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!

Before I had my DS 12 weeks ago I was quite open minded as to what I wanted in labour. I would just take things as they come and have what was necessary. I ended up having forceps (as they couldn't get the ventouse cap on his head). Looking back this was better than having a CS, but my son was in special care for a week afterwards and they put his symptoms down to 'trauma of birth'. He did have a big head it has to be said, even made my mum wince and she's an experienced midwife!! If I have anymore children and am in the same position I would have a CS, not for me, but the child.

Hope all goes well for you susie.

hi,
hm....am not sure if no forceps/ventouse is always an option....there are times when it's to late to go down the C-section route, i.e. something unforseen happening whilest Baby is halfway down the Birthcanal....so, personally I would try to keep an open mind and just make clear that if that you would like and active, etc...Birth, and that, you would prefer a C-section over Forceps/Ventouse if possible...!

my labour was so so quick and ds was getting really distressed. They wanted to use the ventouse but they didn't have time so they just cut me with scissors

Just wanted to say that reading stories on here/in mags etc may well increase your fears. IMO people generally only tell you the bad stories. People only set up threads when theres a problem. Very rarely would anyone set up an i've had a 'fab labour/after birth experience'. Maybe set up a 'tell me your good forceps/ventouse birth stories' thread and i would think you'll see what i mean.

Just wanted to say Susie100 that those of us who have posted about our ventouse/assisted deliveries are still in the minority of births and you ar more likely than not to have a perfectly normal, unassisted dleivery. It's just we've all posted because we have experienced them. Don't obsess over joining us, try to relax about the birth because stress will not help you now or at the time.

It's so easy to say now I've done it, but honestly things will take their course and going over it all in your head too much doesn't help. Take care of yourself

Snap eddas

I said to my consultant, 'I absolutely refuse to have forceps or any other kind of assisted delivery. If you cannot guarantee this then I will have that caesarean I have asked for.' and she said, 'OK, fair enough'!

Typed a long reply then lost it .

susie, 2 things: the birth plan is generally not worth the paper it is written on. Your "consent" can always be manipulated, especially in the heat of the moment. If an overzealous consultant tells you the baby is in distress, I guarantee you will agree to ANYTHING.

I totally agree with you about prefering cs, rather than instrumental. Eye-watering stories on mn and from RL friends about shredded bits are the reason.

Do bear in mind that ventouse is generally less invasive than forceps, esp high forceps. In ventouse, the baby could just be almost there and just need a little help. Also, if the baby is too far down the birth canal, sometimes it is not possible to do a cs, which would involve pulling the baby up again .

One strategy is to have a cs, rather than high forceps ie go for cs before it is too late.

The other strategy is to be open-minded about what is going to happen, but then do what you can to maximise the chances of a natural birth eg be active in labour, hire a doula. Definitely don't agree to being induced.

Blueshoes, press the back button if you lose a post

Re Eddas post about great ventouse/forceps deliveries, I had one of those!!
My first birth was 5 years ago and was a vaginal delivery involving episiotomy, failed ventouse and then forceps.
Basically my son was a little on the large size for me and got a bit stuck towards the end.
It may sound bizarre, but the whole experience was fantastic. The best day of my life bar none.
My midwife was great, the doctors were close at hand, everyone listened and involved me every step of the way. I always felt in control despite the high level of intervention.
My episiotomy healed with no problems (no tearing), I breast fed about 5 minutes after the birth and I fell head over heels in love with my healthy and beautiful little boy.
My husband really got the raw end of the deal as he saw what was actually happening to me physically and said the ventouse was like a tug of war with about 3 doctors pulling in a row (it all passed me by with the gas and air).
It probably helped that I've always been very open minded about medical intervention and I would agree with all the other posts about not being too specific in your birth plan as things can happen quickly and generally everyone will want to act in yours and baby's best interests on the day.

Just keep an open mind you never know what might be necessary. DS had the cord around his neck and was getting distressed without an assisted delivery he almot certainly wouldn't be here.

It wasn't bad - I had some gas and air and that was it and the stitches healed up no problems.

Hm, I think I've probably had one of the experiences that has scared you. Would it help to know that I was incredibly unlucky? DD was OP: 95% of babies that are OP turn during labour. I had a very active birth, and walked around, went on all fours etc, which really ups the chances of the baby turning, so that was even more unlucky. Even so, there are mums here who delivered "star-gazer" babies that came out facing up! The MW told me that I had worked so hard that if DD had been just a pound lighter then I would have been able to deliver her naturally, so it was unlucky that she was big compared to me. Then after the delivery, 97% of women who have an episitomy can have sex after the 6 week check-up (whether they have the energy is another matter....).
How did your Mum deliver? My Mum had an almost identical experience with me (her first), and that seems quite common, I suppose due to the same pelvic structure, so talking to her might give you an idea of what you might be in for.

I had a "good" ventouse - it was very quick, didn't feel traumatic and healed fine, better than some of my friends who had "natural" tears. Some people don't need an episiotomy at all, and they usually try without before they give you one.

Oh, and fwiw I was told by my midwife that at the hospital I delivered in they never do "high" forceps anymore, they would always choose CS in that instance.

I would state your fears on your birth plan but avoid ruling anything out, you may be in a situation when you have been pushing for hours, the baby is almost out and just needs a little help to make the last inch. I have far more friends who were traumatised by a late CS after hours of pushing, than ones who were traumatised by a ventouse. Actually I don't know anyone who has been traumatised by a ventouse.

My 2 boys were delivered by ventouse, DS1 after a very long labour, he got stuck and in distress, was walked to theatre and given spinal in prep for C/S and had 2 massive contractions on way that meant ventouse would work, which it did wonderfully and I was very relieved that I had averted the C/S. DS2 was just bloody massive and stuck and again, ventouse delivered him swiftly.

Both times had episiostomy and nice clean stitches which healed well...better than tears imo.

Good luck, do go with what you feel is right

I took the same stance as Aloha did because my fears were similar to yours and hers. I ended up with a pre-term em.section but I don't regret it.

I would think that if you've expressly requested a c section rather than forceps/ventouse, the medical team will do that. However I think you ought to bear in mind the after effects of a c section. My first birth was ventouse, after 26 hours of labour and no luck with forceps, with 3rd degree tears to boot. It was traumatic but, the recovery was far faster than a friends who had a c for a breech birth. My second was forceps with tears but (a lot) less blood loss and a whooping bruise on my perenium but I was still more mobile 3 days later than my friend was with her c 3 weeks later.
Don't mean to scare you btw, with a c it will be less traumatic but, you will need a lot of support afterwards.

I had a forceps delivery, was cut but stitched up expertly, no real pain afterwards and I didn't need any painkillers, although they tried to give me them. Physically I don't think I was any different from people who had an unassisted delivery. IMO way better than a Caesarian for lots of reasons. Dd had forceps marks on her head for a couple of days but otherwise fine.

I had forceps which failed and then an emergency c.s.. The consultant made the decision to attempt an instrumental delivery but talked it through with me (in particular she didn't know whether she would use forceps or ventouse until she had a chance to have a proper look) and I had to sign a consent form before they took me to theatre.

Although it didn't occur to me to say no - the consultant seemed very authoritative and I trusted her not to push her luck with an instrumental delivery - I am sure that if I had said no to the forceps, she would have gone straight to a c.s.

By the way, she was so good she managed to get the forceps in without doing an episiotomy (which I understand is pretty unusual - I am not exactly (ahem) capacious) and since the baby was not delivered using forceps I was not cut and if I tore it was only minor.

I would echo what the others are saying about not being too rigid in your birth plan, but it seems to me that many doctors - especially those who are nervous about forceps - might be quite glad to get a patient who is happy to go straight for a section. I would be inclined to put something like "I do not want an instrumental delivery and may prefer to have a c.s. if the baby will not be born vaginally without assistance. Please discuss the options with me properly before attempting an instrumental delivery."
Of course, if it did go wrong the hospital would do what they needed to to protect you and the baby but in those circumstances you will not care.

One thing that did freak me out during my first labour was the midwife looking at me when I was pushing (DD was stuck in my pelvis and nowhere near crowning) and said "I am pretty sure I am going to have to cut you to deliver the baby". I was horrified, since episiotomy scared me an awful lot (an unjustified fear; I was so drugged up I doubt I would have felt it, but I didn't want DH to see it happen either). It is a comment I will be discussing in detail with my next midwife if I ever get pregnant again. The idea of episiotomy as a foregone conclusion seems bizarre to me and it is my understanding that a decent midwife will be able to control the head and help you not to push to fast, thus minimising tears and the need for episiotomy. Perhaps you could discuss the use of episiotomy with your midwife too?

mm, would agree with most posters on here, I also had a ventouse and it was fine, in fact so fine I didn't even notice (I mean I knew it was happening but couldn't feel a thing ventouse wise even though I had no pain relief). it did make my perineal recovery slower but the episiotomy was hardly painful at all tbh. otoh I had a c section with my first and there was no comparison for pain/healing time etc. and this time round I only had labial grazes and my perineum is fab but that was really ouch!
maybe that was all tmi? sorry!
I disagree with some posters about the value of birth plans, for my third, and by then I'd experienced a fair few things already, I had the most comprehensive plan going, ranging from if baby was unexpectedly breech to detailed third stage plan. I wanted to cover as many bases as pos. I also had a doula to make sure it was listened to. for me, it was all about staying in control and having my wishes respected. a few things I'd wanted on my birth plan didn't happen but it was all explained to me at the time and also afterwards and i was absolutely fine with it. so long as you don't expect your birth plan to be stuck to rigidly regardless of circumstances I think they are really good. you could write on all about why you would prefer csection in what kind of circumstances and why for example. and for what it's worth, i agree with you on the csection over high forceps thing.

I had a major phobia about needing a difficult foceps (as opposed to a "lift-out" when the baby was nearly out) when pg with dd. I knew she was back to back and not budging and I felt very strongly that if the baby got stuck that I would far rather have a c-section than a rotational forceps.

I made an appointment to see my consultant and she agreed that if labour was very slow and it was looking as if I was heading the way of potentially needing a rotational delivery that I could "bail out" and opt for a section. She wrote it in my notes and I included it in my birth plan. She also reassured me that most OP babies turn in labour.

I did feel far more reassured after this and as it happenened had a very straightforward labour. Was pushing for quite a long time but dd rotated and came out the right way. The first thing the midwife did when I got into labour ward was go through my birth plan which again was very reassuring.

So I think it is worth while putting things like that in your plan but also to think about differentiating between a potentially difficult instrumental (ie whe you'd go to theatre & have an epidural) or a straightforward one (where in fact a c-section woiuld be very difficult due to the baby being so far down the birth canal).

I defintely wanted a totally natural birth but after 27 hours of labour and ds' heart rate dipping so often even the midwife started to look worried I was perfectly happy for them to use ventouse to get him out. I think you'll find once you are in the moment any fears about yourself (cuts. scars etc) become umimportant as you just want your baby to be safe.

Thank you all for your responses, my first post and am overwhelmed by how many people have taken the time to share their experiences, good and bad, much appreciated.
I see now there is a difference between ventouse and forceps and high forceps. Also thank you for pointing out how rare instrumental delivery really is, 5% at the hospital I am delivering at so not so bad (although if they try instrumental and then c-section I imagine this goes into the section statitics instead?) Will talk to midwife at next appointment and disucss my fears with her and ask that instrumental only be used if baby is close, so no high forceps.
I will be looking in to a doula also as it seems this reduces the chance of c-section and other interventions quite substantially.

On the point about not caring as long as your baby is healthy, I agree and in the heat of the moment am sure I would consent to anything. I suppose that is why I am trying to be careful as although healthly baby is most important thing, it is not the ONLY important thing as I imagine a horrific birth injury would hinder your ability to spend time/bond with your baby in turn.

Thank you again for all your input, will let you know how it goes!

Hi, It amy be worth looking on the NICE website & reading their guidelines on CS & interventions. I was leaning more to the CS but reading their guidelines on this changed my mind. WOuld also add I had forceps delivery, was out within 12 hours, Bfed & bonded fine, recovered quickly, infact so quickly I am now pregnant again & DS is only 7.5months old!! I have a very good friend who had a CS 6wks before me & still isnt right so there are pro & cons with both options. A CS is major surgery though with all the restrictions that apply after, including in some areas a fight to be allowed a VBAC. Good luck.