How to avoid assisted birth? Can i just say no?

[SunnySideUp2020]

So i am only in second trimester but started thinking about birth.
It's my first.
My pain threshold is good I'd say. But i am just terrified of being butchered down there with assisted birth (forceps vaccum). It's not so much the pain it's more the recovery and after.

I have anterior placenta which i read increases chances of needing tools.

So my question is how can i avoid it?
Is there something i can do? Not do? To reduce chances of needing it
During labour can i really decline it?

Any opinions or experiences welcome !

Thank you

I’m the same as you, I’d love to avoid it but my mother in law bluntly told me that if baby is stuck, tough luck.

That quickly made me realise that I’d rather forceps that something happening to baby.

Of course you can decline ANY medical treatment, but unfortunately it could well be a choice between medical intervention or SERIOUS consequences for the baby.

Probably the only way to be absolutely sure is to go down the ELCS route, but that's not necessarily a walk in the park either.

@Fruitloops34
I know but that's why i wonder if instead we can just go straight to emergency c section.

PP is right. With a first baby you've no idea what your body will do during labour and birth. If you need those things, you need those things.

I didn't need any intervention with my two. I tore badly with number one and didn't at all with number two.

[quote SunnySideUp2020]@Fruitloops34
I know but that's why i wonder if instead we can just go straight to emergency c section.[/quote]
Ah ok, that's a different question.

Short answer is depends on the situation. There are a lot of variables at play here so it will massively depend on what is happening

You have the right to refuse forceps or vacuum. Make sure that your birth partner knows your views and will advocate for you if necessary.

You can clearly state in your birth plan your preferences, for example i outlined i would prefer ventouse over forceps, and a C section over forceps, would prefer to tear naturally. The positive birth movement is a good place to start, google them. Well done for being proactive in thinking about this. You can even outline things such as what you want in individual scenarios, for example I had a c section birth plan. I also had an independant midwife second time round and she really empowered me.

Everyone wants to avoid intervention. But there are situations where it’s warranted to save the baby’s life (or yours). Sometimes it’s too late to do a c section

Both of my babies needed assisted delivery. Neither they, nor I, would be here now without both ventouse (failed for dc1) and forceps.

Despite this I was on my feet almost immediately, home the next day and driving 5 days after delivery, which you might struggle with after C-section.

I'm not the same as I was before birth down below, but I don't feel butchered, and I have zero complaints from my dp. The rest of my body certainly isn't the same as it was dc either (nor my sanity, sleep pattern...)

Just don't be tempted to look down there afterwards if you do end up needing any sort of intervention.

I was threatened with intervention and I refused on the basis that the pain meds weren't working properly, so they waited while the pain meds were upped (which didn't work). Luckily my midwife was fab and with her help I pushed baby out without forceps or suction cup, although got a decent tear for the effort. At some point, if I hadn't been able to get him out, they would have had to intervene, so you can decline to an extent but at the end of the day if baby is stuck and needs help out then baby needs help. I suspect they'd be highly against an emcs before trying forceps or suction.

You can refuse anything you wish. You can keep your legs crossed until its too late. Question is, would you want to?

You need to explore the pros and cons of every single intervention from the start of labour until you have your baby and weigh up the risks for each step. Also, what are the alternative options? Knowledge is power.

Is this an emergency? Can we take some time to think first?
Then BRAINS (and your birth partner, if you can have one) needs to know this as it's possible they'll be more able to think than you.
B – what are the BENEFITS of this course of action?
R – What are the RISKS?
A – Are there any ALTERNATIVES?
I – What are the IMPLICATIONS of following this course of action? Will it make further INTERVENTIONS more likely?
N – What if we do NOTHING and wait for an hour or 2 before doing anything?

And remember it's not necessarily adversarial. The doctors/midwives aren't there to butcher you, they're their to help. It can be sometimes they get used to doing things a certain way and there could be alternatives, but that's not the same as wanting to cause you problems.

I hope it all goes smoothly and you either get the birth you want or one that is good enough in other ways to be a wonderful experience.

Finally IF it doesn't go the way you want and you feel sad about it, allow yourself time to feel sad - it's ok to grieve - but don't blame yourself. When you give birth you simply cannot do anything wrong. It's strange really but we all just do the best we can in the circumstances presented to us. And we can't co trip everything because it's not just us involved, our babies are too, after all, it's the baby who starts it, if it's a physiologically "natural" start to birth, not the mother.

Apologies for typos - harangued by hungry kids!

It's not as simple as just opting for a emergency C section to avoid forceps. Sometimes this is ill-advised as having a C section at full dilatation comes with its own problems too. Although there is a slightly higher chance of baby being back to back with an anterior placenta, there is still a good chance baby will turn during labour. Good luck OP.

I had a failed ventouse and then forceps with my first not ideal but it was needed to get them out quickly and safely. I had a birth review and asked questions about it unfortunately due to a combination of baby’s position (OP or back to back) and my pelvis resulting in shoulder dystocia several doctors agreed that I would have ended up with an assisted delivery and for any subsequent deliveries they recommended elective c section. It’s worth bringing up your thoughts with your midwife and discussing and maybe they can advise about dos and don’ts. I suppose it depends on the situation too, personally I wouldn’t decline during labour but it was made very clear to me that it was what was needed to cause least damage to me and baby (baby was too far down the birth canal for section). I don’t believe professionals intervene lightly with these things and would only progress to assisting a delivery if there is an issue. I recovered well although it did take a good few weeks. I have some friends who have done hypnobirthing courses and the like which are supposed to be helpful but I didn’t explore this personally. My birth plan was literally just any intervention that’s required for us both to be alive and well at the end. FWIW I didn’t feel butchered it was just something that had to be done to have a good outcome for baby.

Look in to hypno birthing. Really helped me both times. Even if you do end up needing intervention (which I believe is less likely when you do hypno, of course still might be necessary) you will likely have a calmer experience and feel more informed and in control.

I'm not sure if you can decline if it's an emergency but you do have to give your consent before forceps etc.
My issue was getting them to intervene at all even when my baby was in severe distress.
I wasn't keen on intervention but it was very obvious they should be doing something. They eventually used forceps and made a right cock up. For good measure they accused us of abusing our baby two weeks later as her face was bruised (from the forceps)
The feedback we had from the hospital was that Yes, they should be allowing women to make their own decisions on whether they would prefer a CS (which I'd have much preferred).
I was in and out of hospital for weeks due to burst stitches, infections, etc and it was months before I felt ok.
Make sure they stick to your birthing plan - mine was ignored, as was anything my partner had to say on the matter.

I wanted all natural but ended up ventouse with the first.

Again for the second, I wanted no intervention and ended up in theatre and getting forceps (my greatest fear) because baby was stuck in there.

I have to say my recovery from ventouse - tiny episiotomy - I was on the go, breastfeeding, zero complications - was just ideal. Tiny cut that healed and disappeared.

Ok my second baby was frightening but you have to roll with the intervention or humans can die (not meaning to scare you) but this is why you’ll hear over and over “keep an open mind” which trust me is better than the gory stories. Nobody goes into labour hoping for intervention.

Good luck! Even though mine didn’t go to plan they were unbelievable experiences I never felt so powerful as I did in those moments of being the pain and doing it.

Like you, I was terrified of interventions during childbirth and wanting to go to an emergency C section. I think that the more reading you do, the more worked up you become about it!!! I was also a FTM and it was scary because you hear all the horror stories and you have no idea what to expect. Anyway, I had my baby in May and it was absolutely fine. I didn’t require forceps or vacuum and got away with a small tear. The doctor had the forceps ready on the table and I said, wait let me push!! The doctor said okay I’ll let you try and the baby just came out with 2 pushes!! So a few seconds. I was lucky!
What might have helped me was I had my DH do perineal massages for 3 mins every other day for the last 3 months of pregnancy. Google it! I think it might have helped although it is uncomfortable I think it’s worth it. Good luck!

Home birth is a way to avoid/reduce unnecessary interventions. I’ve been in hospital with girlfriends during their births, and the hospital seemed more in a hurry and apt to reach for forceps and such.

I think that, once interventions such as forceps are considered, baby is often too far down the birth canal for a c section to be a safe option. Forceps and suction are used once baby has crowned but isn't progressing, I believe. I say this because my midwife and I discussed this when I wanted to avoid interventions in a home birth scenario with my 2nd, having experienced forceps with my first.

@Hopeislost

You have the right to refuse forceps or vacuum. Make sure that your birth partner knows your views and will advocate for you if necessary.

You can refuse. Yes. But if the baby is at risk, why on earth would you?

I ended up in an emergency section, not great for me, but the best thing for my baby and that's ALL that matters

@catfeets

I'm not sure if you can decline if it's an emergency but you do have to give your consent before forceps etc. My issue was getting them to intervene at all even when my baby was in severe distress. I wasn't keen on intervention but it was very obvious they should be doing something. They eventually used forceps and made a right cock up. For good measure they accused us of abusing our baby two weeks later as her face was bruised (from the forceps) The feedback we had from the hospital was that Yes, they should be allowing women to make their own decisions on whether they would prefer a CS (which I'd have much preferred). I was in and out of hospital for weeks due to burst stitches, infections, etc and it was months before I felt ok. Make sure they stick to your birthing plan - mine was ignored, as was anything my partner had to say on the matter.

Of course you can decline medical treatment. The mother or baby may die as a result of that decision but it’s the patient right to consent or not to consent to medical treatment.

@PlanDeRaccordement

Home birth is a way to avoid/reduce unnecessary interventions. I’ve been in hospital with girlfriends during their births, and the hospital seemed more in a hurry and apt to reach for forceps and such.

If you have a home delivery and NEED intervention though you can’t have it. It’s also a way to reduce entirely necessary interventions.

If it was the only possible way to get my baby out safely (ie he was too far down the birth canal to safely get out via EMCS) then I would have consented to forceps, but I declined a trial of forceps in favour of EMCS at full dilation. I consented to an ultrasound and vaginal exam in theatre to see how far down the baby had descended. They thought they had a good chance of succeeding with forceps but I was very worried about shoulder dystocia as I thought he was big (he was!) and I’m very glad I declined the forceps although there was some pressure to consent.