What is a forceps delivery?
A forceps delivery is one type of assisted vaginal delivery. This simply means that forceps were used to help deliver the baby vaginally.
What are forceps?
Forceps are a type of medical instrument doctors and surgeons often use to help facilitate medical procedures. Forceps come in different shapes, sizes and serve different purposes. Forceps used for delivering babies are shaped like a pair of large spoons or salad tongs and are used by health care professionals to help guide the baby out of the birth canal.
How are forceps used during the birth process?
Forceps are placed on the baby’s head (inside the mother’s uterus) and can be used to rotate the baby’s head to help the birth process.
When might a doctor use forceps to help deliver a baby?
In certain situations, a baby may need help being delivered and a doctor may offer the mother in labor the option of a caesarean birth or forceps delivery. However, in certain situations, your doctor may recommend or decide that you need a forceps delivery.
Forceps are sometimes used:
- If your baby’s heart rate or rhythm is abnormal (a nonreassuring heart tracing on the fetal monitor.)
- If your baby is in fetal distress and needs to be delivered quickly;
- If your baby is not in a safe position for the pushing stage of labor;
- If your baby gets stuck in the birth canal or you are pushing and your baby is not progressing, or if there is a prolonged second stage of labor.
- The mother is exhausted and can no longer push, or has received medications that inhibit her ability to push.
- The mother’s health is in jeopardy (i.e., she has a medical condition such as high blood pressure, aneurysm, or a heart condition that would make pushing too hard or dangerous.)
- If the mother starts to hemorrhage (bleed suddenly and heavily).
- After-coming head in a breach delivery.
What are the risks associated with a forceps delivery?
As with any medical procedure, the use of forceps to aid in delivering a baby has the risk of complications, however, the benefits of correct use of forceps may outweigh the risks of delaying birth, or those of a cesarean delivery for certain women who may have their own health risks.
A forceps delivery carries the same risks for both the mother and her baby as a non-assisted vaginal delivery, however, there are additional risks associated with forceps assisted vaginal deliveries, and there are more likely to be complications in a forceps delivery than in an unassisted vaginal delivery.
Possible risks to the mother include:
- Pain in the Perineum (the soft tissue between your vagina and your anus, this is also an expected risk in non-forceps vaginal deliveries.)
- Lower Genital Tract Tears and Abrasions (this is also an expected risk in non-forceps vaginal deliveries.) If your doctor performs an episiotomy to repair tears, there is also a risk of postpartum bleeding and infection.)
- Difficulty Urinating or Emptying Your Bladder
- Short- or long-Term Urinary or Bowel Incontinence (involuntary urination or defecation)
- Secondary Anemia Due to Blood Loss
- Third Degree Tear
- Injuries to the Bladder and/or Urethra
- Uterine Rupture — when the uterine wall is torn, which could allow the baby or placenta to be pushed into the mother’s abdominal cavity
- Pelvic Organ Prolapse (Tearing, or weakening of the muscles and ligaments supporting pelvic organs, causing pelvic organs to drop lower in the pelvis.)
Although every birth story is unique, generally speaking, when forceps are properly used, the delivery should be quick and the baby should not be injured. To reduce the risk of injury to both the mother and child, there are certain conditions that must be met before a doctor should use forceps, and certain situations under which they should never be used.
- Facial Injuries Due to the Pressure of the Forceps
- Facial Palsy (weakness in the facial muscles which can be temporary or permanent)
- Eye Injuries (including minor external eye trauma, strabismus (crossed eye), and other eye injuries)
- Skull Fracture
- Bleeding Within the Skull
Maternal Potential Long-Term Complications of a Forceps Delivery
Forceps deliveries can result in injury to both the mother and her baby that may not be immediately evident. In the case of the mother, she may develop secondary anemia as a result from blood loss, or an infection. More concerning, however, is the potential to have longer-term complications associated with obstetric anal sphincter injuries (OASIS). One study review (see below) showed that women suffered endosonographic sphincter damage in 83% of forceps deliveries:
Forceps delivery and complications
The review article by Patel and Murphy gives a concise and clear overview of the current state of play regarding the use of forceps in modern obstetric practice. The article addresses the issue of third degree tears, but does not discuss the occult sphincter injury that may lead to symptoms later in life. The incidence of endosonographic sphincter damage following forceps delivery has been reported in 83% of forceps deliveries when studied prospectively, and this was supported by manometric abnormalities in these patients (1). Faecal incontinence which develops in women in later life (age 60-70 years) has been associated with previous obstetric sphincter injury in 70% of patients, in whom a sphincter defect can be demonstrated ultrasonongraphically (2). Source: BMJ
In conclusion, the article states:
There is thus a cohort of women who will have an occult sphincter injury that will only develop symptoms later in life. Women undergoing forceps delivery should be warned of this possibility.
Did your baby suffer a birth injury as the result of a forceps delivery?
If you, or your baby suffered a severe injury as the result of forceps assisted delivery or medical neglect or malpractice you may be entitled to compensation. If you have questions about what happened and why your baby was injured, don’t trust an insurance company or doctor to provide you with all the information you need, call our lawyers today.
We offer a free legal consultation so you can tell us about your unique situation. Our lawyers will be able to tell you if you have a case, the value of your case, and discuss your various legal options. We encourage you to at least talk to us and learn what your rights are so that you will have knowledge to help you make the best decision for your family about how to protect those rights for your child.
The Los Angeles area law firm of Donahue & Horrow, L.L.P., handles birth injury cases throughout California. The initial consultation will be at no cost. Cases are billed on a contingency fee basis. There will be no cost unless or until we recover compensation in the form of a trial award or insurance settlement.
Contact us today and you will have taken your first step towards ensuring your child’s future needs will be met.