Going into labour is both scary and exciting. While you may be anxiously awaiting the birth of your child, you may also be worried about the process (and how painful it may be!).
If your labour is not progressing, it may be necessary to use special tools to assist in a vaginal delivery. Obstetrical forceps are a toll that aren’t used frequently. They are used to guide a baby through the birth canal and/or to turn a baby into a better position for birthing. However, the use of forceps in the hands of a doctor that hasn’t been properly trained (or isn’t careful) can be associated with birth injuries for both the mother and baby, including vaginal lacerations, nerve damage, and even cerebral palsy.
The Birth Injury Lawyers Alliance (BILA) advocates for the rights of families who have experienced birth injuries, including from assisted deliveries. Read on to learn more about forceps deliveries, and how you can get help for a birth injury caused by medical negligence.
When Is a Forceps Delivery Appropriate?
Forceps are tools that obstetricians and other healthcare professionals use to assist in a difficult vaginal birth. Obstetrical forceps look like metal salad tongs but are specialized instruments that are curved to cradle a baby’s head and accommodate the shape of the pelvis. Different types of forceps can be used for circumstances such as breech babies and rotated babies. During a forceps delivery, they are used to grasp the baby inside of the birth canal and help to guide it out.
This type of assisted vaginal delivery is used when labour has stalled. It may be used to avoid a surgical delivery (a cesarean section or c-section). Forceps may be used when a mother is in the final stage of labour but is not progressing.
There are 3 stages of labour: labour, pushing and birth, and delivery of the placenta. During the second stage, if pushing isn’t working to advance the baby down the birth canal, then the medical team should carefully monitor both the mother and fetus. If the baby’s heart rate shows signs of stress from labour – or if the mother has a health condition that makes pushing more dangerous, such as high blood pressure – then the healthcare team may decide to intervene. This is particularly true if a heart rate pattern indicates that the baby may not be getting enough oxygen in the birth canal.
There are two options for assisted delivery: forceps delivery and vacuum extraction. These procedures can only be used if the baby is at least halfway through the birth canal and the doctors can determine their position. Otherwise, it may be necessary to perform a C-section instead of proceeding with a vaginal delivery.
The forceps are placed, one blade at a time, on either side of the baby’s head or feet. This will be done during the rest periods between contractions. At the next rest period, the doctor will apply gentle traction to help guide the baby out or rotate the infant. Forceps should only be used as long as they are helpful and necessary.
Forceps are not used frequently, in part because the use of forceps to deliver an infant requires a great degree of skill and training. However, forceps have a higher rate of success than vacuum extraction. They can also be used on a baby in the breech position (feet first) or to rotate an infant into a better position for a vaginal birth.
Forceps delivery may be indicated if you have been labouring unsuccessfully for a period of one to four hours (depending on your health), the baby is at least halfway down the birth canal, and the baby’s heart rate shows signs of fetal distress. However, there are some contraindications for a forceps delivery, including:
- Not being fully dilated
- An infant that is more than 6 weeks premature
- The baby’s arms are leading its body through the birth canal
- The infant’s position cannot be determined
- The baby has a bleeding or bone disorder
- The baby appears as though it may not fit through the birth canal
If the use of forceps will not be safe for the mother or baby, then the delivery team should consider other options for a vaginal birth or proceed to a c-section.
Injuries and Complications That Can Occur from Forceps Deliveries
While a forceps delivery may be necessary to safely deliver a baby, it comes with a risk of severe injuries to both mother and baby. This can include both minor, temporary birth injuries like bruises and lacerations, as well as more serious and permanent disabilities like cerebral palsy.
Potential injuries to a baby from forceps delivery during a vaginal birth include:
- Shoulder dystocia
- Bone and skull fractures
- Brain damage
- Intracranial hemorrhage (bleeding inside of the brain)
- Seizures
- Nerve damage, particularly to the arms, hands, and shoulders
- Facial palsy, which is usually temporary
- Facial injuries, including bruises and lacerations
Most seriously, the use of forceps can increase the risk of brain damage in a baby. Brain damage is associated with several conditions, including cerebral palsy (CP). Cerebral palsy is a movement disorder that can cause motor delays and lifelong disability.
Nerve damage is another potential complication from a forceps delivery. One of the most common forms is Erb’s palsy, which results from nerve damage in the shoulder, arm, or hand (the brachial plexus). It is often associated with shoulder dystocia, where one or both of the baby’s shoulders gets stuck in the mother’s pelvis during a vaginal birth. If a doctor pulls on the baby to dislodge the shoulder, it can tear the nerves in the baby’s brachial plexus.
This type of assisted delivery also carries the risk of injury to the mother. The use of forceps is associated with:
- Vaginal tears, which are more common with forceps than with a vacuum delivery
- Urinary incontinence
- Tears of the muscle or walls of the rectum (third or fourth-degree tears)
- Pelvic organ prolapse
- Uterine rupture
While there are situations where a forceps delivery is appropriate, cesarean delivery may be safer in many cases. If your medical team used forceps to deliver your baby and one or both of you suffered permanent damage as a result, you may be able to file a claim against the medical professionals. Through this type of personal injury lawsuit, you can recover financial compensation for your losses.
How BILA Can Help Families Dealing with Birth Injuries
A forceps-assisted delivery may be necessary when the mother’s medical condition and/or the baby’s heart rate require it. However, an instrumental delivery can lead to serious complications. In some cases, a baby and/or mother suffers permanent injury as the result of a botched or unnecessary forceps delivery.
BILA works with families who have been affected by medical negligence. We help clients throughout Canada learn more about their rights and determine if they have a potential birth injury lawsuit. To learn more or to schedule a free consultation with a birth injury lawyer in your province, call BILA today at 1-800-300-2452 or fill out our online contact form.
My Baby Suffered a Birth Injury from Forceps. Can I File a Lawsuit?
The short answer is; possibly. You may be able to file a lawsuit if a physician or other healthcare professional harmed you or your baby due to medical negligence. For example, if a doctor used forceps when it was not appropriate, then it may be possible to file a medical malpractice lawsuit against them.
Through this type of claim, you can recover financial compensation for your child’s injuries and your expenses and financial losses to care for your injured child. Pursuing legal action may also help you feel a measure of justice for the loss that you and your child have suffered. Contact BILA today to schedule a free consultation with a birth injury lawyer in your province.
Are Forceps Delivery Injuries Treatable?
Some forceps delivery injuries are treatable, and may just require time to heal. For example, bruises and cuts may heal on their own. However, some forceps delivery complications cause permanent disability, such as brain damage and cerebral palsy.
If you or your child suffered a preventable birth injury due to the improper or inappropriate use of forceps, you may be entitled to financial compensation. Reach out to BILA to talk to a birth injury lawyer in your province about a potential claim.
How Common Are Forceps Deliveries?
Forceps deliveries are fairly rare. In the United States, just 0.5% of all vaginal births involve the use of forceps. By comparison, 2.6% of births involve vacuum delivery. Approximately 30% of all births involve a cesarean delivery.
While the rate of forceps births is low, the number of birth injuries is high. One study found that 25.3% of all forceps deliveries in Canada resulted in material trauma and .96% resulted in severe neonatal injury, including death. If you or your baby have been harmed by a forceps delivery, contact BILA to talk to a birth injury lawyer in your province about your options.
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