultimately that's all that matters. None of the options discussed are anyone's ideal but honestly, when your there in the situation you care less and just want babies safety. The experts know best so trust them as best as you can.

If it helps my second dc was very very quick and with minimal problems. Cord round neck but that was easily sorted.
If I'd had a third, it would probably have been born before I got to hospital.
Most deliveries are straight forward, but it is difficult to plan as babies do tend to have minds of their own.
Good luck when the day comes. Remember it's worth everything when you get to cuddle your baby

Another straightforward ventouse delivery in the room here. Not a smidge of pain and I didn't have an epidural. DS was almost out (dh said you could see approx a circle of head which was about6cm across) but I was exhausted after pushing for 3 hours. Did tear but most people do however they deliver. I took painkillers regularly following the birth and as a result that didn't hurt either.

Would have been WAY more dangerous to push a baby who was almost crowning back up!

I have said no forceps, but I'm happy with c section or ventouse. I have a lot of extra attention due to the problems I had with DS and a TFMR so they are aware already.

IMO ventouse is more gentle and less stressful than forceps. Would you be open to them?

First of all, please don't rely or set your heart on a particular birth plan. Your baby hasn't read and signed it! Just be as informed as you can be about all the options and trust the experts.

I had an epidural and forceps with ds (not in my birth plan!) and it was all fine. They needed to get him out quickly as his heart rate kept dropping and forceps was the quickest- it was a no brainer, why would I insist on going to surgery?
He was out and snuggled on me in a jiffy. Yes I had to be cut but there is that risk with a natural birth anyway.

As long as you and the baby and both fine does it really matter how s/he came into the world? Believe me you'll soon have other things to worry about!

Good luck and don't worry about it. It's too late now anyway .

I did hypnobirthing and laboured with just gas and air until the pushing stage, when my DD got stuck (I was also exhausted - can happen with first time births). I went for an epidural (not in my birth plan) and signed consent forms for a c-section if assisted delivery didn't work. Had a very neat episiotomy, forceps delivery and she arrived within two pushes. No lasting effects for either of us and jolly glad I didn't have to contend with a big tear as can happen.

The hypnobirthing gave me loads of techniques to stay calm which helped enormously. You can't "choose" your birth (unless ELCS) IMO so going in with an open mind and being prepared to be flexible if needs must.

A lot of others in my group were terrified of ventouse/forceps but I think you need to remember thousands of women deliver their babies this way every year and safely. Risk can't be totally eliminated in any medical procedure, even hypnobirthing can't do that!

Good luck! You'll be fine!

I had said in my birth plan I was reluctant to consent to use of forceps. In the event I was rushed to theatre for a crash c section (suspected placental abruption), prepped with spinal block, only for the surgeon to find when he did final check that actually I was fully dilated all of a sudden and the baby was practically there. It took 3 pushes and a minute or so with forceps, section would have been much longer and involved pushing baby back. By all means have in mind what you would prefer but be prepared for things not to go quite to plan on the day!

No it doesn't matter how the baby is born, I'm just looking for more info. I am pro-section just as much as I am pro-free-birthing! Just want some reassurance and good forceps/ventuose stories, and my original question to be answered, which it has been :) Definitely don't think I'd be up for the baby being pushed back up just so I could have a section!

Just really don't fancy having fecal incontinence. But then I don't suppose anybody does, do they?

It took 3 pushes and a minute or so with forceps, section would have been much longer and involved pushing baby back. Yes see that is what I didn't think about - c section taking so much longer to prepare.

Just carrying the baby and going through labour can damage pelvic floor, so there are those risks even with a section. Not that that made me feel any better about the risk!!

I felt the same way, OP.

The reality is at a certain point it is too late for a c section.

So my plan was to do everything Possible to avoid that scenario arising.
I chose to go to a midwife led unit.
I read up on everything to do with childbirth so nothing would be unexpected and I'd know what I wanted in every scenario.
I refused induction.
I stayed upright and off the bed until the later stages.
I refused an epidural.
Lots of little things too but they were probably more psychological.

Most women can avoid unecessary intervention if they don't require it for a medical reason if they are properly prepared and supported to have a natural birth. This essential support is often lacking in the NHS. If you have the money what I'd most recommend is hiring an independent midwife.

Yes Bree, the c-section in itself wouldn't have been dangerous but prepping me as I'd not had an epidural and waiting for theatre would have meant dd possibly wouldn't have made it.

As it was they shoved me on an oxytocin drip, did ventouse and a huge episiotomy in the room and all was well.

To be honest it didn't feel scary at the time, everyone was very calm but firm about what had to happen really.

It wasn't until our 'traumatic birth' debrief did we realise how serious it had been.

And the ventouse/episiotomy wasn't bad at all. I'd say my recovery was on par with my friend who had an elective section but then my stitched ruptured on day 5 after a hematoma (sp?) so I was set back a bit.