Forceps vaginal delivery is done due to the below conditions:
- When the mother is pushing but the labor has stalled or if the baby is stuck in the birth canal
- If immediate delivery is required due to fetal distress (change in the baby’s heartbeat suggesting that the baby’s health is at risk)
- If the mother is exhausted due to pushing and may not be able to push further
- If the baby is at an unfavorable position during the pushing stage (the forceps may be used to rotate the baby's head)
If the mother suffers from certain health conditions, forceps delivery may be recommended. Health conditions, such as:
- Cardiac diseases like class III or IV heart failure (heart could not pump sufficient blood)
- Hormonal imbalance
- Spinal cord injury
- Severe anemia
What is a forceps delivery?
Forceps delivery is a type of assisted delivery in which tong-shaped instruments are used to ease the baby out of the birth canal. These instruments are used to cradle the baby’s head in the vagina and turn the baby into a better position if needed so that they can be guided out. However, the use of forceps has decreased in recent years. Below are a few common benefits and risks of forceps delivery:
- Delivery may be achieved faster
- The rate of successful vaginal delivery is higher compared to vacuum extraction
- The incidence of fetal scalp injuries is lower
- They can be used to rotate the fetal head into the right position and facilitate normal delivery
- They do not detach from the fetal head during traction if correctly applied
Forceps delivery has its risks for both the mother and the baby. The mother’s risks include:
- Vaginal tears during the delivery
- Bladder injuries
- Urethra injuries
Post the delivery the mother may experience:
- Fecal and/or urinary incontinence
- Perineum (the area between anus and vagina) pain
- Difficulty while urinating
- A weakening of the muscles supporting the pelvic organs
The baby’s risks include:
- Bruising on the baby’s face due to the usage of forceps
- Nerve damage to the face caused by the pressure of the forceps
- Facial injuries
- Skull fracture
- Internal bleeding within the skull
- Temporary eye trauma for the baby due to the pressure of the forceps
- Seizures or shaking of the body
How is forceps delivery performed?
Forceps delivery is done during the second stage of normal vaginal delivery. During this procedure, the patient may be on anesthesia to numb the pain.
The doctor gently inserts two or more fingers inside the vagina and beside the baby's head.
- The doctor then gently slides one part of the tong between the fingers and the baby's head, followed by the positioning of the other half of the tong on the other side of the baby's head.
- Both parts of the tong are then locked together to safely secure the baby’s head in between them.
- If the baby is facing upwards, in between the mother’s contractions, the doctor uses the forceps to gently shift the position of the baby’s head.
- As the labor progresses, the doctor may remove the forceps before the widest part of the baby’s head goes through the birth canal or they may retain the hold of the forceps.
- When the mother experiences the next contraction, the doctor gently guides the baby through the birth canal using the forceps.
If after using the forceps, the doctor is not able to move the baby after three pulls or the baby is not delivered within 20 minutes, the doctor will most likely suggest an emergency cesarean delivery. Alternatively, the doctor may also opt for vacuum extraction.
What should a patient do after a forceps delivery procedure?
While using the forceps to assist in the delivery of the baby, if the doctor had made a cut on the side of the vagina during the delivery (episiotomy), or you had a vaginal tear, there are a few things you can do to accelerate your healing:
- Apply ice packs in the area of the wound right after birth; even when at home, continue using ice packs in the area.
- Use sitz baths a few times a day, which may provide relief from the pain.
- During urination, keep pouring warm water over the area; this may take away the sting of the urine.
- Do not put pressure in that area while passing a stool.
- After urinating or after a bowel movement spray some warm water in the area and pat dry using very soft towels or baby wipes.
- Do not use toilet paper or rub the area hard.
- While sitting down, use a doughnut cushion or a pillow.
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