WWYD - Bad Forceps Delivery last time.

[TattieHowkerz]

4 years ago I had DD at 38 weeks, induced due to diabetes.
I am nearly 13 weeks with my second and beginning to think about the next delivery. It will be another 38 week induction.

I had a difficult labour as it came on quickly and I wasn't allowed to move off my back due to continuous monitoring. After a long stage of pushing 8lb11oz DD was delivered with mid cavity forceps. Later we were told there was cephalopelvic disproportion i.e. Her head was too big for my narrow pelvis. The first attempt at forceps didn't work, a more senior member of the team came in and delivered DD. Her face was injured, with the top layer of skin basically shorn off in large patches on each cheek. She attended the wound care clinic for more than 18 months and still has very light scarring on her cheeks (most people wouldn't notice it) plus a large teardrop shaped scar at the edge of one eye socket, caused by skin splitting and crushing. I had a post partum haemorrhage and we were in for a week following delivery as Group B strep was detected in DD's wound.

I feel like something went wrong, but everything has been played down (covered up?). Obviously I am glad to have a healthy child but I feel sad that my daughter was in a lot of pain early on and has these scars, I'm not sure it was necessary. I also have mild rectocele.

I attend the high risk obstetric clinic but haven't seen a senior member of the team yet. I've been told they'll expect another vaginal delivery. I'd prefer this, but not if it is likely to mean similar outcomes for me and the new baby! Not sure how to proceed. I am worried no one will be honest with me as I think they were scared of being used last time (couldn't get a minute to myself in hospital without someone popping in from the medical team for a visit - not a consultation).

Just not sure how to proceed, or if I have too negative a view of my last birth.

Used = sued!

Oh my goodness, that sounds absolutely brutal. Your poor DD.

I'd proceed straight to ELCS. No question. I had one myself after a third degree tear with DC1 (it was a textbook waterbirth, so I came to the conclusion that my anatomy just wasn't up to the task of delivering a 7lb 15oz baby).

It was fantastic. I spend the entire pregnancy not having to worry about the delivery (facing a natural birth would have had a massive impact upon my mental health) and I didn't have to worry about any further damage to my pelvic floor.

Bearing in mind you have diabetes, will face another sizeable baby (most likely larger than the first - my second was 8lb 7oz at 39 weeks) and the cephalopelvic disproportion AND the rectocele, I really don't think there's a dilemma. You want to avoid damage to the baby and to yourself.

You hear a lot about the risks of ELCS but in my opinion, I wanted to take the known risks of surgery vs. the many and varied unknown risks of vaginal birth. Didn't regret it for a second. Recovery was easy, pain relief minimal, scar nearly invisible nine months later

I had forceps with DS due to back to back it was horrific luckily I came off worse DS was just a bit bruised and shocked but I will never never in my whole life do that again, when I think about DS birth I remember confusion fear pain it makes me so sad I have no happy memories from that day I know I felt happy seeing him because there are photos of me looking at him in amazement but when I think back none of the good bits stand out just the bad. I remember 2 consultants standing in front of me giving their arguments for a section vs naturally and being so confused, I wish i had went for the section it would have saved hours or pain and the trauma of forceps.

I'm 12 weeks with my second and said from day 1 of even trying i said I'm having an elcs this time I want to remember the happiness and feel in control if any decisions need to be made.

How awful everything you and your DD went through

I can really sympathise as I had failed forceps and ventouse (7 attempts) that ended in an EMCS with my DD 2.5 years ago. The damage done by the forceps was so bad DD spent the first week in NICU and was monitored for suspected cerebral palsy for the first 18 months of her life. She has come out of it all with no long term effects thank goodness.

I'm now 34 weeks pregnant with DS and going for an ELCS. I know there are risks with a CS but on reviewing all the information they gave me it seems the risk of a CS is to the mother whilst the major risks of a VB are largely to the baby (although I don't think they're very upfront about this in their data). There is no way I could face the possibility of having a repeat of last time and would happily take the risk on myself rather than even marginally increase the risk on my baby. Though I am very aware that my perspective is very shaped by my previous experience!

It's a very personal decision but from everything you've said I would be going straight for an ELCS if I were you. Best of luck whatever you decide.

Obviously I don't claim that this would have made a difference but it's impossible to measure pelvic proportions when a woman is laying on her back. During labour the sacrum moves to allow the baby through. I'm horrified on your behalf that they would be so brutal with forceps rather than help you onto all fours.

I agree, I would be insisting on an elective section if it's unlikely that you would be encouraged to be able to labour in a more mobile way. C section has risks and it will probably take longer to recover from but the chances that your baby will emerge ok are good and I personally couldn't risk going through what you describe a second time.

My first birth had some similarities to yours induction stuck baby & rarely used high forceps i also was v.poorly myself after birth dd was luckily ok though had to be resusitated. I was induced again for ds (dc2) for gestational diabetes he was 9lb 9 and all was good - very quick no forceps. I wanted to avoid elcs if possible due to potential recovery time. I think you should ask lots of questions to midwife and obs team and see how you feel only you can decide. Just wanted to say it can be very different.