We are currently living through a great revolution in maternity where the appreciation for natural childbirth is increasing more and more1. Aiming for quicker postpartum recovery for the mother, breastfeeding that occurs more naturally because the milk comes in faster, and the risk of complications being much lower than with a Cesarean section, but there are situations in which medical intervention is necessary for the baby to be born, leading to a forceps delivery. Forceps birth is a vaginal birth, but performed with the help of a surgical instrument similar to a large spoon to aid in removing the baby. The instrument is opened and each end is placed around the baby’s head to assist and enable a quicker withdrawal from the vaginal canal. This method is often used in risky births or when the baby gets stuck, making it difficult to come out, and intervention is required for delivery to occur without distress to the mother and baby.
But as with anything in life that carries risks, forceps birth is not very well regarded by the public and is portrayed as a traumatic situation for mother and baby, which is why it should only be used in extreme necessity2. However, the method is used as a last resort in vaginal birth before resorting to an emergency Cesarean. It is worth noting that the high forceps method, which was invasive and widely used in the past, is rarely used nowadays, giving preference to outlet forceps, when the baby’s head is already visible, and even then is used in only about 5% of vaginal births.
The instrument is also different from older times, when it resembled two spatulas. These could injure the baby where they were attached to pull them out. Nowadays, the forceps is more concave, fitting the baby’s head. Thus, it causes less trauma than the old spatulas.
Consequences of Forceps Birth
There is a lot of wrong information reported about forceps birth, one of them being about the aftereffects left by the procedure. There isn’t much evidence to prove any harmful effects, so nothing can be stated as fact. However, stories from mothers in the 60s and 70s, when forceps were used more frequently and with fewer criteria, explain its reputation. Babies often came out quite bruised, the sides of their heads ended up with deep marks that took a long time to heal. In some cases, babies had a deformed skull for a time due to the force of the procedure. If the baby suffers a superficial bruise as a result of the procedure, it will be much less severe than the consequences from the old types of forceps. Some Cesarean deliveries also use forceps to pull the baby out, usually when the baby is still very high.
One consequence of forceps birth is also the inevitable episiotomy3 during the procedure. The woman will undergo a cut in the perineum (perpendicular to the vagina towards the rectum) to facilitate the baby’s exit. Fortunately, nowadays, high forceps is no longer used. The method is now gentler and aims only to help the mother during pushing so that the baby is born more smoothly. The doctor responsible for the forceps delivery may choose the method when the mother is too tired to push, or when the baby is about to be born but, somehow, cannot come out. It is worth remembering that forceps are not as risky as our mothers and grandmothers say. It is indeed a good way to ensure a trauma-free birth for mother and baby, and also to save the baby’s life. Another method used to help the baby come out more quickly is the vacuum extraction or vacuum delivery, which uses equipment to “suck” the baby out so the doctors can receive them.
See also: All About Natural Childbirth – Does the Cord Interfere?
Photo: Gilberto Santa Rosa
