Forceps or Ceasar?

[Sanzinoz]

Just wondering...
If the most likely scenario of your upcoming birth would involve a forcepts delivery, would you chose an elective c/s or the VB with forcepts?

[Ana Gram]

C-section. I had a vb with forceps and ended up with some pretty nasty damage.

[sam's mum]

VB with forceps. I have had both and would take the recovery from my VB anyday of the week. It was painful and long, but nowhere near as painful and long as the recovery from the cs.

just because you have a cs it doesn't mean that there won't be forceps used though. DS was a cs and they still needed forceps to get him out.

DD2 was a cs and they couldn't get the forceps to her so it was a horizontal and a vertical cut for the cs.

[Duchessa]

VB with forceps. Apart from all the various benefits of having a vag birth, what Sam's mum said about the use of forceps with CS extraction. If you haven't seen footage of a CS and you are planning to have one, you really ought to watch so that you know what they do. Same with if you are planning a vag birth.

My second twin was extracted via my vag with forceps and I only suffered bad bruising and grazing, no tears, no sutures, short recovery.

[Sanzinoz]

Thanks ladies, your responses are interesting. I guess I will elaborate a bit and explain why I am asking. I look forward to any further opinions.

I have had my child and I chose the c/s. I went with what my ob recommended but I guess I am asking because I never actually thought a forcepts delivery VB was considered more risky than a c/s. I dont regret my decision, but I guess I have always wondered about it. And if there was ever a next time, would I do it differently.

I was destined to have another difficult birth and it would no doubt end with the same outcome as the previous 2 (and this baby was 2lbs bigger) which were VBs with forcepts. My ob told me forcepts with a VB can cause all sorts of nerve damage and other injuries to the baby and said a c/s would be preferable. He also said it was safer for me because I heamoraged badly with the first two. I also broke my coccyx both times, and the recoveries were pretty tough. I didnt care about myself and was willing to do it all again, but I in the end I chose not to because I was told it was "safer for the baby". How could I say no to that?

Anyway, believe it or not, my c/s recovery was 100 times better than my two VBs. I felt physically great, didnt haemorrhage, had no pain afterwards, and was up and about not a problem. But I admit I missed the climax of delivery, I felt a bit.. I cant describe it..flat?

I know it turned out better for me, but is it really safer for the baby?

[biscotti]

I would really have to put some thought into it :( If they were the only two options I would find it hard :(

My first child was a VB with forceps delivery and 11 yrs later you can still see the forceps marks on his cheeks. He was born bleeding from these :(

His three sisters though were all lovely VB deliveries but if I had to choose forceps or C/s............hmmmmmm

[MamaLlama]

I'd be very surprised if any Dr actually did forceps. They are very rare now (not so much 11 years ago). Now they will use vacuum pump almost every time forceps was usually used in the past and vacuum has nothing like the risks or disfigurement of forceps.

I would choose vacuum over C/S any day. And I'm not scared of c-sections, I have had 32+ surgeries and have been fine after all of them.

If the Dr really says he will only use forceps not vacuum:

1. I would ask why as it may be he is out of date and you need a new Dr

2. if he has a good reason that you're one of the rare cases where forceps is better than vacuum then it is a close call. I would be pretty indifferent really between the 2 as long as I had a good epidural for the forceps.

HTH!

[Lastcenturymum]

I had two lots of forceps - one high and the other I asked for! Yes I did! he was stuck, I never felt the urge to push :no: and just wanted him out as I knew it was the last time I would be going through that!

SO glad I didn't have a C section though.

And my kids are bewdiful! :D (oh and no marks or dints after birth either!)

[MamaLlama]

LCM how old are your kids? I asked all about forceps a couple of years ago because I thought I might have DC in Australia. They said the same as the US Drs, don't do forceps usually anymore, vacuum will do 99% of the same job better. My OB said it was 10 years since he'd used forceps.

I was a little paranoid about forceps because I was a forceps birth and got a blockage in my ventricles possibly as a result (though this didn't show up until day 10 and you can't see any scar). So I was reassured that they don't do forceps much. Vacuum didn't scare me at all and I have had vacuum used for DC.

I'm sure the risk in forceps is really low btw, so I wouldn't worry hugely but as I said, I'd rather vacuum if I had the choice.

[Duchessa]

I had forceps just 3 years ago, but it was for a high and swift extraction of internally versioned second twin - vacuum wouldn't have done the job. She suffered a small palsy on one side of her face for a couple of days. In hindsight it probably wouldn't haven been necessary if I hadn't have had the epidural. But that is the risk - drugs increase interventions.

[sweetpea4]

hi all
although forceps and vacuum cup are both used to deliver baby vaginally ,there are 2 very separate indications to use them, its not a case of one or another.
Forceps are used to deliver babies that are higher in the birth canal and to rotate baby to an occiput anterior position then vacuum cup maybe used to deliver not to 'pull' on the forceps, there are 3 different types of forceps too, 2 of which are very rarely used.
Vacuum cups or kiwi cups are only used as a 'lift out' so mum is exhausted after pushing for a while or there is fetal distress, it is obviously less traumatic to the babies head than forceps because of the distance travelled, however it entirely depends on the Drs capabilities which is why lots of women opt for c/s rather than forceps, obs are only supposed to have minimum attempts then its a c/s, and serious consequences if there is birth injury which is why it is rarely attempted, experienced obstetric consultants excepted,
as a midwife I would rather have a c/s than a forceps delivery, vacuum no probs though:thumbsup:

[indigoin0z]

as much as i hate cs...

for the babies sake i would choose cs, as hopefully would end up with less damage, treated a 'little' more carefully/compassionately?....:fingerscrossed:

[edit to add]

btw..
i was a forceps baby and i feel i have a disfigured face structure from it... even DH has seen where a certain mark looks like forcep mark.. & they didnt show me to my mum for 3 days........
*shudder*

[Ana Gram]

Forceps are not rare at all. Lots of women are subjected to them. Apart from the risk of injury to the baby which of course if an important issue, the mother can sustain a lot of damage as well. Thank you rotational forceps which have left me unable to have sex again at the age of 27 :crying:

[MamaLlama]

I had forceps just 3 years ago, but it was for a high and swift extraction of internally versioned second twin - vacuum wouldn't have done the job. She suffered a small palsy on one side of her face for a couple of days. In hindsight it probably wouldn't haven been necessary if I hadn't have had the epidural. But that is the risk - drugs increase interventions.

Actually if it makes you feel any better it almost certainly was not the epidural.

First the research at Northwestern Uni in 2005 or 6 showed no causation of further intervention. Correlation is because women with harder longer labours are more likely to want epis.

Second, epis can decrease the need for forceps or vacuum. In my case for instance having the epi allowed me to "labour down" (ie stay at 10cm and bub descending but not pushing). Not possible without the epi. Otherwise I'd have had a very long pushing phase and could quite easily have been a candidate for a caesar. With the epi I got to within a stone's throw of crowning without pushing, did a short pushing phase and had DC.

Anyway don't know if you will feel better about it but hope so. The latest research is not very well known in the lay community yet and certainly isn't disseminated by midwives who would rather there were no epidurals. Even OBs are probably inured to the criticism of them and don't respond effectively which is a shame.

I did considerable research on the forceps and yes very high rotational procedure is the 1 thing vacuum can't do that forceps can. That's why it is only a 99% replacement. But as I said, 2 OBs have told me they haven't used forceps in a decade (2 partners in the practice I went to), and I very much doubt Australian women are that physiologically different :laughing:

So while you might find a few of the 1% group in this thread (which sufers a selection problem of course as those with experience of forceps are more likely to reply) that doesn't mean they are common.

Anyway FWIW there you go. I have personal issues about the forceps myself having had problems afterwards, but I know enough to know those problems are very rare amongst forceps deliveries (and again this thread will have a selection bias). So I would find it a close call. I certainly think the downside of c-sections is overrated too, they're not as bad as all that and I think much of the fear is due to lack of info and being thrust into an emergency one, which is never going to be by choice obviously.

Good luck!

[tickle]

MamaLlama, it is widely acknowledged that the use of an epidural can diminish the urge to push, thus rendering the pushing ineffective, leading to assisted deliveries. The correlation between the two cannot be dismissed. If I have time, I will dig up some info on it for you, if you like?

I'd love to see that research you referred to by the way.

[Funkychicken]

LCM how old are your kids? I asked all about forceps a couple of years ago because I thought I might have DC in Australia. They said the same as the US Drs, don't do forceps usually anymore, vacuum will do 99% of the same job better. My OB said it was 10 years since he'd used forceps.

I was a little paranoid about forceps because I was a forceps birth and got a blockage in my ventricles possibly as a result (though this didn't show up until day 10 and you can't see any scar). So I was reassured that they don't do forceps much. Vacuum didn't scare me at all and I have had vacuum used for DC.

I'm sure the risk in forceps is really low btw, so I wouldn't worry hugely but as I said, I'd rather vacuum if I had the choice.
Whether an OB uses forceps or a vacuum is purely personal choice, barring those that specifically need one or the other.
If an OB prefers to use forceps, he or she will; if an OB prefers to use a vacuum, he or she will.

[biscotti]

MamaLlama, it is widely acknowledged that the use of an epidural can diminish the urge to push, thus rendering the pushing ineffective, leading to assisted deliveries.


:yes: :( Exactly what happened to me as I mentioned previously in an earlier post and so my boy was born with the really huge (can't remember the technical name lol!) forceps, bleeding.

Never ever again :no:

[Samaras Mummy]

I would choose elective ceaser...Mainly due to the fact my first was an emergency ceaser and the idea of forceps scares me.

[sockstealingpoltergeist]

I would choose the Cs rather then have to go through what you had to again. Wow.

I had a CS with my son and he was so engaged that they had to use forceps to get him out also, so he had a little bit of bruising from that.

[NibbleCurlynBub]

I'd go my VB and put the Forceps somewhere the Dr would not want them to be.

Surely you do not HAVE to have forceps used if you don't want to?

Position change can be just as effective! :)
Pushing lying on your back is actually the least productive position to be in.

ETA: I am also with Tickle!

[stellarella]

Actually if it makes you feel any better it almost certainly was not the epidural.



Actually I would suggest the exact opposite.

It is widely known that epidurals DO in fact increase the rate of further intervention - including assisted deliveries and c/secs.

Have you ever read anything about the "cascade of intervention"...might be a worthwhile read.

I'd also love to see this actual research you continually speak of.

To the OP, I would probably choose to have a VB and cross the "forceps bridge" when and if I come to it. With the knowledge that no two births are ever the same I'd at least give a normal birth a go.

But I see you have already had bub. Congratulations! :hugs:

[NibbleCurlynBub]

Why are you always so easy to agree with Stella?

You really should stick a permanent :iagree: as your signature, because my finger is going to fall off if I keep clicking it every time I see your posts!

[Sanzinoz]

In hindsight it probably wouldn't haven been necessary if I hadn't have had the epidural. But that is the risk - drugs increase interventions.
I didnt even have an epidural with either of my 2 previous births and still ended up with forcept deliveries! Two different obs so no comon factor there either. I tend to think that the size of my babies heads (larger than average circumference), and the size/shape of my pelvis (and coccyx), are just not a good combination.


I'd be very surprised if any Dr actually did forceps. They are very rare now (not so much 11 years ago). Now they will use vacuum pump almost every time forceps was usually used in the past and vacuum has nothing like the risks or disfigurement of forceps.


For both VB births the vacuum was used first but was ineffective. After numerous attempts the obs then used the forcepts. All the vacuum did was suck the skin off their heads!


I'd go my VB and put the Forceps somewhere the Dr would not want them to be. Surely you do not HAVE to have forceps used if you don't want to?

My first two babies were well and truely stuck, I doubt any position change would have helped. Of course nothing would have been certain with #3, but given my two previous births ended this way, and #3 was 2lbs bigger, it was highly likely. If Id tried VB again and he did get stuck like the other 2, by that time there would be no other option but use forcepts.

My ob was actually trying to avoid using them again so I probably wouldnt suggest he put them where the sun dont shine. I think he wanted to use them about as much as I wanted them used on me!

Thankyou everyone for your responses. I honestly didnt realise that forcept deliveries were so risky and injuries were that common. Im sorry some of you and your babies were harmed as a result of forcepts. I was obviously lucky to have had two uninjured forcept babies, and an unharmed c/s baby aswell. You have made me feel more comfortable with my decision and Im certainly glad I listened to my obs advice. Thankyou, that is one lingering thought put to rest permanently, Im glad to have had the chance to discuss it.

[MamaLlama]

That which is "widely known" is usually proved to be untrue by scientific study later on. As it has been in this case.

Please provide evidence to prove that what is "widely known" is actually correct.

[Tam-I-Am]

Actually if it makes you feel any better it almost certainly was not the epidural.

First the research at Northwestern Uni in 2005 or 6 showed no causation of further intervention.

Only in comparison with women who received systemic opioid analgesia - not amongst women who received NO medication during labour. There has been no such study between women who received no medications during labour, and those who received epidurals. See study here (http://content.nejm.org/cgi/content/full/352/7/655).

[muls]

Forceps are still used all the time. I had a VB with attempts at position change and then the vacuum. That didn't work so onto the forceps. I was scared but it wasn't that bad and Locke did come out with a line that we thought was a cut on his eye but within 2 days it had faded away and there are no signs that he was a forcep delivery. I would try to always chose a VB if that was an option.
In saying that everyone is different - CS was my worst fear and I cringe at the thought of an epidural LOL!

[moochymoo]

13months ago my daughter was born. I hadnt crowned yet but they delivered her with forceps. They had 2 failed ventouse attempts first, then used the forceps. She was terribly bruised and sore and i lost 1.5 litres of blood, had a HUGE episiotomy site that took 4 months to heal (the wound broke down twice and was restitched!) and now i have a really bad posterior and anterior vaginal prolapse. BUT i am still glad i delivered vaginally rather than having a caesarian believe it or not! It was a quick last minute decision whether to remove her manually or do a caesar, im glad they chose the first option. She is fine now and so am i!

[Benji]

I had this choice very late in my labour and I chose the VB with forceps.

[moochymoo]

Hi Sweetpea, thats interesting you should say that as a midwife. I often wondered what midwives thought about forceps vs CS if it came down to making a decision. I start my post grad mid in July next year and will hopefully be a bit more educated by the time we have our second baby! :thumbsup: Not that i had much choice in the matter - it was forceps, suction and that was that - had to be done!

[Duchessa]

Mammallama, thanks for your attempt to mollify my feelings about the intervention that followed my epidural, but I can assure you that the epidural more than likely did contribute to it. I think you ought to be very careful perpetuating the dangerous myths about the safety of epidurals. There are many complications, some rare, some common, some minor (headaches, continuing numbness), some extremely serious (paralysis, death) that you seem to be completely ignoring in your quest to bring "painless" labour to all.

[rysmom]

Just wondering...
If the most likely scenario of your upcoming birth would involve a forcepts delivery, would you chose an elective c/s or the VB with forcepts?


I had an Emerg. Caesar WITH forceps and they bruised my sons face, another 4mls and he would have lost his eye! Something about large metals "tongs" just dosen't seem right to me!