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

• medical knowledge even!

You cannot plan anything.
Just go with it

@TheNewLook has summed things up perfectly.

My first I went in blind (apart from watching lots of one born every minute - must add didn't watch this because of my pregnancy I watched it for years before) I laboured for 8 hours the 8th hour I was pushing but getting nowhere, unfortunately my babies head was just at the wrong angle to be able to come all the way down and through my pelvis to be born, I was terrified and didn't really want forceps however it meant that my little boy was delivered safely and he was perfectly fine from it. He had a couple of bruises on the sides of his face from the forceps but other than a c section I can't see that he would have been able to get out any other way without help. I had an episiotomy and yes it was sore for a little while but you just have to take care of the wound. Make sure you clean it well (but very carefully obviously) sometimes it's one of them things. I'd rather have had the forceps than a section.. I'm currently coming up 33 weeks pregnant with twins, now although twin one is head down and I will be able to attempt a vaginal delivery that second baby could go in any which way when he gains all the extra space when his brother is born and I might have to deal with the fact a section will be the only way. I'm devastated but it is what it is, I'd rather my babies arrive safely and are doing well than to refuse assistance when they wouldn't do it if it wasn't necessary.

My first (vaginal) birth was a cluster fuck with pre-eclampsia, induction, ventouse, episiotomy, pph, retained placenta, secondary pph, blood poisoning and all my veins shutting down ending up needing a central line and 2 additional weeks in hospital.
BUT...
One positive i remember is how respectful the surgical team were of my wishes. When the induction didn’t progress, they said the next steps were ventouse, then forceps. I said i wasn’t happy with forceps and if no progress after 3 ventouse attempts please could we go straight to csection and they said absolutely and wrote it down in my birth notes. That did a lot to reassure me that i was being listened to and still had agency despite all the crap.

Ps my elective csection second birth was a dream of tranquility and empowerment.

I feel as you do OP it seems in some ways. For me, I feel even thinking about vaginal birth seems is wholly out of the question for me (I have had repeated nightmares when not even pregnant about going into labour and being forced to deliver). Probably am phobic of it in part but plenty else is also reality based unfortunately.

I hate this 'well as long as the baby is safe and well, that's all that matters'. Or the 'just relax'. Or the 'at the time, you will just want baby out', 'it's only one day'.... the list goes on.

Personally, I think a CS is the only way forward.

Tbh once you are in labour and being told baby is stuck and need to have an assisted birth you probably will not want to say no. I felt the same way before I have birth but ended up having to agree to a forceps delivery which I was very happy to do at the time as baby’s heartbeat was raised and just wanted her here safe and sound.
I did end up having to have an emergency c section as by the time they were prepped to use forceps baby had turned round and was back to back with me.
Whatever happens the safe arrival of baby will likely be the only thing on your mind if it comes to it. Good luck and hope everything goes as smoothly as possible for you!! xx

It's great you are very keen for no interventions, definitely avoid an epidural as that hugely increases your chance of needing intervention. The aim at the end of the day though is to have a living baby and mother and sometimes to achieve that interventions are needed! Don't get yourself too hung up on it otherwise you'll just be more upset if it doesn't go to plan. My birth plan was I wanted everything as natural as possible with as little intervention as possible but was happy to take medical advice and go with the flow basically. I had no pain relief and a very slight graze.

It always makes me chuckle when I see people claiming perineum massage will save you needing forceps. No amount of massaging your bits with oil will prepare it for squeezing a human head out. It's always the people who didn't tear (pure luck or very stretchy 🙈) that claim it was due to all that oily massage ...what a load of rubbish. The fact of the matter is that your birth experience will be a mixture of how well you cope mentally, how well your body copes, how well your little baby copes and the staff you have around you on the day. Any number of small things will impact it. It's a risk. But women do it every day and it is SO worth it. And yes women do matter...of course they do but you chose to have a baby...so do what's best for the baby and get the baby out as safely as you can.

If it makes you feel better better I had ventouse with my son and I healed IMO completely normally. I don’t feel any different to before.

You absolutely can decline. I made this clear in my notes, I told each midwife who came into my very long labour that i will not consent.

Still when my son got stuck, still high in the birth canal the consultant spent a long time arguing with me. Wanted to use kellands forceps which have broken necks and are banned in other countries.

Thank god I did not back down. My baby is here safe and well via EMCS.

If I could go back in time I would request ELCS in the first place as the fear of instrumental took over all my joy in the third trimester.

I was terrified of intervention, wanted a water birth to reduce chances etc.

Ended up with episiotomy/forceps (to save my baby's life) and I don't know if I was lucky but I was completely fine down there. Absolutely no pain afterwards, everything looked and felt back to normal in a couple of days etc. I think potentially better than a natural tear that could have been very debilitating.

Anyone saying try to avoid induction and to ask about the 'benefits' etc before making the decisions are (in my opinion) completely unrealistic. This was drummed into me in NCT and went totally out of the window. When someone tells you that you have to deliver your baby in the next 2 minutes otherwise they will be seriously ill, you say do whatever the hell you need to do to get them out. And don't feel like you failed about it afterwards.

However, I am tempted to push for an ELC next time though just because I feel I might not be as lucky next time...

@flossletsfloss totally agree. I never did any massage and tore badly on the first time and not at all on the second. I think me not tearing the second time had way more to do with delivering on all fours, being in water, and listening to the midwife and my body.

I've had two ventouse births, neither were done lightly, and it's not 'butchering'. No damage to me or baby either time.

One was when I was very close to delivering after a fast labour and the baby was clearly in distress and needed out that minute.The cord was round his neck twice. It got him out before his condition or Apgar score were impacted.

The other was after a very long labour and cascade of interventions. The head was big for the gestation and he was beginning to go into distress. I had a PPH afterwards but presumably would have done anyway.

Re episiotomy. First time (the long labour) I had an episiotomy which healed perfectly and with no trouble. Second time (the fast one) I had a 2nd degree tear, I think along the site, which again healed perfectly. I later had another baby without intervention, on all fours in an extremely precipitous labour, first degree tear.

You can increase your ability to birth without intervention by having a drug free, upright labour as possible.
I deliberately chose a hospital that did not provide epidurals and the midwives supported and encouraged active labour.
I stayed home as long as possible, arriving at the hospital 7 cms dilated and birthed within two hours of arrival.
I spent no time on my back in labour, walked through contractions or on my knees over a bean bag to support an open pelvis. No monitors or tracing that stopped me moving freely. Low lights. Calm space.
It won't guarantee no intervention but active labour increases your chances of an intervention free labour and birth.

I had an assisted birth (forceps and episiotomy) and would absolutely have it again if necessary, over and emergency c section.

I wasn't "butchered" I had no pain when healing and my stitches healed fine.
A c section is major abdominal surgery and, for me, was a much bigger decision than using forceps/episiotomy

I also had an epidural, which helped as there was no hanging round waiting for the anaesthetist to come along once the decision to go with forceps had been made. (DD was moving down and then going back up the birth canal)

My "ideal" birth had been a water birth with gas and air in the midwife led birthing centre and I ended up in the delivery room with epidural, episiotomy and forceps due to high blood pressure (which only appeared on the day I went into labour)

I guess, my advice would be - know all of your options and be fully informed in case, on the day, they do become necessary

Honestly i am so glad i made this thread.
The stories i heard in real life from friends and family have traumatised me a bit but reading all of your experiences has allowed me to open up my mind to all the possibilities and understand that it might happen and it might not be the worst birth.
I guess it's the fear of the unknown. And wanting to prepare for the worst and hoping for the best. The fact that i have heard very few positive first time vaginal birth experiences around me hasn't helped so far.
But thanks again everyone for taking the time to share your stories, it really helps to have different perspectives.
I will continue to do my research, talk to DH and MW about my fear and preferences etc.

The best advice I can give you is to have an open mind and do your research.

It is not true that if forceps are needed the baby is too low for a CS. Google High Rotational Forceps.

In my own experience, my first birth I was very much 'i'll do whatever the doctors think is best if needed'. I wish I'd have done my research thoroughly instead of just doing NCT classes who told us that if you stayed calm and breathed properly you'd never need forceps.

I had a 3 day drip induction with a back to back fairly big (9lb and in 5"2 and slim) baby with epidural (which massively increases your risk of needing assistance, on your back unable to walk etc). Got to 10cm, pushed for 2 hours, nothing. Doctors took me to theatre, told me they may need to go to CS, prepped me but very much told me that they must try forceps first. Baby was in no distress. I said ok, thinking normal forceps. Oh no. High rotational ones (I didn't realise at the time) first. These turn baby and pull them into the birth canal (and are banned in some countries, like the US).

So those first, then two attempts at normal forceps. Baby was stuck with a severe shoulder dystocia. I lost 2l of blood. They had to go in my hand and pretty much drag my baby out. Luckily they didn't have to break her arm or collarbone but that is common in these births and they only knew these weren't broken after she as born.

We were lucky, were were both injured but lots of babies with that level of SD are brain damaged or die. My baby was battered and scarred for life on her face with permanent damage to her eye, but alive and well.

I on the other hand, was rather injured and five years later am having to have a hysterectomy because I've got so much damage from the forceps that my bladder and womb have prolapsed badly. I'm 35.

I say all this not to scare you - any birth can go any way. Lots of people have forceps with no issues at all. But do your research thoroughly and decide before you go in what you are comfortable with and what you want to say no to. I wish I had known about the HR forceps because I would have said no and gone straight to CS - baby was fine for me to do that at that point.

Second birth was a planned ELCS (because of the first birth!) and it was an absolute breeze for me, in terms of the procedure itself and the recovery. It took me months to feel anywhere near normal (and downstairs is definitely not normal still) after the first birth. Second time, I was up and about after a fortnight almost back to normal except for heavy lifting and hoovering and that was with a newborn and toddler.

Good luck.

Sorry, excuse my ignorance, but wouldn't recovery from a c section be worse than from an assisted delivery? A c section is a pretty major surgery, no?

Not in my case @CoalCraft. Not even close. The CS was far far easier and quicker.

A straightforward natural or assisted birth, yes probably is far easier to recover from. A rough assisted birth, no not always.

My eldest child would have died without an assisted delivery. She actually came out blue and silent. Another few minutes and she wouldn't have survived.

Let the health professionals do what they need to do to ensure the safe arrival of your baby!

Second time around I refused an epidural as I thought that contributed to needing the ventouse delivery and I stayed stood up and leaning on the bed as much as possible rather than staying still which I think helps. Keep fit, keep walking and keep active as much as you can.

Good luck, I know it's scary the first time but our bodies have been built to do this. It's never as scary as you have imagined x

@sunflowershine
Sorry to hear about your experience, it sounds like you both have been through a lot. Unfortunately this is what i had heard before and what made me really look into my options and really start to educate myself on the subject (hence this thread).Instead of just going with the flow on the day. Thanks for sharing.

@CoalCraft
From the people i know c section recovery has been longer in terms of being able to resume daily activities and being able to care for your baby by yourself. Or sometimes caused haemorrhage. But rarely resulted in long term issues or trauma like some assisted birth have. Again, that's just based on people around me.