Forceps Delivery Can Endanger Baby

Assisting vaginal delivery of babies with the help of forceps has been practiced for thousands of years, according to ancient Greek, Egyptian, and Sanskrit writings. In current times, forceps delivery is one of two assisted or operative delivery methods used. Although more common in past decades, it is becoming a less frequent option today, accounting for only about three percent of all vaginal deliveries. Since the 1980s, the method of choice for assisted deliveries has increasingly favored vacuum deliveries.

Making the Decision to Use Forceps

The decision to use assisted delivery (forceps or vacuum) is based on the following indications concerning the mother, baby or both.

• Second stage labor (pushing stage) is not progressing;

• Immediate or potential distress for the baby;

• Maternal factor such as exhaustion, bleeding, or heart or pulmonary disease;

• Baby is abnormally positioned (poised for breech birth).

If one of these conditions exists, then several other medical criteria and prerequisites must be immediately assessed before using forceps (the baby’s head must be engaged, cervix must be fully dilated, position of head must be known, and so on). One of the most important prerequisites to forceps use is a practitioner who is skilled with the tool and technique, as well as skilled at recognizing and managing potential complications. This includes knowing when to halt the procedure and consider other options such as cesarean delivery.

Medical Complications of Forceps Delivery

Forceps delivery is accomplished using a metal instrument, similar to tongs, that has rounded edges and handles. The forceps fit around the baby’s head, holding it as the baby is gently pulled out while the mother is pushing. Several types of birth injuries to the baby as well as maternal injuries can occur with forceps deliveries. The risk of injury is higher when a practitioner uses improper technique.

Injuries to the Baby

Fetal complications associated with forceps delivery included:

• Facial bruises or lacerations

• Facial nerve injuries

• Cephalohematomas (bleeding next to the baby’ skull under the scalp)

• Intracranial hemorrhage (bleeding in the brain)

• Skull fractures (very rare)

Injuries to the Mother

Maternal complications include those that occur at the time of deliver as well as longer term complications. The risk of early complications is increased in women delivering their first babies. Injuries include:

• Lacerations to the vagina, cervix, bladder or perineum

• Extensions of episiotomies, rectal tearing and rectal sphincter damage

• Increased blood loss

• Hematomas

• Intrapartum rupture of the uterus

Late complications are usually related to the tissue and organ trauma in the pelvic area that occurred at delivery and include:

• Urinary stress incontinence (urine loss physical activity in the abdominal area such as sneezing, coughing, lifting, sit-ups)

• Pelvic organ prolapse

• Fecal incontinence (from damage to the rectal sphincter)

Forceps deliveries seems to be on the decline. Fetal outcome depends on many factors. Among the most important factors is the skill of the medical team. For the mother, there can be long term negative impacts on the integrity of the pelvic area. Because of this, the American College of Obstetricians and Gynecologists has advocated that women can opt for cesarean delivery on-demand to preserve their pelvic musculature.

If your baby was injured during a forceps birth, you may have a legal claim. Contact an experienced birth injury lawyer to find out if you might have a valid accident lawyer and help decide whether to file a claim for compensation.

(Article from Birth Injury and Medical Malpractice Legal View)