Obstetrical forceps

Obstetrical forceps are a medical instrument used in childbirth. Their use can serve as an alternative to the ventouse (vacuum extraction) method. Forceps births, like all assisted births, should only be undertaken to help promote the health of the mother or baby. In general, a forceps birth is likely to be safer for both the mother and baby than the alternatives – either a ventouse birth or a caesarean section – although caveats such as operator skill apply. Advantages of forceps use include avoidance of caesarean section (and the short and long-term complications that accompany this), reduction of delivery time, and general applicability with cephalic presentation (head presentation). Common complications include the possibility of bruising the baby and causing more severe vaginal tears (perineal laceration) than would otherwise be the case (although it is important to recognise that almost all women will sustain some form of tear when delivering their first baby). Severe and rare complications (occurring less frequently than 1 in 200) include nerve damage, Descemet's membrane rupture, skull fractures, and cervical cord injury. Maternal factors for use of forceps: Maternal exhaustion. Prolonged second stage of labour. Maternal illness such as heart disease, hypertension, glaucoma, aneurysm, or other conditions that make pushing difficult or dangerous. Hemorrhaging. Analgesic drug-related inhibition of maternal effort (especially with epidural/spinal anaesthesia). Fetal factors for use of forceps: Non-reassuring fetal heart tracing. Fetal distress. After-coming head in breech delivery. Cuts and bruises. Increased risk of facial nerve injury (usually temporary). Increased risk of clavicle fracture (rare). Increased risk of intracranial hemorrhage - sometimes leading to death: 4/10,000. Increased risk of damage to cranial nerve VI, resulting in strabismus. Increased risk of perineal lacerations, pelvic organ prolapse, and incontinence. Increased risk of injury to vagina and cervix. Increased postnatal recovery time and pain.