No to forceps and ventouse?

[susie100]

Hello all,
I am new on here and expecting first baby in 2 months time. Just finalising my birth plan and wondering how hospital will react to 'no forceps or ventouse' on my birth plan?
I strongly feel that if things aren't going to plan despite position changes, active labour etc I would rather have c-section than an instrumental delivery. Am terrified of being cut, horrific tears etc and of any effect instruments can have on the baby. I know there are risks with c-section too but am prepared to take that risk. Would either want to do it naturally (I know you can tear but less extreme generally) or have a scar Ican see! Many people seem to be of the view (which I share) which is either natural and intervention or c-section. It is the in between, loss of control, scary interventions which seem to be the stuff of birth trauma!
Do they have to listen to me? I know they need my consent to perform anything but could they refuse a c-section if I refuse instrumental if you see what I mean?
Thanks in advance for your help!

I see birth plans as more of a general idea of what you would like rather than what is definatley going to happen. They will listen to you and only use ventouse or forceps if it's really nessescary and only with your consent.

With DD one's birth, his heart rate dipped while I was pushing. I could tell by the look on the midwife's face it was serious. An obsteotrician appeared as if by magic, and delivered my baby by vontouse. I tink if you find yourself in this position there is no way you are going to argue about it. And they wont ask, they'll just get on and do it! My DS was fine, I didn't need an epesiotomy, and I only had 2 stitches.

Hi Susie

I would echo the comment about general ideas and birth plans! As my LO came early we didn't even take the birth plan to the hospital...

Just to share my experience: my DS got stuck after a very long labour. I was pushing and pushing but every time his head crowned it would disappear back in! They realised that this was happening because the cord was round his neck and pulling him back in and got him out with ventouse very, very quickly. He suffered no ill effects at all apart from a rather pointy head!

I think very few births are cut and dried, if you see what I mean. It's great that you are thinking about taking control and educating yourself but I would say: don't rule anything out as you never know what might happen!

If you're worried, why don't you talk to your midwife or doctor? They might be able to reassure you. Have you had a tour round your hospital yet? That's always good to do, and a good time to ask questions.

They won't use ventouse or forceps just for the fun of it, honestly But it is a clinical decision and you would have to have a pretty major phobia before they would decide to perform major surgery on you if you don't need it.

I understand where you are coming from and I sort of felt the same way, but in the end I had ventouse and although it was traumatic, that wasn't because of the ventouse itself but because the situation of needing assistance was traumatic. And whereas the ventouse was over with in a matter of 5 minutes, a c-section would have taken a lot longer and involved a lot more cutting/longer recovery.

Do you think you might be projecting your fears about labour onto this one part and hoping to get some control? That would be perfectly normal, but I think you might want to talk this over in more detail with your MW before making a final decision that they might not agree with anyway.

Hopefully you will have a normal delivery anyway..good luck

personally i fought hard for a trial assisted delivery (ventouse - successful) after a long posterior labour labour when they wanted to section. the recovery time was much less than a section would have been and it's given me a much better chance of having a straightforward vaginal delivery second time round.

my "small" episiotomy gave me much less trouble than (unscientific survey) 2 of the girls in my antenatal class who tore badly in their natural deliveries.

if you're in a position where it's a choice between instruments or section you're already into the "loss of control" territory i'm afraid, it's not the same as a scheduled section any way you look at it.

Just to add he no longer has the pointy head...:O

Susie,I think you should write what you told us,rather than bluntly putting "No ventouse/forceps",otherwise what Goingfor3 said.
Try to keep an open mind though,you really don't know how you will feel when you are in the moment.

I am of the opinion that birth plans are a bit of a waste of time. As goingfor3 says, only really worth while as a general idea. IMO you never know what is going to happen with childbirth so how can you plan it?

Not sure i really understand why you wouldn't want forceps/ventouse but would be ok with c-section.

Personally, i would take the advice of the mw and doctors as they've been there lots of times before. They only do something if they think it's right and best for you and the baby.

sometimes a c.s is better than forceps or ventouse....i know of women who have put c.s rather than instrumental birth in their birth plans...

however, if you are simply a little tired ,and baby just needs a helping hand, then instrumental is possibly better than full blown surgery

you can certainly say you prefer one over the other, but it is one of those wait and see things!

Hi susie100, sorry I don't have time to read the whole thread but am sure you are getting some good advice. Mine is to avoid induction if poss as statistically your chances of all sorts of interventions increase if you are induced. If you have a good library ask them for a copy of Your Birth Rights by Pat Thomas. Best of luck.

Like krang my ds's cord was round his neck. The consultant acted very quickly - one snip, pull of forceps and he was out. He had a slight mark on his cheek which faded after 4-5 days. A C-section would have taken longer, my recovery would have been slower, and it's major surgery.

To be honest, I don't understand why you'd rather have major surgery, with more chance of complications etc than forceps. Would you feel differently if you knew they would give you an episiotomy rather than letting you tear?

As others have said, birth plans are only a guide, when you're in the midst of labour your preconceptions often go out the window.

Echo what everyone else has said - at the end of the day what you and the medical team want is a healthy baby (and Mum!) - certainly state what you would like to happen but don't rule anything out....

I can completely understand this I definitely did not want a forceps delivery and told the hospital right at the start of my induction that I would not consent to this. I was less anxious about ventouse as they look less traumatic for the Mum and baby.
In the event it didn't come to this as I had a failed induction so went for a c-section. It would be worth telling the hospital how anxious you are about this when you go in.

I didn't want a c/section or ventous or forcepts, but after pushing for nearly 3 hours I wanted them all!

Instead of putting it in your birth plan discuss the procedures with your practitioner.

I don't know anyone that has had a vaginal delivery, and I was very concerned so I had a talk with my doctor and she explained the circumstances to which she did C-sections and what the procedure was like and what would be allowed to happen to me. Needless to say my fear has waned.

Thanks for all your replies!
The reason I don't want an instrumental is because I am terrified of longlasting problems - pain, incontinence etc. Seems that all the heartbreaking threads recently on mumsnet of ladies with 4th degree tears, still suffereing sometimes years after birth have involved instrumental deliveries.
I certainly don't take the risks in c-section lightly and would want to avoid this but I know childbirth is unpredictable and life is risky!
I would not want to do anything that endangered my child, obviously.
NineUnlikelyTales - You are right, I am projecting these fears onto this one element of birth. i think (maybe naively) I can put up with anything for 72 hours but a 4th degree tear and longlasting problems are the worst case scenario for me, however unlikely.
Lulumamma - I am interested in why your client put this on her birthplan? Did she have a previous bad experience?
I will talk to my midwife about my concerns, hopefully she will provide some reassurance (although given I have seen a different fraught midwife everytime I wonder how reassuring she will be!!)

Sorry to contradict you LynetteScavo, but from a legal point of view, they would be in BIG trouble if they "just got on and did" an assisted delivery without consent. That is assault. So, if you definitely do not want an assisted delivery, say so in your birth plan. (You can, of course, change your mind during the delivery if you want to).

Good luck with the birth!

My midwife seemed to spend just as much time writing as attending to me. Every time something was likely to be different from my birth plan she would tell me about it, make me confirm it was okay, twice, and then write it down!

My birthplan won't be so ridgid next time, - it made things slower and more difficult!

I was surprised (honestly) to find that the hospital wasn't full of bored/lazy midwives trying to torture me with all kinds of horrible instruments/chemicals!

They'd really rather not if possible!

I see what you are saying although birth experiences seem to be down to the luck of the draw in terms of which midwife you get, how well staffed they are on the night you are there etc. Obviously your body plays a part in how things go as well but those around you seem to make a difference as to how traumatic everyelse, how well explained, how in control you feel.

I am also terrified of the instrument wielding midwife (or junior doctor in fact) Hoping to get a nice one who is 'with woman'. I imagine if you trust the professionals caring for you, you will be to accept whatever they suggest. Maybe that is the issue for me, deep down.
Maybe I should get a doula?

I would say to get a doula or make sure that you birth partner is someone who understands your fears and will not be afraid to advocate for you.

My poor husband gets to listen to all my fears and worries about this delivery (after all I had a great delivery once, why would I ever have another one) The good thing is that he is aware of how I feel and what I want, and knows that it's his job to make sure that labor and delivery go as smoothly as possible.

Chocolate Bar, I won't go into now, but have had rather a lot don to me whilst in labour with out my consent. The only way the midwives would have got into trouble is if I had kicked up a fuss, which obviously I didn't. (I know they did realise they had gone too far when they double, and triple checked whether I wanted my baby to have a vitamin K injection.)

Just to say I had ventouse with ds - looooong stop-start labour, he was basically stuck and getting distressed. The doctor was fantastic, did it very quickly, ds had no problems and his APGAR was 10, I had an episiotomy that gave me minor discomfort for the first few days and then healed as if by magic. I have no incontinence etc. (I am a little bit more 'windy' since the birth , which might, though, be coincidence).

In other words, it doesn't have to be a bad experience (although tbh I am glad it was ventouse and not forceps). For me a cs is a last-resort type thing and I much preferred (if that's the word) having the ventouse. But if you feel differently, then of course those looking after you must, and will, respect that.

You are right about how those around you made all the difference. The people looking after me were fantastic - so much so that a 2-day labour with various interventions including the described conclusion was actually not that bad an experience.

I have to say that I had 'no forceps' written as part of my birth plan last time and I would absolutely not consent to them being used. I also informed DH that if I'm not really able to consent for myself then this is the only thing I want to make sure he makes clear to everyone. I also feel the same this time around, for my second birth. I agree with the others that birth plans are nice, but its not always possible to follow them, but this is the one thing I will not budge on! I am open minded about ventouse though. I know a C-section is major surgery and am fully aware of how situations can change very quickly during birth but that is my choice.

A doula is a great idea I think - I'm having one next time!
Remember pain is always worse if you're frightened, so make sure you understand what's going on and the reason for any interventions that are suggested. Nothing should be done without your consent, although you might be surprised what you will consent to at the time! If it's so important to you that you don't think you'll want to change your mind 'under pressure' then definitely make sure your birth partner knows your wishes too.
FWIW, I couldn't have an instrumental delivery (due to DH and possibly DS having a form of the skin condition epidermolysis bullosa - an assisted delivery would have caused too much skin damage) so I had a section, which I'd really hoped to avoid. We're all different...
DS did turn out to have EB, and as there's a 50% chance any other children will have it, it'll be the same again next time for me.
Good luck and I hope you get the birth you want