Assisted deliveries using forceps: what mothers should know

Posted: 23/04/2021

Assisted vaginal deliveries are common, accounting for around one in eight births in the UK. The aim of an assisted delivery is to mimic a spontaneous birth with the use of instruments to minimise risk to baby and mum. Indications for assisted delivery include labour which is not progressing, concerning changes in the baby’s heart rate, or a health condition of the mother such as heart disease or high blood pressure which limit the amount of time she can safely continue to push.

One of the instruments commonly used for assisted delivery are forceps, smooth metal tongs which are curved to fit around the baby’s head to help them out of the birth canal. The midwife or obstetrician will ask the mother for her verbal consent for this procedure, and they will explain why a forceps delivery is advised along with the risks involved. The tongs are inserted between contractions, and carefully placed around the baby’s head. In some cases an episiotomy (small cut to the perineal tissue) will be performed before inserting the forceps to avoid tearing, and local anaesthetic will be given for pain. During the next contraction, the mother will be asked to push whilst the obstetrician gently pulls on the forceps blade to help to deliver the baby’s head.

Forceps delivery is usually a safe and effective method of assisted delivery. However, there are certain situations in which it should not be attempted. These include where the baby’s head has not descended past the midpoint or the birth canal, abnormal positioning (eg shoulders or arms first), or where the position of the baby’s head is unknown. There are also small but significant risks to mum and baby which should be discussed prior to attempting the procedure. Serious injuries to the baby are rare, but can include the following:

• facial injuries
• facial palsy – damage to facial muscles
• skull fracture
• cranial bleeding
• seizures
• eye trauma

We are currently investigating two separate potential claims where our clients’ babies have suffered major lacerations to the face following attempted forceps deliveries. In both cases the forceps blades became stuck and after several attempts at extraction, had to progress to removal in theatre followed by emergency caesarean section. Major lacerations such as these are very unusual, and we are investigating whether they were as a result of a lack of reasonable care and skill.

If you are concerned that you or your baby have suffered avoidable harm following assisted delivery, a member of our specialist team will be able to have an initial, no obligation discussion with you and to assess your options in pursuing a legal claim.

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