Forceps Delivery

1 What is a Forceps Delivery?

A type of assisted vaginal delivery is called forceps delivery which is sometimes needed in the course of vaginal childbirth.

Your doctor will apply an instrument shaped like a pair of large spoons or salad tongs called forceps to the baby's head to help guide the baby out of the birth canal which is done during contractions.

A forceps delivery poses a risk of injury for both mother and baby. A cesarean delivery (C-section) might be needed if a forceps delivery fails.

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2 Reasons for Procedure

The reasons for forceps delivery include:

  • your cervix is fully dilated
  • your membranes have ruptured
  • and your baby has descended into the birth canal head first, but you're not able to push the baby out

Your doctor may suggest this if:

  • your baby’s heartbeat suggests a problem because if the changes in your baby’s heartbeat
  • you are pushing but labor is not progressing - labor is considered stalled if you've pushed for a period of two to three hours but hasn't made any progress if you've never given birth before
  • your baby is facing the wrong direction – if your baby is in occiput posterior position rather than occiput anterior position
  • you have a health concern such as medical conditions

Your doctor may give you precautions against a forceps if:

  • your baby's head hasn't yet moved past the midpoint of the birth canal
  • your baby has a condition that affects the strength of his or her bones, such as osteogenesis imperfecta, or has a bleeding disorder, such as hemophilia
  • your baby might not be able to fit through your pelvis due to his or her size or the size of your pelvis
  • the position of your baby's head isn't known
  • your baby's shoulders or arms are leading the way through the birth canal

3 Potential Risks

Some of the forceps delivery potential risks include:

  • lower genital tract tears and wounds
  • pain in the perineum after delivery
  • anemia due to blood loss during delivery
  • difficulty urinating or emptying your bladder
  • injuries to the bladder or urethra — the tube that connects the bladder to the outside of the body
  • short-term or long-term urinary or fecal incontinence (involuntary urination or defecation)
  • the weakening of the muscles and ligaments supporting your pelvic organs, causing pelvic organs to drop lower in the pelvis (pelvic organ prolapse)
  • uterine rupture — when the uterine wall is torn, which could allow the baby or placenta to be pushed into the mother’s abdominal cavity

You're also at risk of postpartum bleeding and infection if your doctor does an episiotomy which an incision in the tissue between the vagina and the anus that can help ease the delivery of your baby.

Possible risks include:

  • seizures
  • minor external eye trauma
  • temporary weakness in the facial muscles
  • minor facial injuries due to the pressure of the forceps
  • skull fracture
  • bleeding within the skull

Serious infant injuries after a forceps delivery are rare.

4 Preparing for your Procedure

In preparing for your forceps delivery, you must follow your doctor’s orders.

Your doctor may try other ways to encourage labor to progress before he considers forceps delivery such as adjusting your anesthetic to encourage more effective pushing or intravenous medication (Pitocin) to stimulate stronger contractions.

Your doctor will explain the risks and benefits of the procedure and ask for your consent if a forceps delivery seems to be the best option.

Your doctor will give you an epidural or a spinal anesthetic if the procedure is not done for an emergent reason (the baby's heart rate is dropping) if you haven't already been given a regional anesthetic.

Your doctor or nurse will place a catheter in your bladder to empty it of urine.

5 What to Expect

Read on to learn more about what to expect before, during, and after your forceps delivery.

You will lie back on a table slightly inclined to spread your legs apart. You might be asked to grip handles on each side of the delivery table to brace yourself while pushing.

Your doctor will place two or more fingers inside your vagina and beside your baby's head in between contractions.

He will gently slide one tong between his or her hand and the baby's head, followed by placement of the other tong on the other side of your baby's head.

To cradle your baby's head, the tongs will be locked together. Your doctor will use the forceps to rotate your baby's head between contractions if your baby's head is facing up.

Your doctor will unlock and remove the forceps before the widest part of your baby's head passes through the birth canal if delivery of the baby is certain.

Forceps deliveries aren't always successful. Your doctor may get a cup attached to a vacuum pump to deliver your baby or think of a C-section if he did not properly grasp the baby with the forceps.

C-section will happen if your doctor applies the forceps but isn't able to move your baby after three pulls. After delivery, your doctor will examine your injuries because any tears or incisions will be repaired.

Your baby will also be monitored for signs of complications that can be caused by a forceps delivery.

By the time you got home, you may:

  • soothe the wound by applying an ice pack to the affected area or use hazel pads
  • take the sting out of urination by pouring warm water over your vulva as you urinate
  • prevent pain and stretching during bowel movements
  • sit down carefully such as tightening your buttocks as you lower yourself to a seated position, you may also want to sit on a pillow
  • consider complimentary treatments like lavender to relieve the pain after a tear, you may use this at your bath or directly apply it in the affected area

Consult your doctor if you develop a fever or you notice a pus-like discharge.

You might leak urine when you a cough, strain or laugh because pregnancy and delivery stretch the connective tissue at the base of the bladder and can cause nerve and muscle damage to the bladder or urethra.

Do Kegel exercises and wear sanitary pads. Kegel - tighten your pelvic muscles as if you're stopping your stream of urine. Try it for five seconds at a time, four or five times in a row.

Work up to keeping the muscles contracted for 10 seconds at a time, relaxing for 10 seconds between contractions. Take steps to keep your stools soft and regular if fear of pain leaves you avoiding bowel movements.

Eat foods high in fiber such as fruits, vegetables, and whole grains — and drink plenty of water. Consult your doctor if you have persistent trouble controlling your bowel movements.

6 Procedure Results

Understanding the results of your forceps delivery will be made possible by your doctor.

Forceps use during delivery has two main purposes to provide traction to gently pull the baby down the birth canal and out into the world, and rotation of the baby’s head if it’s not facing the right way.