If you are a loving mother who is about to have a baby, you have high hopes and a little fear in your heart about the birth of your baby. Sometimes everything does not go as we think. Imagine, you have been pushing hard for hours, but the baby is still late to come out. The doctor understands that you are very tired and this is difficult for the baby. It is at times like this that the doctor tells you about a "Forceps Delivery" as a help. You may be scared when you hear this name. But when you know exactly what it is, your fear will disappear. Let's talk about this today.
Simply put, what is Forceps Delivery?
Forceps Delivery is a method in which the doctor uses a special device to carefully remove the baby if there is any difficulty during childbirth. This is also called "Assisted Vaginal Delivery". It means that it is an assistance in normal childbirth.
These forceps look like large salad tongs. But they are designed to hold the baby very carefully without damaging the baby's head and to guide the baby out as you push. The most important thing is that only a doctor who has received special training in this can use them.
Often, when labor is prolonged, a cesarean section (C-section) is the last resort. However, if certain conditions are met, this method can be very useful in delivering the baby safely without having to undergo a C-section.
Why do you have to use forceps during childbirth?
During the second stage of labor, the stage where you push the baby, sometimes labor can stop and not progress. No matter how hard you push, the baby may not come out. In this case, the doctors will monitor you and your baby very closely.
There are several main reasons to use forceps:
- Prolonged labor: If you push for hours and the baby doesn't make it down the birth canal, this can be stressful for both you and your baby.
- Mother's health: Some mothers have conditions like high blood pressure or heart disease, which make it risky for them to push for too long. In such cases, doctors resort to this method to reduce the pressure on the mother.
- Fetal Distress: Sometimes changes in the baby's heart rate can be seen. This lets doctors know that the baby is experiencing some pressure inside the birth canal and may not be getting enough oxygen . If this happens, the baby needs to be delivered as soon as possible.
In such cases, doctors resort to assisted methods such as Forceps Delivery or Vacuum Extraction to protect both the baby and the mother.
Forceps? Vacuum? What's the difference?
You may have also heard of a method called Vacuum Extraction. The pros and cons of both methods are very similar. A doctor will choose one of these two based on their training, experience, and the condition of you and your baby at that moment.
Forceps Delivery is a less commonly used method than Vacuum Extraction because it requires more skill and training. However, forceps are very useful in some cases where the Vacuum method cannot be used.
Let's take a closer look at the differences between these two methods.
| Feature | Forceps Delivery | Vacuum Extraction |
|---|---|---|
| Required training | It requires a very high level of skill and special training. | Training is relatively easy. |
| Baby's position | Even if the baby's head is rotated to the wrong side, it can be helped to turn it to the right side. It can also be helped for a breech baby. | It is usually best when the baby is head-first and positioned correctly. |
| Success rate | The success rate is relatively high. | The success rate is a bit low. The vacuum cup may come off. |
| Possible impact on the mother | There is a slightly higher risk of vaginal tears. There is a greater need for anesthesia. | The risk of tearing is relatively low. |
What are the situations where forceps delivery can and cannot be performed?
This is not something everyone can do. The doctor makes this decision after considering many factors.
| Status | Description |
|---|---|
| Prerequisites for using forceps | |
| Doctor's training | The doctor performing this procedure must have good training and experience in it. |
| Progress of labor | If you have been pushing for several hours (1-4) and the delivery has not been successful. |
| Baby's position | The baby should be about halfway down the birth canal and at a level where the forceps can be grasped. |
| Baby's health status | If the baby's heartbeat indicates fetal distress and the baby needs to be removed quickly. |
| Contraindications to the use of forceps | |
| Cervical dilation | If your cervix is not fully dilated. |
| Baby's development | If the baby is more than 6 weeks premature. |
| The baby's medical condition | If the baby has a bleeding or bone disorder. |
| Baby's position | If a part of the baby, such as an arm, comes out first, or if the baby's position cannot be found exactly. |
| Baby size | If you suspect that the baby is larger than your pelvis. |
How does this process happen?
Before resorting to this method, the doctor will explain everything to you and obtain your informed consent. Only then will the process begin.
Preparation
- If you haven't already been given painkillers, you will be given medicine to reduce the pain.
- If the amniotic sac hasn't broken yet, it will break.
- A catheter may be inserted to empty the bladder. This increases the space in the birth canal.
- Sometimes, a small cut may need to be made in the area between the vagina and anus (the perineum) to make room for the forceps. This is called an episiotomy .
How to use forceps
Although you may feel a little intimidated by this device, it is designed to fit the shape of the baby's head and the curve of the mother's pelvis.
The process goes like this:
1. You are made to lie down on the bed with your legs spread apart.
2. You are usually told to push when it hurts and to rest when it doesn't.
3. While you rest, the doctor will carefully place the forceps blades, one by one, on each side of the baby's head.
4. Next, as you push, the doctor will use forceps to gently guide the baby down.
5. If the baby's head is turned to the wrong side, turn it to the right side when there is no pain.
The important thing is, this is not a forceful pull. It is just a way to help your pushing. Usually, after one or two attempts, the baby will come out. If the doctor finds that this is not helping, he will immediately abandon this method and move on to another option.
What happens after a forceps delivery?
If the baby is successfully delivered using forceps, your delivery will end normally. However, if this method is not successful, your doctor may perform a C-section to deliver the baby.
After you have your baby, the doctors and nurses will carefully examine you and your baby.
- If you have: vaginal tears or an episiotomy, they will be repaired with stitches.
- For the baby: The baby's face or head will be checked for any minor scratches or bruises from the forceps. The baby's health will also be monitored closely for several hours.
If there are no complications, you can go home with your baby as usual.
Is this safe? What are the risks?
This is the biggest question on every mother's mind. Remember, there are some risks involved in any childbirth. The role of doctors is to minimize those risks for you and your baby as much as possible.
A doctor will only resort to a forceps delivery if he is confident that it is less risky than doing nothing . Remember, the potential harm from prolonged labor and oxygen deprivation to the baby is much greater than the minor harm that can be caused by forceps. Also, the risks of an emergency C-section are greater than those of a planned forceps delivery.
However, as with any medical procedure, there are some risks. However, serious complications are very rare.
| Who is at risk? | Possible complications |
|---|---|
| Risks to the mother | |
| Vaginal tears | The risk of tearing is slightly higher than during a normal delivery. Sometimes severe tears (3rd or 4th degree tears) that extend to the anus can occur. |
| Difficulty urinating | Urinary incontinence or difficulty urinating may occur temporarily after childbirth. |
| Pelvic organ prolapse | While this can occur after a normal delivery, the risk may increase with severe tearing. |
| Risks to the baby (most are temporary) | |
| Superficial skin lesions | There may be minor scratches or bruises on the baby's face or head where the forceps blades hit. These will heal completely in a few days. |
| Facial nerve palsy | Temporary damage to a facial nerve can cause muscle weakness on one side of the face. This also heals on its own within a few weeks. |
| Skull fractures | A newborn baby's skull is very soft. Sometimes, very small fractures can occur, but they heal on their own without any treatment and do not cause long-term damage. |
| Bleeding inside the skull | This is a very rare and serious condition. Doctors are very careful about this after the baby is born. |
How long does it take to heal?
You will need to stay in the hospital for an extra day or two after a forceps delivery, but the recovery time once you go home is similar to a normal delivery. It usually takes about six weeks. If there was a severe tear and stitches were needed, it may take a little longer.
Your stitches will dissolve in about a month. You will need to use pads as usual. If there is pain, it can be controlled with the usual painkillers given by your doctor. If the pain is unbearable, be sure to tell your doctor.
Take-Home Message
- Forceps delivery is a safe method performed by a trained doctor to help both mother and baby if labor stops midway.
- This can help prevent having to undergo a C-section.
- Like any medical procedure, there are small risks, but the risk of doing nothing is often greater.
- Most complications are temporary, and serious problems are rare.
- If you are expecting a baby, it is very important to talk to your doctor about these emergencies before giving birth and to be informed about any questions you may have.
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