Will I need forceps for my delivery? How about a vacuum extractor?
In a forceps delivery, the physician applies the metal instruments shaped like a pair of large curved spoons to the baby’s head after the mother is fully dilated. With great care, the physician pulls on the instrument during a contraction while the mother pushes.
Your doctor might recommend a forceps delivery if:
- You’re pushing, but labor isn’t progressing.
- If there is a change in your baby’s heartbeat and an immediate delivery is necessary
- You have a medical condition such as a narrow aortic valve and your doctor needs to limit the amount of time you are allowed to push for your safety.
- The baby’s head is facing the wrong direction such as occiput posterior –facing up rather than down –occiput anterior
Minor marks on your baby’s face after a forceps delivery are normal and temporary. Serious infant injuries after a forceps delivery are rare.
If a forceps delivery seems to be the best option, your doctor will explain the risks and benefits of the procedure and ask for your consent.
History tells us that the modern forceps were invented by the eldest son of the Chamberlin family in the early 17th century or late 16th century. Five generations of the Chamberlin family kept the secret of the instruments that were the key to the success of their midwife/obstetrician dynasty as they served the Royal families and nobles of Europe.
My first experience with forceps was as a third year medical student. A woman presented in advanced labor ready to deliver. She said she had delivered 4 or 5 children before but had not had prenatal care for that pregnancy. This was just the case for me a doctor-in-training. I performed all the maneuvers that I had studied and was just waiting for the placenta to deliver when we discovered the feet of the second baby presenting. The room exploded with personnel and I watched as the chief resident skillfully applied forceps and guided the after-coming head of the seven pound healthy baby boy out of the birth canal. This experience probably had a good deal to do with my decision to go into obstetrics and gynecology.
Attempts at forceps deliveries aren’t always successful. If the doctor isn’t able to properly apply the instrument, she may opt for a Cesarean section instead.
The vacuum extractor is used for all of the same reasons as the forceps and may be used instead of forceps at the preference of the doctor. The main advantage of the vacuum is that it is easier to place on the baby’s head.
Use of forceps and vacuum extractors to assist in a vaginal delivery rather than cesarean section in certain selected cases is promoted by the American Congress of Obstetricians and Gynecologists.
A number of obstetricians however, well trained in their use, have abandoned the use of forceps and vacuum extractors. This is because of sometimes poor publicity concerning these instruments and fear of medical litigation. These instruments, like anything else are safe when used properly and in the hands of trained practioners.