Forceps Delivery Injury
Kimberly Langdon, M.D. Medical Reviewer
Birth-assisting tools have been commonplace during difficult deliveries for many decades. Although they are certainly beneficial when used appropriately, the percentage of birth injuries associated with these tools, in particular forceps, has been a cause for concern. Even though the statistics show that forceps delivery injury are a real problem, physicians continue to use them, despite the chances of inflicting trauma on infants.
What are Forceps? How are They Used?
A pair of forceps is a birth-assisting tool that closely resembles large salad tongs. The open end of forceps are typically placed around the infant’s head to help guide the baby out during the mother’s contractions.
Most physicians acknowledge that sometimes there is a risk of forceps delivery injury, but if there are other problems, such as fetal distress during labor and delivery, they may turn to forceps for assistance.
When Do Doctors Use Forceps?
The most common reason forceps are used happens when the mother is unable to push the baby out alone during delivery. This can happen for a variety of reasons including maternal exhaustion, non-reassuring fetal well-being, a prolonged second stage of delivery, illness or infection, hemorrhage or when drugs keep the mother from being able to push the baby out successfully.
In almost all cases, forceps are not used unless there is a means to perform an emergency cesarean section surgery (C-section) within 30 minutes should the use of forceps prove unsuccessful, which is the case at all hospitals and birthing centers.
What are the Risks of Using Forceps?
When doctors use forceps, both mother and baby are at risk for injuries.
Maternal risks include:
- Tears and lacerations in the lower genital tract area
- Fecal and/or urinary continence
- Perineum pain
- Anemia
- Bladder injuries
- Urethra injuries
Infant risks include:
- Facial palsy and facial injuries
- Bruising and swelling on the head
- Skull fractures
- Seizures
- Brain damage
What are the Symptoms of a Forceps Injury?
In most instances, the symptoms of a forceps injury are straightforward, such as lacerations or bruising. Other symptoms of forceps injury can include:
- A misshapen head (such as with a newborn hematoma, or cephalohematoma)
- Nerve damage
- Skull fractures
- Intracranial hemorrhage
Forceps deliveries rarely result in serious injury, but you should take a forceps injury seriously. Be certain to have your doctor assess your baby’s head and brain for a number of birth injuries that may pose serious health issues, including:
- Seizure disorders
- Neonatal stroke
- Neonatal hypoxic ischemic encephalopathy (HIE)
- Cerebral palsy
Do Parents Have a Choice?
Physicians not only have the responsibility to ensure that you and your infant are as safe as possible during a forceps procedure, but they are also obligated to inform you of the risks. It’s a common misconception that parents do not have a choice of the physicians using forceps or not, but if you feel uncomfortable, you can always recommend to forgo it and undergo a C-section or if the baby is stable, allow a longer second stage (pushing stage).
Kimberly Langdon, M.D. is a retired board-certified OB/GYN with 19 years of clinical experience. She currently works as a medical writer and featured healthcare expert. She is a regular medical reviewer for Birth Injury Guide.
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