Scarey forceps and a monitored labour

[baddyfreckleface]

Hi,
I am currently 21 weeks pregnant with my second and having a major stress about what's going to happen with the birth.

I had severe pre eclampsia first time round and had an emergency c section at 37weeks. Although this was obviously very scarey for my husband I was surprisingly calm as I just had to let the professionals take over and wasn't all that aware of what was going on.

I went to see the consultant last week and he was very breezy about everything and said basically that the plan for me is to have a normal birth but that I will have to be hooked up to monitors from coming into hospital and the whole time I will have to be flat on my back in bed.

I understand why I need monitoring but am absolutely petrified of forceps and know that this is much more likely if I labour on my back. Seriously, just thinking of my baby being yanked out by it's poor little head with the doctors foot up on the bed pulling so hard makes me feel sick and panicky!

My husband asked about a c section and the consultant said we would have to really argue our case if that's what we wanted (I am not even sure I want that yet).

It also didn't help that as soon as I chatted to my mum about all this she said ' oh no, have a c section, labouring like that will be too much!' She is a very calm mum who I expected to tell me to go for it and I would be fine!

Please tell me I am being an over-dramatic wuss.

How horrible for you

I think you need to work out which birth scenario is going to be the most positive/least damaging for you and work out how likely it is you'll get it.

It's pretty standard in a lot of hospitals now for ELCS to be turned down out of hand, but as your consultant says if you fight for one you'll probably get one.

Plenty of people on MN and one I know in RL have had forceps deliveries and really not found them too bad.

I had a forceps delivery that left me with PTSD so bad that the only type of birth I could consider afterwards was an ELCS, and I've met a few people in RL who have had the same experience.

Can you ask your consultant for a trial of labour so that at the first sign of any issues you go straight to c-s rather than instruments?

Firstly don't panic!!

Secondly, having a forceps delivery (and mine was 22yrs ago!) is nothing like how you've described even then, and they've moved on from there.

Also, check with your mw about the monitoring. At our hospital it's cordless now so that you can move about. I've already checked this out as I'm due to be induced on my due date due to spd, and I really don't want to be labouring on my back!

I'm really not trying to scare you OP, please no one flame me for saying it but I just want to give a balanced and honest view - harassed, that's EXACTLY what my forceps delivery was like. It does happen. Hopefully it won't happen to the OP.

I think the consultant is a fuckwit! I've had two monitored labours due to high BP and had nothing in terms of pain relief the first time and gas and air the second time. I stood up for most of labour then both times knelt over the raised bed head to deliver! Both labours were lovely despite BP cuffs and baby being continuously monitored.

I cross-posted with pocketfullofposies.........

My first delivery was forceps as baby was posterior and stuck after 36hour labour. I had an episiotomy too. It was fine!! So much so that I'm now 28wks with dc4, and tbh forceps is the least of my worries.

Just wanted to balance the view of forceps delivery a bit.

harassed

'Forceps' isn't just one type of instrument. There are many different kinds, ranging from the scary sounding ones that have a bad reputation to ones that gently ease the baby out. The main 3 kinds used in British hospitals are Wrigleys, used for low cavity work just to help with the last bit of birth, Neville Barnes, Mid cavity forceps (I had these) used when the baby's head has passed through the cervix but become stuck - these require an episiotomy but not necessarily 'foot on the bed' tugging. The last kind are Keillands - high rotational forceps, rarely used and should only be handled by an experienced consultant. These are banned in some countries and are used to both turn babies and pull them out if they are stuck high up.

Personally I'm comfortable with the use of either Wrigleys or Neville Barnes, but have put on my birth plan that if Keillands are thought necessary then please assess the need for this and consider an emcs instead.

I think you need to check what the monitoring entails. Even if you can't move around much due to various wires etc., maybe they could position you in more of a sitting, leaning forward position, at least for the first stage of labour, which would be much better than flat on your back.

I had a forceps delivery and I'm afraid it was exactly as you describe :(

FWIW, with my friends who attempted VBAC, none of their consultants were willing to take much chance and as soon as both of them failed to progress they were given a CS.

You DO have a choice in the matter though, with VBAC they can't use any inducing interventions due to scar rupture. If you don't want to attempt a VBAC then shout loudly until they listen. They CANNOT force you to have a VBAC.

If you can't have hand held monitoring - and have to be reasonably still (for a strap) you can often sit on a birth ball (to keep upright).

I went to my NHS antenatal class yesterday - they said that if you have an epidural you do have to be on the bed - but the bed can convert to an upright chair position (so you stay upright) - so it's worth asking about if either of these options are available at your hospital.

how do you feel about an epidural? have you watched one born every minute usa? pretty much all the women flat on their backs, monitored, epidurals in, smiling, chatting, "ooh am i 10cm already??"

I had failed forceps and EMCS first time. My memory of the forceps is pretty hazy I'm afraid but I didn't end up with any tears.
But, if you do decide you would prefer an ELCS I don't see how they can force you into a VBAC. I'm having an ELCS this time and noone has questioned my choice. But if they had, I was ready to argue that VBAC has a level of risk that the woman has to be willing to accept, and also the risk of faliure meaning that a CS will be done anyway. I don't see how they can force any woman to take these risks if she doesn't want to. I can see how refusing a CS after a distressing natural delivery is kind of more acceptable (though not really), but surely we should be in charge of what risks we consent to facing?

Bedhog I had Keillands. They were horrendous. The delivery was as OP describes and much worse (esp. the recovery). The only "need" for them rather than CS is to keep the hospital CS stats down. You'll already be in theatre with a spinal good enough for a cs if they're attempting Keillands. Brutal and unnecessary but great for the consultants ego.

Hi everyone and thank you so much for your replies.

For those of you that have had a bad experience - I am so sorry it happened to you. How were your babies afterwards? if you don't mind me asking.

I am sure there are plenty that have had a positive experience and I certainly like the sound of trying labour and being able to move about on the bed like you describe Reality (and congratulations!)

I thought that if it got to forceps time' it was too late for c section but then I suppose if they see failure to progress they can do a c section before it gets to that stage maybe?

Thanks bedhog for your advice, I could certainly put something in my birth plan about no keillands. Maybe the Neville barnes too. I suppose I just worry that at the time the staff will just do what is best for speed and ease to them just as herethereandeverywhere sadly experienced.

I think I need to have a good talk with my midwife at my 24 week appointment. I am also considering changing hospital anyway (for lots of other reasons) and that consultant may be more willing to chat rather than tell me what to do.

Turtles - i am steering clear of OBEM as it's a forceps delivery I saw on there in the first place!! I had a epidural last time for c section and can't understand how you can push with one of those! After the section a nurse said she was lifting my legs, I had to look down to check, it was like looking at someone else's leg!

I did not have a forceps delivery, but I did have a bad time and a third degree tear. My friend had a ventouse (sp?) with her VBAC and said recovery was so, so much better than after her EMCS.

I was induced for prolonged rupture of membranes, with an unfavourable cervix (ie high, closed, hard) so was considered a high-risk, likely to end in section induction. Hence I was monitored throughout (and bloody struggled!!). I could move a bit- I did change to stand by the bed for a bit, they let you off to go to the loo (and hide in the bathroom for a bit!), and I ended up delivering kneeling up holding the back of the bed. With all my monitors on. So I don't think you necessarily have to be flat on your back. The maternity unit at our hospital only has one mobile monitoring system so I kept asking but it was never free for me (I delivered on a weekend when they had a record number of births), but it is an option.

I also think if you've had a section once they don't let you struggle for so long. I was given the option (and time I'd have to go for it if no progression- think 20 hours, not a cm dilated...) twice in my labour, but chose to keep going a little longer. Despite the third degree tear and theatre stitch up (which was totally different to the epidural- I was walking with the epidural, was fine), it's normally a spinal for a section (or third degree tear repair...) but because they had 5 goes over nearly an hour to get my epidural in, they just topped it up very high. It was TOTALLY different, i couldn't move/roll/sit up/feel my legs. Very different to being up and about with it a few (!!! and the rest) hours earlier. So don't think an epidural will be just the same as you can ask for a low dose- I could feel all the contractions etc and everything, just less painful.

I'm nearly 12 weeks pg with number 2, and for all that, bricking it!!!!!! But think i will go for it again. Will obviously be seeing a consultant because of my tear, but if risk of re-tear isn't too horrendous, I'll be hypno-birthing myself and going for it (terror, terror).

Don't know if this waffle is any use to you....

Baby was fine in the long run baddyfreckle - short term trauma, haematoma on her skull that went after a couple of months, inability to breastfeed properly which may or may not have been related to her delivery resulting in 20% loss of birth weight and admission to hospital at 8 days old.

She's fine now though - a very happy and bright three year old who is upstairs in bed reading Jungle Book with Daddy. For all I hated her forceps delivery she is here and she is well.

Be warned that what you put in your birth plan may not be followed anyway. I wasn't asked to consent to forceps but had them anyway.

However, with my second pregnancy I was referred to the head of midwives at the hospital who assured me that we could sit down and write a birth plan together and she would ensure it was followed. The trust had gone for me by that point though, I just couldn't try for another natural delivery. But i do think she would have done what she could to help me. And if you do think you want a natural delivery then I think it's worth fighting for.

Good luck

DS was fine after the forceps - had an apgar score of 9 after 1 minute and 10 after 5 minutes, and some bruising on his cheeks which went after a few days. He was over 10lb though!!

DD 's face is permanently scarred (small but noticable). She also struggled to feed and was readmitted after 3 days, losing over 15% of her birth weight - my milk eventually came in on day 6. Part of that was the fact that we were treated no differently to mums who'd breathed their babies out with nowt more than a graze though. With a cs there is an expectation bf will be harder, you can't do certain things, with forceps trauma you're no different to mums on their 2nd and 3rd straightforward delivery in the eyes of the midwives.

"With a cs there is an expectation bf will be harder, you can't do certain things, with forceps trauma you're no different to mums on their 2nd and 3rd straightforward delivery in the eyes of the midwives."

Absolutely true herethere.

Or whopping tears!! I asked for my bloody sheets to be chaged on the ward, and the MW told me I was the wellest of her mothers, go in the corridor, find the trolley and do it myself!!! I think she felt bad when she finally did a full blood count on me as I nearly fainted (holding DD!) and discovered I was quite bady anaemic following my tear and bleed...

DD was ok after forceps. She needed some oxygen for a few minutes, then went straight onto the breast. She kept crying on and off and I kept telling the nurses she was in pain but no one would listen. Finally, they took her off to the nursery (we had her at Portland) and a pead came and asked if they could give her Calpol as she clearly had a headache :( Until she was at least 1, I was unable to put anything on her head as she got too upset.

I had a very difficult birth with DS 2 yrs ago and had forceps in theatre. I will be completely honest - the forceps delivery itself was absolutely fine, I already had an epidural which was topped up to the max so I felt nothing at all, no pain or pulling whatsoever, there was no 'foot on the bed' tugging or anything remotely like that. DS had a forceps shaped bruise on his face (the forceps were mis applied) and a slight cut on his eyebrow but these went after a day or two. He didn't take to breastfeeding easily, (I know now that it was likely he had a major headache and should have been given some Calpol) but with a bit of perseverance we got there in the end and I breastfed for 7 months. He was absolutely fine and suffered no ill effects whatsoever. I, on the other hand, was diagnosed with an anterior and posterior prolapse 6 weeks after the birth due to the damage the forceps did and will avoid them this time around unless it's an emergency situation. Just because you may be on your back for a long time though doesn't necessarily mean you will end up with forceps, and if you do need some help, you can insist on a ventouse instead of forceps which are far less brutal.

I had Keillands Ds didn't turn turn quite enough so couldn't descend.
Regsitrar delievered ds under guidance of very experienced consultant.
Ds fed had marks on face which faded after 2-3 days. He fed fine.
I had a tear which was an extension of the episiotomy - tbh that was far less painful than the piles i got from 2 hours of unproductive pushing when i didn't have the urge to push.

I'm just glad they were used by the right people.
Will be much more assertive this time about allowing the baby to descend enough naturally before pushing.

Thanks to you all so much for replying. You have armed me with things to say to my midwife when I next see her.

Although just hoping to make it to full term now as my hands and feet are swelling recently so more to worry about with Pre eclampsia popping up again maybe.

Being pregnant is so stressful!

can only echo what everyoen else says - your consultant is being very negative - there is no reason at all why you can't be monitored and still be free to move around the room.

It's horrid that he's making you worried and scared at this stage in your pg.
:(