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Forceps Delivery: Why It's Done, What to Expect, How to Heal

by Vannessa Rhoades 03 Apr 2023
Forceps Delivery: Why It's Done, What to Expect, How to Heal

Many people are able to give birth without any medical complications or interventions. Sometimes, however, labor may become stalled, and there is a small chance your healthcare provider will need to help it along. In these instances, they will do what is referred to as an assisted vaginal delivery and use a tool like forceps to help safely deliver the baby. 

What is a Forceps Delivery?

Forceps are smooth metal instruments that resemble large spoons or tongs. They're curved to fit around the baby's head. During a forceps-assisted delivery, the physician will use them during contractions to help gently guide the baby’s head through the birth canal and out into the world.

When is a Forceps Delivery Necessary?

There are a number of situations in which a laboring person might need help getting their baby out. Doctors will sometimes use a forceps delivery in the hopes of avoiding a C-section. According to the National Library of Medicine, forceps delivery may be used for the following reasons:

  • The baby may be stuck (after several hours of pushing) and need assistance exiting the birth canal.
  • The mother may be too exhausted to continue pushing.
  • The mother may have a medical issue (like hypertension or a heart condition) that makes pushing too risky.
  • The baby is experiencing fetal distress and requires extraction faster than the mother can push it out unassisted.

In order to use forceps, the baby’s head must be situated far enough down in the birth canal. The physician will examine the patient carefully to ensure that it’s safe to use forceps. Most patients will not need assisted vaginal delivery. In fact, the use of forceps in infant delivery has fallen out of favor among obstetricians in the past three decades. According to the National Institute of Health, forceps deliveries now make up about only 1.1% of vaginal deliveries in the United States.

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What Happens During a Forceps Delivery?

During a forceps-assisted delivery, the pregnant person will lie on their back with their legs spread apart. The physician may instruct them to hold onto their birthing partner or the handles on either side of the delivery table for support while pushing.

Between contractions, the doctor will place a few fingers inside the vagina to locate the infant’s head. Next, they’ll gently slide the forceps on either side of the head. During the next contraction, the doctor will use the forceps carefully guide the baby through the birth canal. They may also turn the baby’s head downward if it’s facing the wrong way. 

If the doctor determines it is unsafe or ineffective to use forceps, they may try using a vacuum cup attached to a pump to draw the infant out. If neither procedure is ineffective within about 20 minutes, they’ll probably need to deliver the baby via C-section. 

What Are the Types of Forceps Delivery?

More than 700 types of obstetric forceps have been designed to perform assisted vaginal delivery. Specific types of forceps work better for certain delivery situations, so hospitals tend to have several different types available. Some of the most commonly used forceps include the following:

  • Simpson forceps. These have an elongated cephalic curve and are utilized when the infant’s head has been squeezed into a cone-like shape while in the birth canal.
  • Elliot forceps. These have a rounded cephalic curve and are implemented when the infant’s head is round.
  • Kielland forceps. The extra shallow pelvic curve and sliding lock on these forceps are typically used when the baby needs to be turned.
  • Wrigley’s forceps. These have short stems and blades that can reduce the risk of uterine rupture. 
  • Piper’s forceps. The downward-curving stems on these forceps fit around the underside of the infant’s body, allowing the doctor to grasp the head during a breech delivery.

What Are Some Forceps Delivery Complications?

When done correctly by an experienced obstetrician, most infants do very well with a forceps delivery. They usually have only minor marks on their faces immediately following delivery. Serious injuries are quite rare but may include the following:

  • skull fracture or bleeding
  • seizures
  • temporary facial palsy or muscle weakness
  • facial injuries

There is no evidence that forceps delivery has any effect on a child’s development, according to the American College of Obstetricians and Gynecologists (ACOG).

For mothers, forceps-assisted birth is associated with a small increased risk of injury to the tissues of the vagina, perineum, and anus. Some people may have urinary incontinence or fecal incontinence as a result of these injuries. Incontinence may resolve on its own, or treatment may be needed.

Can You Avoid or Prevent a Forceps Delivery?

It’s always possible to experience unexpected complications in the delivery room. Generally, though, the most effective measure you can take to ensure a smooth birth experience is to try to have a healthy pregnancy. That includes eating a healthy diet, following your healthcare provider’s instructions, engaging in regular moderate exercise, and taking a childbirth class to help you prepare for the big day. Knowing what to expect and being prepared can help relieve anxiety and help you stay more relaxed during the process. Pregnant people who are older, have had a previous delivery, or are carrying a larger baby may be at an increased risk of needing an assisted delivery. 

What Is a Recovery From a Forceps Delivery Like?

Patients who experience a forceps delivery will likely have some pain and discomfort for several weeks following delivery. Speak to your doctor immediately if the pain is extreme or doesn’t resolve on its own after a few weeks. Severe or persistent pain may signify a serious medical issue that requires immediate treatment. To help ease pain and swelling after delivery, the American College of Obstetricians and Gynecologists (ACOG) recommends trying the following:

  • Take an over-the-counter pain reliever, like ibuprofen or acetaminophen.
  • Apply an ice pack, cold pack, or cold gel pad to the area.
  • Place a witch hazel pad on a maxi pad. Witch hazel has a naturally cooling effect and is available over the counter at the pharmacy.
  • Use a peri-bottle to gently spray warm water over your perineum during and after urination.
  • Ask your healthcare provider about using a numbing spray or cream to ease the pain.
  • If sitting is uncomfortable, try using a donut pillow to relieve the pressure.
  • Take a sitz bath. This means sitting in cool water that is just deep enough to cover your buttocks and hips.

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The Takeaway

Childbirth is unpredictable. To reduce complications, many birthing centers keep tools like forceps available when needed. Talk to your doctor about their policy for using forceps during birth. Find out whether they are trained and comfortable doing these types of procedures. Some doctors don’t use them at all. Either way, it’s important to discuss this ahead of time and let your doctor know your preferences regarding operative vaginal deliveries. If you don’t want one, you can state this in your birth plan. However, understand that if complications arise, you may require a C-section instead.

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