At the end of a labour, when the baby is about to come out, sometimes the birth stalls a little or requires a final nudge in order to fully deliver the baby. Apart from a major intervention such as a caesarian, there are other options. These include performing an episiotomy, or using a ventouse or forceps to ease the baby fully out of the mother's vagina.
What are forceps?
Like ventouse, forceps are a manual way of easing the baby out. But where ventouse uses a sucker motion to pull the baby out, forceps are large, gently curved tongs which are inserted into the mother's vagina and clasped around the baby's head. They are then used to ease the baby down the birth canal.
Your labour team would decide if using forceps was the best option in the circumstances, and, whilst they would only use forceps (or ventouse) if absolutely necessary, forceps would certainly be seen as preferable to opting for a caesarian.
When might forceps be used?
At the very end of the labour, when the neck of the womb is fully open and the mother has begun to push, things can suddenly slow down, or prove to take longer than hoped.
If the baby's head is already in the birth canal but the mother begins to find she is too tired to push any more or any harder, or if the baby begins to show signs of distress and needs to be delivered more speedily, then assistance to ease the baby out might be needed. (Forceps may also be used if the baby is presenting in a posterior position or when the baby is being born naturally, but is in a breech position.)
What happens when forceps are used?
If the mother is not already lying down, she will need to get onto the bed. And if she has not already had any local anaesthetic, a spinal block or epidural might be administered at this point.
The mother's legs are then raised and kept in position in stirrups (as when having a gynaecological examination). Then the forceps are inserted into the vagina one at a time (there are two) and placed so they fit at the sides of the baby's head, over the ears.
The obstetrician then pulls gently for about half a minute at a time, easing the baby down to the point at which the head can be freed with a natural birth or with an episiotomy. While the forceps are being used the mother should not experience any pain, and once the baby's head has been delivered, the forceps can be take out allowing the rest of the baby's body to be delivered without any trouble.
Are there any risks when using forceps for delivery?
Although some women may feel they have 'cheated' slightly by having assistance to get the baby through the birth canal, there is still a great deal of physical effort during the labour and such feelings should be put aside.
However, using forceps can increase the risk of the mother needing stitches because of a tear or an episiotomy, and there can be a greater risk of damage to the muscle around the anus.
There can be some bruising to the baby's face or head, but this should only be temporary and leave no long-lasting marks.
