The use of forceps has always been “controversial,” used in situations where they were a “last resort.” Today, some obstetricians are questioning whether using forceps is wise given the risk of fetal injury. Because of this risk, the use of forceps has declined over the past few decades. With fewer doctors teaching and performing forceps deliveries, healthcare professionals have less experience with them than ever before. Unfortunately, many birth injuries occur due to that inexperience. These birth injuries can have devastating and lifelong effects on newborns and their families.
When is it safe to use forceps?
There are a number of conditions which must be met in order for forceps to be used safely. They include:
- The mother’s water must have already been broken
- The mother being fully dilated and effaced
- The baby’s head being in a specific position in the birth canal
- The mother’s pelvis and the baby’s size are known and compatible
- Anesthesia is available for the mother
- Personnel and support equipment is on stand-by
- The surgeon is familiar with forceps and has the skills to use them
- There is a willingness to abandon attempts if the forceps don’t work
- The mother understands the procedure and has agreed to it
Forceps should not be used if any of these requirements are not met.
Forceps must be properly placed to avoid injury
In cases where forceps are used, it is essential that they are properly placed on the baby’s head to avoid injury. Forceps resemble tongs. Proper placement requires that the “blades” lie evenly against a baby’s head, placed in a location where they are not likely to cause birth injury and damage. If the forceps are applied unevenly to the baby’s head, strain could increase and cause compression of the head as well as bleeding in the brain. Other potential problems include facial bone distortions, brain swelling and brain damage which could generate other secondary issues such as seizures, epilepsy, and ischemia.
Although forceps deliveries are less and less frequent, the potential for catastrophic birth trauma still exists. In cases where birth injury or brain damage as a result of forceps is suspected, a thorough investigation is a wise course of action.