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

For as long as you have capacity you can decline any medical intervention. To have capacity you must be in a state to weigh up the benefits and risks - extreme pain and distress is a factor that can affect capacity (arguably a woman in labour)

Consider UFO

Upright (gravity assists)
Forward (lean forward on the bed with feet resting on floor or over the headboard/ birthing ball)
Open (opens cervix)

This can open your pelvis by as much as 25% more than lying on your back which is only used as a convenient position for medical professionals, not for the woman.

Midwives can monitor you throughout in this position, it's slightly more difficult but not impossible at all).

I had 2 hospital births this way.

@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.

Dangerous

I was terrified of both and ended up with both. Recovery really wasn't that bad. I declined forceps at first but my babies heart rate was dropping fast and I just wanted baby out.

Sometimes you really can't say no. Well, you can but the outcome wouldn't be good. For example my first needed forceps, by that point he was too low for a c section and that would have taken too long but he was in distress and needed to be out ASAP. C section prep would have taken too long. I had forceps with no pain relief and honestly it wasn't too bad. I had a 3rd degree tear and a year of physio but fine overall. I also had an interior placenta. I think the main thing to avoid would be induction, I hyper-reacted to the pessary and went form 2cm-born in 40 minutes.

Argh sorry for typos and grammar. Anterior placenta. You get the gist I'm sure.

Speak to your midwife and birth partner about your concerns so they re aware of your wishes.

I ve just had my first baby on Friday night and they gave me a while of pushing before they did an episiotomy and they weren't going to use forceps without giving me more time after that. This was after my waters had been gone over a day and I was on a drip to speed things up, so I know they were sure to give me a good chance of having what I wanted before intervening baring in mind baby was 9lb 15oz and I m quite small myself. They would only use forceps or the vaccum after already giving you a good chance without first.

All in all I have the episiotomy, and 2 2nd degree tears and the pain is so far manageable with paracetamol and dihydrocodeine ( I can't have any anti inflammatory drugs due to an allergy so the swelling is a bit worse than other people's who can take it so I ve been told ) and I m was able to walk down a long ward up to where my baby is about 9 hours after birth so it's not as bad as I expected at all, much easier than some the people I ve spoken too who have had emergency c sections.

I was the same to the point I planned a home birth. However, I ended up in hospital and needed an assisted delivery and did suffer some damage. By the time my DS was born he was in distress and needed oxygen.

With my second I had a planned CS, for unrelated reasons. This was most definitely not an easier option and took weeks to recover from.

I suppose what I'm saying is if it's needed it's needed and skipping that for a CS is not necessarily a walk in the park either.

With my first I put no forceps on the birth plan and it was a good thing because they just went straight to emcs and forceps wouldn't have worked. The second was a VBAC and I only avoided tools because the midwife chased the doctor out saying I could do it and I did. There was no birth plan as I was booked for a c section

I would put no forceps on birth plan as it should mean they go for an emcs earlier than they would usually.

I was very anti-intervention but was so exhausted at the end that I was begging them to intervene. I didn’t need it in the end- but my point is, you don’t know how you’ll feel until you’re experiencing it.

I don't know why anyone would refuse intervention? They only intervene in with things such as forceps in an emergency, not for the sake of it.

My first was delivered with forceps. Too low down for c section end was literally ready to deliver but was stuck back to back and needed rotating and pulling.

She was in distress and so was I, you just do what's necessary.

Your midwife or consultant can help you weigh up risks, but if this is done while you're labouring, it might be difficult to think clearly.

You might have a long or complicated labour where intervention is recommended due to your own exhaustion, or risks to your or the baby's health.

It may be worth talking to your midwife or consultant about ways to minimise stress during labour, e.g. using a birthing pool if possible, being afforded the freedom to walk around while labouring, and not being restricted to giving birth while lying on your back etc.

I would say avoid induction if at all possible (though I know maybe easier said than done). I had to be induced due to pre eclampsia. I had an awful time, including a forceps delivery but on the other hand, my friend was induced a few years ago and only needed gas and air, and no forceps. I hope they're letting partners be present during the whole birth now...my partner arrived after my baby had been yanked out. DD is fine but I'm still fairly traumatised by the whole thing. I'm sure the outcome would have been better if my husband had been there with me.

I gave birth 7 weeks ago and I tried following pregnancy dos and don'ts throughout and had an uncomplicated, low risk pregnancy. Having forceps was my worst birthing fear.

I had a quick labour (5 hours) but my babys heart rate was dipping during each contraction and they wanted to get him out fast, so I ended up having a forcep delivery. I initially asked if I could just ha e a c section but they advised it would be quicker and safer for baby to use forceps, as his head was ready to come out. Turns out the cord was around his neck, and I am so glad I agreed to forceps and got him out the quickest way possible.

You can refuse any medical procedure but listen to their reasons for you needing an assisted delivery if that happens. A pp mentioned using the B.R.A.I.N methodology, and this is absolutely golden advice and one that I followed.

I can tell you, when you are in the throws of labour, getting baby out is top priority to you, and in my case they made complete sense as to why forceps would be the best for my baby.

I had an episiotomy and forceps under an epidural and I felt absolutely nothing! Afterwards it was a little sore, but the hemorrhoid I had bothered me more! I wont be scared to have forceps again if I had to. I don't look back on my birth negatively.

Of course do everything you can to give you and baby the best chance, but I think the most useful advice i can give you is to research and inform yourself of the all the possibilities you may have to face, and what circumstances you will agree to them. I found once I made peace with what will be will be, my anxiety about labour faded.

Maybe put no forceps on your birth plan and in the event that intervention is required, you would probably get EMCS instead?

If it were me, I'd do whatever the midwives/doctors told me. Their main priority is getting baby out safely and that is the thing to remember. Recovery might be tougher for you but so long as baby is healthy, that's all that matters. Well, that's how I see it anyway.

I've had a friend go against medical advice and the outcome was not good. She has to live with that for the rest of her life.

DD was stuck and honestly, I didn't care after over 2 hours of pushing how she got out, as long as she was safe and well. I got moved up to labour ward and by the time I'd got there she'd moved and become unstuck but they were planning on forceps. Honestly OP, you won't be bothered when the time comes.

When it comes to it u will do anything they say to get that baby out. Have a plan but be flexible as baby hasn't read the plan and has their own. Keep active if you can and relaxed

[quote SunnySideUp2020]@Fruitloops34
I know but that's why i wonder if instead we can just go straight to emergency c section.[/quote]
Isn't a C-section inherently riskier (for mum, in particular) than intervention with forceps or ventouse?

No one wants a forceps birth. It is a last resort. C sections are still risky. my first I had a 1.9l PPH, the c section was awful and, recovery was horrific even with a blood transfusion. My second C section was like a painful dream.

You need to do what's right at the time and you won't know until you're there doing it.

My advice would be to go into labour with absolutely no expectations. I think there's too much emphasis on the 'perfect' birth and whilst it's fine to have a preference, be completely prepared that it's out of your control anyway.
My first baby I had planned a water birth and it was all going to be lovely and calm and what I ended up with was an emergency c section at 9.5cm dilated due to my DS heart rate dropping. The doctors intervening and either assisting with your delivery or rushing you in for a section sometimes really is a matter of life or death. When I was faced with that situation I just wanted the the baby delivered as quickly and as safely as possible, nothing else matters at that point.

I refused forceps and asked for section instead. They said they wanted to try forceps but a section might be necessary. I decided I would rather not have forceps as I felt at the time it wasn’t going to work. They had already tried ventousse. They asked several times and I kept insisting.

Given the obstruction I had it was a good thing as forceps wouldn’t have worked but would have caused me a lot of damage. I would have had failed forceps and then a section as well. It wasn’t possible to see this until in theatre.

They had to do a longer section cut than usual and push DD into position but I’m still glad I refused forceps.

I guess there may be situations where you will want to consent because forceps are going to be better than the alternative and it’s too late for a section but if you’re given the choice/can request it and it’s not too late, the theatre etc is available then you should be able to avoid forceps and go straight to section.

Speak to your midwife about it.

I’m having a planned section this time to avoid any possibility of forceps!

So this happened to me, baby stuck and in distress, consultants come running, say trial of forceps if no good we go to section.
I sooo badly wanted to avoid forceps, I shouted I just want a section. Doctor calmed me down and said let's try forceps first it's safer for you and I think there's a good chance of success. So went for forceps.

So glad I did! I had no pain post delivery for 2 days (thank god for suppositories)! And apart from a pesky stitch with a big knot poking me that was removed on day 5, my recovery was quick and not painful (and I'm a wuss)

I did have episiotomy that was stitched and a small tear, again stitched, but all in theatre so with epidural. My bits feel back to normal and behave as they should, waterworks included. I've not looked but I wasn't in the habit of looking before hand!

5m post partum.

You only read of horror stories but it's not all horrific

Good luck. Stay relaxed x

Can’t you ask for a section. At least it’s controlled.

I have just had a baby (10 weeks old) delivered by forceps and in my experience I didn’t care at the time. I was very against intervention while I was pregnant, I planned a home birth and all that jazz but after getting to 10cm at home by myself and after 4ish hours of pushing we did not make any progress at all so we had to go into hospital and get my daughter out by forceps. The doctor said I was so swollen that it wouldn’t have ended any other way. I ended up with a 3rd degree tear but recovered really well, I still see my birth experience as really positive and I would even be happy to have forceps again in the future. When you read all of this stuff while pregnant it all sounds so scary but actually gone through it you don’t really care when you have your baby next to you! (That’s my experience anyway)

You can always request a Caesarean but all hospitals/ doctors are different on whether they will say yes but one thing to think about is caesareans bring on their own problems and risks so it’s more whatever option you consider is the riskier or more problematic out of the 2 options for you.
P.S I would recommended hypnobirthing, it made me feel so in control and calm throughout.

When you are nearing the end of Labour you’d let anybody do anything down there to get the baby’s out!

There’s nothing you can do to stop yourself needing assistance, woman died in the past, luckily we have other options these days. You may need a few stitches but it sounds worse than it is. I had a 3rd degree tear with my first, I went on to have a second child as do many people so it can’t be that bad. Hope this helps.