1 in 3 first time mother's need forceps or vaccum

[KayBM]

Just stumbled across leaflet on rcog site...it was published in April 2020, so too late for me! But it says 1 in 3 women who are first time mother's need forceps or vaccum. Pretty sure there should be a bit of discussion about this with midwife...

The leaflet also says that for women who don't want an assisted birth they should consider a caeserean.

Just wondering if any first time mother's out there have been told this? Do you think women should be told this? Anyone think this should be on the NHS site too?

Anyone else think that a natural birth is highly unlikely for a first time mother? I wonder what the induction rates and c section rates are for first time mother's too?

Had I know DC #2 I would probably have thought I couldn't delivered (I am tiny) so I'm glad I didn't know - unassisted delivery after being induced.

In the USA they have highly medicalised births don't they, not sure how their rates compare to ours.

It’s disgraceful we are not given honest information on birth. The focus on natural birth and ignoring and minimising of birth injuries is also shocking

I certainly wasn't told figures (Dd1 is now 20) but needed a ventouse as she was back to back and 9lb12oz. No episiotomy either, I preferred not. Much preferable to me than an emcs.

Further 2 births were simple vaginal deliveries.

@MNHQ

So many of us feel we were uninformed going into birth...thank you for giving us this platform for discussion.

@UnderTheBus this is a really interesting point and something I’d like to know more about.

That's terrifying!! Due next week with first baby and I definitely want to avoid forceps or ventouse :(

If I have had a normal pregnancy so far, baby is lying very low, not back to back, how likely is it to need interventions?

I had an induction which I know leads to more interventions, which for me was forceps and an episiotomy.

My daughter had shoulder dystocia, so I doubt even without the induction I would give birth without intervention. She was an average baby at 7lbs 15oz.

I know I was born by ventouse and also was aware that intervention is more likely in first birth (I’m currently pregnant with my first) but I don’t think anyone’s told me that, I’m just a knowledge seeker. I’m certainly keen to avoid as much as possible things that will make intervention more like, like epidurals and being on my back. I feel quite strongly that I don’t want forceps at all, I’m slightly more open to ventouse if I have to but perhaps don’t know enough

@weegiemum

I'm really pleased that vaccum was a good option for you and you had 2 simple vaginal births after that.

I think a lot of women would just like the information though. As someone with issues after a complicated forceps birth- I would have appreciated being able to formulate a birth plan in line with my wishes.

When I think back to my birth (52 hour labour, no pain relief, episiotomy, ventouse) I wasnt informed about anything. I went to an NCT class and it was hardly mentioned. My midwife didnt mention it. When it was happening I didnt actually know why other than they wanted me to 'decide if I wanted it' (even though they were all there with their instruments, the scrub team were present ready to run me off to theatre, and they said the heart monitor was 'concerning'). I had to make a decision if I wanted assistance with no information. I said yes simply because I figured they were there for a medical reason. Nobody ever spoke to me after about why things happened the way they did. Nobody ever asked me how I was. The only advice I was given was 'dont lift boxes for a week'. Helpful and very caring. I felt like a complete failure because I couldn't birth my baby myself.

Now on my second pregnancy I am utterly terrified of being in labour again. I have no idea what my options are. My midwife (who I have never met) now has coronavirus so I have no idea who my midwife is. I am guessing I will have minimal information this time around too. I feel like assisted birth is inevitable.

If you have someone supporting you throughout your labour, you are less likely to need an assisted vaginal birth, particularly if the support comes from someone you know, in addition to your healthcare professional.

Wow, I didn't realise having support would make a difference

Assisted vaginal births are less likely if you do not have any complications in your pregnancy and plan to have your baby in a midwife-led unit. Using upright positions or lying on your side after your cervix is fully open in labour can reduce the need for an assisted vaginal birth. Having an epidurall* for pain relief in labour may increase the chance of you needing an assisted vaginal birth, but this is less likely with modern epidural anaesthetics.

This was the exactly the way my unassisted birth was, no epidural, on my side for part of it or in the water, in a midwife led unit. The thought of an assisted birth terrified me, I actually remember them wheeling in a cart with medical instruments and thinking they were about to say I needed forceps and thinking f@*k I need this baby out, it was actually just the stuff they needed for cutting the cord etc but it really freaked me. At the same time all anybody wants is for them and their baby to be safe and healthy, I just worry about the long term health problems around forceps etc on the women as they're so eager to get the baby out

@SqidgeBum 2nd births usually go better because your body has done it before, the pushing stage is usually much quicker.

I think we should be taught far more about being more physically active when pregnant and what to do to optimise the best position for baby etc it gets mentioned but if it was given a huge focus as something you should daily perhaps it would reduce back to back labours etc

@peridotty

I will say I don't know. I have read that you should avoid epidural, keep active and keep eating and drinking if you can.

Some people told me after I'd given birth that they'd used things like spinning babies website to get baby into good position if not already. Look up as much as you can online... wish people had told me before!

I'm not going to say you definitely won't need instruments but you can ask for vaccum instead of forceps in a lot of situations. You can also put no forceps on your birthplan...I'm not saying you would want to refuse them but it will get the staff's attention. If there's a choice between forceps or EMCS they may take your preference into account too, if you have that on you plan. Some people have put low threshold EMCS so I have been told and you can ask midwives to check baby is in a good position when you go into labour.

Doesn't surprise me. I've been told before that student midwives must attend a certain number of natural births (and complete a set amount of post natal checks etc) to qualify. Truly natural births can be hard for them to come by and so when there's a sign of someone having a natural birth, the student midwife is often brought in so she can tick another one off on her list!

I can understand why they can't stop to explain these things in delivery, time can be so crucial but I am shocked to hear that there's reluctance to discuss it at pre-natal classes.

My baby was back to back and I had been in labour for just over 24 hours from my waters breaking. They refused me an epidural due to the speed I was dilating so I was just on gas and air.

I had a clip put on my baby's head as they weren't sure how well he was coping with the labour and I had had a horrific bright red blood bleed as I entered hospital so they were concerned about the placenta.

Then I stopped dilating at 9cm and had a lip of cervix. So for 2 hours I didn't progress plus Ds was dipping his heartrate a bit. A male consultant came in, internally examined me and declared they would give me an epidural (so when they want me to have one it is suddenly available) put me on a pitocin drip and then deliver me with forceps.

The worst part of that was they said they would use the forceps to TURN my baby whilst bringing him out.

Whilst they were talking about this Ds1 decided he had had enough and crashed his heartrate, within the space of a few minutes the room had gone very calm as they all watched the monitor. It was decided that a c section was the best outcome at that point and we agreed. I wouldn't have agreed to the assisted turn my baby bit anyway.

That was 17 years ago and it still haunts me. I hated the way I was treated by the staff.

I had a forceps delivery. I was induced at 36 weeks due to complications with my type 1 diabetes. Had an epidural but it failed and made literally no difference. By the time they had realised I was fully dilated so no time for anything else. It was really weird, I had literally no urge to push that you hear about, just the pain of contractions. Idk if that was because of the epidural but when the midwife told me to push I had no idea what I was doing really. After a while I was so exhausted I was falling asleep between contractions, I had had enough so ended with a forceps delivery and episiotomy in theatre.

It really wasnt as bad as I was expecting, the spinal block took away all of my pain and it was very quick.

The thing is, there is no way of having a baby without pain and the risk of complications. It just can't be done, short of putting every woman under general anesthetic for a c-section and dosing them up on the strongest painkillers possible afterwards.

I know it is an unpopular opinion but I think it is a risk we have to take when we decide to have a baby. I think overloading women with scary statistics and horror stories does more harm than good.

I knew that the baby's position was crucial to delivery.

I knew that my typical modern UK lifestyle was not conducive to the baby being in an optimal position.

I started my leave at 32 weeks so I could spend 10-12 hours a day on exercise that would be beneficial to baby position.

For both DC.

DD1's birth was amazing. No pain, just pressure. TENS at home and the pool in the midwife unit.

DD2's birth was more painful. My movement had been compromised by PGP since 24 weeks. Again, TENS at home but needed gas and air in the midwife unit. She was too quick for the pool: it was still filling when she arrived.

All my issues were post-natal. I didn't do anything like enough planning for after the birth of both DC.

@Peridotty

Just to let you know two relatives of mine had forceps not vaccum and years later are fine. So it does depend. Vaccum is less damaging to mums I think.

@stargirl1701 cool story bro but what's the connection with instrumental deliveries?

It was covered in my nct course which also provided suggestions of how to try to avoid instrumental delivery e.g avoiding induction unless medically necessary, staying at home as long as possible, birth positions and being active etc. I also remember our nct teacher saying instrumental delivery was much more likely if an epidural was used.

I was never told this.
I had my little boy almost 9 months ago and had forceps and an episiotomy after a very rough failed induction. I was prepped for surgery as they were not sure they could get him out with the forceps alone.
It was all very traumatic and violent and I wish I was told about this. Once it all happened my midwife told me how rare it was but from these figures and other ladies on here it doesn't seem rare at all. It took me 3 months to heal from the episiotomy and longer to recover mentally.
I do think this should be spoken about!

Personally I think this is an indication that there’s a problem with how the medical professionals treat child birth. I think it’s not set up for labouring mothers but set up for medical professionals hence the high rate of medical interventions.

@Wolfgirrl I was very aware of the risks of childbirth when I decided to have a baby, I’m under no illusions whatsoever. But I don’t find knowing the facts and getting all realistic information ‘scary statistics and horror stories’, it’s just the information. I’d rather know what I’m potentially up against, easier to prepare that way. For me anyway.

@Wolfgirrl

Everyone has their own opinion- we are all individuals.

For me personally however, I don't expect medical staff to have opinions which they promote knowing that as a result they may potentially impact my health long term. I didn't expect anyone to promote vaginal birth at all costs for me. That is where I disagree with not being given information. They may recommend a type of birth, but I do feel it is good to be given the information so you feel you have been treated like a competent adult.

@Wolfgirrl

Not cool, tbh. It transformed my relationship with my body. I pretty much saw it as transport for my brain up until then. I never realised what my body was capable of.

The OP was about knowing the stats regarding instrumental birth. I knew them. I made choices because I knew them.

Being pregnant in the UK in the 21st century meant I was at huge disadvantage physically. I did all I could to mitigate that disadvantage.