Forceps, like many ancient inventions that have proven themselves successful even in modern times, have evolved from centuries of use. The surgical instrument was established in the 16th century, but for reasons other than many would expect. Interestingly, forceps were first introduced in cases of fetal death, used to remove the fetus to avoid maternal mortality.
Over the years, forceps changed in design and in purpose, to safeguard the lives of both mother and baby. Yet no matter how you slice it, forceps have never managed to definitively achieve this goal. Originally designed without the frailty of a living infant in mind, forceps use in childbirth continues to put both mother and baby at risk.
Knowing the Dangers
A forceps delivery is a form of assisted vaginal childbirth sometimes necessary during difficult labor. For example, the mother may have trouble pushing or display certain health concerns, or the baby’s heartbeat or position can pose a problem. A doctor may then use forceps (a surgical instrument resembling tongs, applied to the baby’s head) to direct the baby out.
However, rather than alleviating these complications, they can make the situation considerably worse. If used without caution – that is, too forcefully – forceps can cause untold amounts of damage.
“It is important to understand that, similar to cesarean deliveries, midpelvic forceps and vacuum deliveries are invasive procedures with their own risks,” said Giulia Muraca, a doctoral researcher at the University of British Columbia, who recently conducted a study on midpelvic forceps and vacuum deliveries in Canada. One in 5 women in the study had experienced complications from forceps deliveries.
Not only might the mother suffer outcomes such as pain, injury to the genital or urinary tract, weakening of pelvic muscles or anemia from blood loss, but the baby can sustain injuries that are carried through a lifetime.
Injury by Forceps
According to Mayo Clinic, risks to a forceps-delivered baby include, but are certainly not limited to:
- Facial injuries due to pressure from the forceps
- Facial muscle weakness (also known as Bell’s palsy)
- External eye trauma
- Skull fracture or bleeding
Depending on the severity of the injury, these outcomes can be either temporary or permanent. However, while it goes without saying that both long- and short-term harm to the child are unacceptable and traumatic, serious injury can indicate much more serious consequences. In some instances, forceps delivery symptoms have resulted in life-altering birth injuries. Consider, for a moment, that:
- Facial injuries can cause nerve damage, resulting in permanent disarrangement of facial features.
- Facial or cranial injury is linked to spinal cord injury, which can leave the baby partially or completely paralyzed.
- Skull fracture or bleeding also has the potential to cause brain damage, leading to incurable and severely limiting disabilities such as cerebral palsy.
The idea of leaving the mother and child in such devastating circumstances is surely enough to put an end to forceps. However, for reasons unknown, they remain an integral method in obstetric practice.
Do Forceps Have a Place in Our Future?
Forceps have slowly phased out of childbirth practice and are now used in only 3 percent of cases in the United States. Nevertheless, despite their potential to cause irreversible harm, one can only wonder why they are still in use at all. C-sections are a more common option for difficult births, qualify under the exact same circumstances, and are proven to be safer.
Compounding this mystery is the fact that, because of forceps’ decrease in popularity, doctors are seldom trained on how to use them properly. Lack of assisted delivery experience makes the probability of dangerous medical malpractice – such as misuse of the instrument or misjudgment of its need in the first place – much higher.
“Unless we can improve our ability to select candidates for midpelvic forceps and vacuum deliveries or improve training in such deliveries,” said Muraca, “Encouraging higher rates of forceps and vacuum delivery to reduce the cesarean delivery rate could increase rates of neonatal complications, especially birth trauma, as well as maternal complications such as severe postpartum hemorrhage, and obstetric trauma such as tearing.”
To avoid unorthodox use of forceps altogether, parents can exercise the right to refuse it. While they are encouraged to enter into every birth plan decision with their eyes open, many still believe that forceps delivery has advanced to safer levels. Yet the risks of injury in forceps deliveries are still unmistakable, and opting against the procedure may land forceps exactly where they deserve to be: in the past.