Forceps seem to be used a LOT in One Born Every Minute

[lucysullivan]

I can't get over how often forceps are used on mothers in Channel 4's One Born Every Minute, every week some poor soul seems to be subjected to them and on tonight's programme forceps were used for 2 births. I've read on here the horrendous damage that forceps can do and know that in some hospitals they are not used at all for precisely this reason.

I've specifically requested in my birth plan for this baby that I will not consent to forceps. Worried though at the extensive use of forceps in British hospitals today, the women I've watched in the documentary don't seem to be told about the risks associated with them, to their health or their babys. Whereas I will be screaming for a c section if forceps are mentioned.

Does anyone else worry about the use of forceps? I'm starting to get very worried that despite me saying I will not consent to forceps I will be told it's either that or I'll be putting my baby at risk, so made guilty if I kick up a fuss about not consenting.

I agree, a lady at our schools husband defends the injury's caused by the NHS and 85% of his cases are forceps related, 1% is caesarians though so lets just hope we never end up with hobson's choice.
I do think though they are far too quick to offer epidurals at that hospital which is far from the norm, I have had two births where I remember mentioning an epidural and was told you're nearly there you don't need it.
And I'd hit the roof if they told me they were going to put me under a general anesthetic and then let me know if i'd had a section or forceps, how dare they.

Lucy, I agonised over the issue of forceps and instrumental births in deciding whether to go for VBAC or opt for an elcs for my second baby.

Legally, you don't have to consent to any medical procedure. The problem is that there isn't any real choice in a life-or-death situation. If doctors tell you the baby has descended too low for a cs and needs forceps to deliver him/her quickly because there are heart decels, you would probably agree to agree to any procedure. You are not in a position to question the medics at that point.

Having said that, not every woman suffers lasting damage from a forceps delivery. Some recover quickly. It is a tough call and best to keep an open mind.

Sorry MillyMollyMoo being thick - dont quite understand "husband defends the injuries caused by the NHS". Is he a Dr or in their legal dept?

I have 2 friend who had forceps deliveries and both have suffered double incontinence as a result, 1 is still having treatment and the other has long-term ongoing issues. Blueshoes, this is what worries me most of all. Although legally I can refuse forceps, I'll be told that if I want to give birth to a healthy baby I have no choice but to have forceps because it's to late for a c-section. I had a third degree tear with my first birth and I cannot go through that again. My consultant has persuaded me to go for a natural birth but I'm wondering if I should just go for an ELCS, the thought of forceps and the long-term damage makes my blood run cold.

Milly, those stats are truly shocking.

No, he's in their legal team.
He apparently sees some dreadful injury's across his desk, which may not be preventable at all, but I still think I'll take my chance with the abdominal surgery.

One question I will be asking a consultant, should I have to see one is if they can pull the baby down with forceps can they not push him to perform a csection ?

I do think the epidurals lead to more intervention though, in fact I believe there is evidence that supports my hunch.

I had forceps as DD was stuck and distressed (3 hour long 2nd stage, got nowhere) though she was so high up that there was a real possibility it could have been a section. I presume forceps were the first port of call as they do not involve major surgery, which obviously carries particular risks.

My birth plan did specify a number of things and the staff did, on the whole, try and follow it. I planned a homebirth with as little intervention as possible and while I ended up in hospital they did try to follow my plan as far as possible.

A friend gave birth in the same hospital and she had clearly stated 'no forceps' and they let her push for a while longer than they usually did as all was fine with the baby (and lo, he came out shortly after)

I assume the cases with forceps for OBEM were chosen because they were 'good telly' i.e. long, drawn out, more eventful than more straightforward births so this probably give the impression that forceps are more common than they really are (but yes, the stuff I've read recently about forceps is indeed quite scary )

lucysullivan - the chance of needing a forcep delivery second time round if you delivered spontaneously last time is very low. There are varying reasons for forcep deliveries and the majority are performed with no lasting damage to mother or baby. There are also risks with caesrean section for mother and baby too and it is certainly not necessarily the kinder option.It is far more dangerous to perform a forceps when a baby is very close to delivery that try to perform a CS.

There is discussion regarding the use of Kiellands forceps which are ones that are used to turn a babies head to then enable it to be born. Many believe these forceps should be stopped and CS performed instead, as the baby's head in these cases has still got a bit to descend. I do think that the skills of obstetricians are no longer there for Kiellands.

I can understand why you are concerned having 2 friends with problems. As a midwife I have cared for many women who have had forceps in first deliveries with no problems and then subsequent normal births.
I haven't seen this week's programme yet.

Lucy, when researching whether to go VBAC or elect, I could not get reliable statistics from the senior midwife on the damage caused by forceps and instrumental deliveries.

Because I could not quantify the risk, I opted for elcs.

Once I decided (at 36 weeks), all my stress and worries about the birth faded and I relaxed.

I wasn't the sort to just take things as they come. So for me, certainty (to the extent possible) was better than a potentially euphoric outcome but carrying a unknown small but dire risk of going wrong.

You do wonder if we all said no bloody way to forceps would the medical staff have to be more patient/think creatively about what they can do rather than rip our fanjo's to pieces.
But then I was pissed off the midwifes were sat eating biscuits in the staff room whilst that poor girl lay flat on her back hanging on to the gas and air for dear life.
Why weren't they helping her to find a position of comfort or one where the baby might rotate if they suspected back to back, they came across as lazy IMO.

MillyMillyMoo - yes babies can be pushed back up but that itself involves risk to the baby and the mother's tissues. For the baby it can cause bleeding into the brain as the head is pushed back through the pressure of the mother's tissues.

It sounds simpler than it actually is.

Yes MMM, you are absolutely right.Women need to be encouraged to be in better positions for birth and not put under time limits for second stage. Guidelines are being changed now to encourage that.

Mears, is that Zavanelli manoeuvre? I thought it was no longer used in the UK?

Thank you for answering that mears, it is a worry as my last baby was back to back and they said had she been my first it would have been forceps, so hopefully in my case everything is so flaccid the baby will just fall out

No, the Zavanelli manoeuvre can be used when the head is out and the shoulders are stuck (shoulder dystocia). Extremely rare. Only heard of it once in 25 years where I work

patient information leaflet

Thanks for the info and the link mears. The leaflet is a bit basic though, isn't it? No references or anything so you can go and look up original research.

Mears - please could you look at the thread about "Did your sweep work" as there is a husband on there looking for some advice and I wondered if you would be able to give some help. Thank you.

I had a Kiellands forceps delivery and had no problems as a result.
MMM as for hitting the roof about not knowing beforehand whether it will be forceps or a section - that babys life was at risk which was why they had to go with a GA. If the forceps worked they would use them other wise a section. In the situation where your babys heart rate is dropping and they say they need to get the baby out NOW I think it would be very unusual for anyone to say anything other than do what you need to do.

So mears, what would happen instead? HELPERR then what?

I expect it is because epidurals are used A LOT!

(Hello mears how nice to see you)

Well I am sorry but i would be furious if a decision was taken on the operating table about my body without my consent, I would want them to know exactly what they were planning to do ie try forceps - and I would say - no thank you, then go straight to a c-section.
I know enough surgeons, anesthetists, nurses to be confident in saying they know exactly how situations will play out, there are very few things that take them by surprise.

Fair dos if you would not accept forceps under any circumstances then you would never be in that situation. I can only assume from the result that the girl in question would prefer forceps to a section as that is what she ended up with.

Well that was my point, nobody asked her.

Is it me or does anyone else wonder why the parents on OBEM are not shown to be asking more questions and having discussions with HCP about their births? Did anyone see a birth plan discussed - or would this not make good telly?