4/20/2019 Forceps delivery - Mayo Clinic

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A forceps delivery is a type of assisted vaginal delivery. It's sometimes
needed in the course of vaginal childbirth.

In a forceps delivery, a health care provider applies forceps — an

instrument shaped like a pair of large spoons or salad tongs — to the
baby's head to help guide the baby out of the birth canal. This is typically
done during a contraction while the mother pushes.

Your health care provider might recommend a forceps delivery during the
second stage of labor — when you're pushing — if labor isn't progressing
or the baby's safety depends on an immediate delivery.

Although a forceps delivery may be recommended during delivery of your

baby, it might be associated with certain risks. If a forceps delivery fails, a
cesarean delivery (C-section) might be needed.

Why it's done

A forceps delivery might be considered if your labor meets certain criteria
— your cervix is fully dilated, your membranes have ruptured, and your
baby has descended into the birth canal headfirst, but you're not able to
push the baby out. A forceps delivery is only appropriate in a birthing
center or hospital where a C-section can be done, if needed.

Your health care provider might recommend a forceps delivery if:

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 You're
4/20/2019 pushing, but labor isn't progressing. Labor
Forceps is considered
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Your health care provider might caution against a forceps delivery if:

Your baby has a condition that affects the strength of his or her
bones, such as osteogenesis imperfecta, or has a bleeding disorder,
such as hemophilia

Your baby's head hasn't yet moved past the midpoint of the birth
canal

The position of your baby's head isn't known

Your baby's shoulders or arms are leading the way through the birth
canal

Your baby might not be able to fit through your pelvis due to his or her
size or the size of your pelvis

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Risks
A forceps delivery can possibly cause risk of injury for both mother and
baby.

Possible risks to you include:

Pain in the perineum — the tissue between your vagina and your
anus — after delivery

Lower genital tract tears

Difficulty urinating or emptying your bladder

Short-term or long-term urinary or fecal incontinence (involuntary

urination or defecation) if a severe tear occurs

Injuries to the bladder or urethra — the tube that connects the bladder
to the outside of the body

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 Uterine
4/20/2019 rupture — when the uterine wall is torn, Forceps
which delivery
could -allow the
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baby or placenta to be pushed into the mother's abdominal cavity

Weakening of the muscles and ligaments supporting your pelvic

organs, causing pelvic organs to drop lower in the pelvis (pelvic organ
prolapse)

While most of these risks are also associated with vaginal deliveries in
general, they're more likely with a forceps delivery.

Your health care provider may also have to perform an episiotomy — an

incision of the tissue between the vagina and anus — before placing the
forceps.

Possible risks to your baby — although rare — include:

Minor facial injuries due to the pressure of the forceps

Temporary weakness in the facial muscles (facial palsy)

Minor external eye trauma

Skull fracture

Bleeding within the skull

Seizures

Minor marks on your baby's face after a forceps delivery are normal and
temporary. Serious infant injuries after a forceps delivery are rare.

How you prepare

Before your health care provider considers a forceps delivery, he or she
might try other ways to encourage labor to progress. For example, he or
she might adjust your anesthetic to encourage more-effective pushing. To
stimulate stronger contractions, another option might be intravenous
medication — typically a synthetic version of the hormone oxytocin
(Pitocin).

You might also ask about alternatives to a forceps delivery, including trying
a vacuum-assisted delivery or proceeding to a C-section.

If you haven't already been given a regional anesthetic, your health care
provider will likely give you an epidural or a spinal anesthetic if the
procedure is not done for an emergent reason (the baby's heart rate is
dropping). A member of your medical team will place a catheter in your
bladder to empty it of urine. Your health care provider might also make an
incision in the tissue between your vagina and your anus (episiotomy) to
help ease the delivery of your baby.

What you can expect

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During
4/20/2019 the procedure Forceps delivery - Mayo Clinic

During a forceps delivery, you'll lie on your back, slightly inclined, with your
legs spread apart. You might be asked to grip handles on each side of the
delivery table to brace yourself while pushing.

Between contractions, your health care provider will place two or more
fingers inside your vagina and beside your baby's head. He or she will then
gently slide one portion of the forceps between his or her hand and the
baby's head, followed by placement of the other portion of the forceps on
the other side of your baby's head. The forceps will be locked together to
cradle your baby's head.

During the next few contractions, you'll push and your health care provider
will use the forceps to gently guide your baby through the birth canal.

If your baby's head is facing up, your health care provider might use the
forceps to rotate your baby's head between contractions.

If delivery of the baby is certain, your health care provider will unlock and
remove the forceps before the widest part of your baby's head passes
through the birth canal. Alternatively, your health care provider might keep
the forceps in place to control the advance of your baby's head.

Forceps deliveries aren't always successful. If delivery with assistance of

forceps is not successful, your health care provider might recommend a C-
section for delivery. He or she might also recommend using a cup attached
to a vacuum pump to deliver your baby (vacuum extraction) as an
alternative. Your health care provider will assess your delivery situation
and make a decision about which option — forceps or vacuum extraction
— is the right choice for you.

If your health care provider applies the forceps but isn't able to move your
baby, a C-section is likely the best option.

After the procedure

After delivery, your health care provider will examine you for any tears that
might have been caused by the forceps. Any tears will be repaired. Your
baby will also be monitored for any signs of complications.

When you go home

If you had an episiotomy or a vaginal tear during delivery, the wound might
hurt for a few weeks. Extensive tears might take longer to heal.

While you're healing, expect the discomfort to progressively improve.

Contact your health care provider if the pain gets worse, you develop a
fever or you notice signs of an infection.
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If4/20/2019
you're unable to control your bowel movements (fecal incontinence),
Forceps delivery - Mayo Clinic

consult your health care provider.

By Mayo Clinic Staff

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