Assisted delivery with forceps

When Is a Forceps Delivery Needed?

Even after your cervix is fully dilated (open) and you have been pushing, you may still need help getting the baby out. Reasons include:

• After pushing for 2 hours or more, the baby may be close to coming out, but needs help to get through the last part of the birth canal.
• You may be too tired to push any longer.
• A medical problem may make it risky for you to push.
• The baby may be showing signs of stress and need to come out faster than you can push it out on your own

Before forceps can be used, your baby needs to be far enough down the birth canal. The baby's head and face must also be in the right position. Your doctor will check you carefully to make sure it is safe to use forceps.

Most women will not need forceps to help them deliver. You may feel tired and tempted to ask for a little help. But if there is not a true need for assisted delivery, it is safer for you and your baby to deliver on your own.

What Will Happen to Me During a Forceps-assisted Vaginal Delivery?

You will be given medicine to block pain. This may be an epidural block or a numbing medicine placed in the vagina.

The plastic cup will be placed on the baby's head. Then, during a contraction, you will be asked to push again. At the same time, the doctor will gently pull to help deliver your baby.

After the doctor delivers the baby’s head, you will push the baby the rest of the way out. After delivery, you can hold your baby on your tummy if he or she is doing well.

If the vacuum does not help move your baby, you may need to have a C-section.

What Are the Risks?

There are some risks with forceps delivery, but it rarely causes lasting problems when properly used.

For the mother, they are:

• Severe tears to the vagina
• Problems with urinating or moving your bowels after delivery

For the baby, the risks are:

• Bumps, bruises or marks on the baby’s head or face. They will heal in a few days or weeks.
• The head may swell or be cone-shaped. It should return to normal usually within a day or two.
• The baby’s nerves may be injured by pressure from the forceps. The baby’s face muscles may droop if the nerves are injured, but they will go back to normal when the nerves heal.
• The baby may be cut from the forceps and bleed. This rarely happens.
• There may be bleeding inside the baby’s head. This is more serious, but very rare.

Most of these risks are not severe. When properly used, forceps and vacuum extractor rarely cause lasting problems.

References

Update Date: 5/31/2012

Updated by: Susan Storck, MD, FACOG, Chief, Eastside Department of Obstetrics and Gynecology, Group Health Cooperative of Puget Sound, Bellevue, Washington; Clinical Teaching Faculty, Department of Obstetrics and Gynecology, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.