Forceps Delivery: When Is It Necessary?

Forceps delivery is a form of assisted delivery or instrumental delivery wherein the healthcare provider uses an instrument (forceps or vacuum) to guide the baby out of the birth canal. Some practitioners still use forceps to this day – when absolutely necessary – but the truth is that it has already fallen out of favor due to the risks associated with it. Learn more about forceps delivery here. 

What Are Forceps?

The one used for assisted delivery looks like big salad tongs or a pair of curved spoons with a hole at the center. Looking at them, you’ll notice that the end can “grasp” a newborn’s head. 

Why Would the Doctor Suggest the Use of This Assisted Delivery?

There are several reasons why a doctor will recommend forceps delivery. They are as follows:

• The baby’s head is in an awkward position. 
• The mother or baby is already tired of labor. 
• Prolonged labor, particularly one where you push but isn’t making progress. 
• The baby’s heartbeat appears to indicate a problem.
• The mother has an underlying condition where prolonged labor or pushing is contraindicated. 

The main advantage is that assisted delivery may save the mother from having a major surgery, like Cesarean Section, which is typically more complex during the second stage of labor. 

Note that the doctor will only ever recommend forceps delivery if the cervix is fully dilated, the membranes have ruptured, and the newborn’s head is already down at the birth canal. 

Also, assisted delivery is only performed in a hospital where CS delivery is available. 

What Happens During Forceps Delivery?

Firstly, the doctor will tell you why they think assisted delivery is now necessary. After obtaining your consent, they will most likely give you local anesthetic if you haven’t had your epidural yet. To make the vaginal opening bigger, they might also perform episiotomy 

If there are more concerns, note that they might transfer you to the operating room where they can perform CS when needed. 

The doctor will choose the type of forceps depending on the purpose. For instance, there are forceps specifically made to turn the baby to an appropriate position. 

When it’s time for the assisted delivery: 

• The doctor will insert one piece of the forceps to fit one side of the baby’s head. 
• Then, they will insert the second piece to fit into the other side of the baby’s head. 
• The forceps will be joined at the handles. 
• With the contractions and your pushing, the doctor will very gently pull the baby’s head using the forceps to guide them out of the birth canal. 

What Are the Risks of Forceps Delivery?

Experts say there are possible risks to both mother and baby, although their occurrence is rare. 

Potential risks to mothers:

• Increased risks for lacerations in the vagina, perineum, and urethra. 
• Urinary incontinence (short-term)
• Increased blood loss

Potential risks to babies:

• Bleeding
• Minor facial injuries, like bruising 
• Facial muscle weakness (short-term)
• Skull fractures. Please keep in mind, however, that skull fractures can likewise occur during CS delivery, particularly when the baby’s head is already at the pelvis. 

When is Forceps Delivery Contraindicated?

The doctor will not recommend assisted delivery if the cervix is not fully dilated, the membrane is intact, and the fetal head has not descended yet to the birth canal. 

Also, assisted delivery is contraindicated if the fetal position is unknown or there is cephalopelvic disproportion where there is a mismatch between the fetal head and the mother’s pelvis. 

Learn more about Giving Birth here.