Call To Ban Forceps – Should Forceps Be Banned During Labour?

Call To Ban Forceps - Should Forceps Be Banned During Labour?

A recent call to ban the use of forceps during labour has sparked debate as to whether these instruments are life saving, or tools of injury.

As reported on ABC News in Brisbane, mother Amy Dawes had a forceps assisted birth, which she says left her with severe vaginal and perineal tearing.

Subsequently, Amy has founded the Australasian Birth Trauma Association support group. She wants forceps to be banned in Australia – or at the very least their use to be restricted.

Why Use Forceps?

Most women can give birth vaginally without any need for assistance. However there are situations when birth needs to happen very quickly, either for the safety of the mother or the baby.

In this situation, forceps may be used. Invented in the 1600s, these metal instruments have been developed and redesigned many times.

Find out more about forceps here.

At the height of the Twilight Sleep era, forceps were used almost exclusively for all women giving birth.

These days, more women will have ventouse, or vacuum assisted births, than forceps. In 2010, 4% of Australian women had a forceps birth; 8% had a vacuum birth.

Of the women who attempt an instrumental birth (forceps or vacuum), less than 3% will need a c-section.

Forceps Versus C-Section

Typically, when a forceps birth is recommended, a c-section is also an option. Care providers should make women aware of the risks and benefits of both options so they can make an informed choice.

It’s particularly important to know there are increased risks for injury when forceps and vacuums are used at the mid-pelvic stage of birth, when the baby’s head is midway down the birth canal.

Many doctors won’t perform mid-pelvic instrumental births. This is important information for women to have beforehand, particularly if they wish to have a vaginal birth and want to find a doctor who is skilled in this procedure.

In the event a mid-pelvic forceps birth is necessary, because a c-section can’t be done fast enough, having a skilled practitioner can be life saving and can reduce the chance of injuries.

If the baby is further than midway though the birth canal then a forceps or vacuum birth is usually the first option before c-section.

Should Forceps Be Banned?

Ultimately, like c-sections or episiotomies, forceps are tools which should only be used appropriately by skilled practitioners, and after all other options have been exhausted.

The vast majority of women give birth in the hospital system, which doesn’t favour normal labour and birth.

Birth has been systematically medicalised to the point where women are more likely to need assistance because of the high level of technology used to keep them ‘safe’ in the first place.

In today’s current birth climate, normal physiological birth is a rare bird in the hospital setting.

In direct contrast to the decline in instrumental births, the c-section rate has been climbing steadily over the past decades. This begs an important question: are obstetricians losing a skill set which would allow them to perform an instrumental birth safely, without risking injury to mothers and babies?

Until recently, a similar situation existed with breech birth. Traditionally, women pregnant with babies in breech position had no choice but to have a c-setion. Care providers with the training and experience to support vaginal breech birth became rare.

A recognition of the need to fill this gap for the safety of women and babies has now led to more obstetricians being able to support vaginal breech birth, providing women with more options.

As ACOG’s Safe Prevention of the Primary Cesarean Delivery statement notes, in a survey from 2007, 55% of resident doctors in training felt they weren’t competent to perform a forceps birth when they’d finished their residency.

The statement recommends training in instrumental vaginal birth and ongoing upkeep of related skills should be encouraged.

Instrumental birth is less likely to occur when women choose midwifery-led models of care. There is a lower rate of instrument use when women have continuous support during labour and give birth outside obstetric settings, such as at home or in birth centres.

Preventing the need for forceps birth is one step in the right direction. For those women who need to decide between forceps or a c-section to birth their babies safely, however, having access to a skilled and experienced practitioner is key to avoiding long term injury.

Should forceps be banned? What do you think?

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Sam McCulloch Dip CBEd CONTRIBUTOR

Sam McCulloch enjoyed talking so much about birth she decided to become a birth educator and doula, supporting parents in making informed choices about their birth experience. In her spare time she writes novels. She is mother to three beautiful little humans.


One comment

  1. I have recently had a forceps delivery using Keillands forceps – these were used to get the baby rotating back to a malposition following manual rotation in order to pull him out. I had no idea about the different types of forceps used during child birth or the risks involved in such a complexed delivery. I had heard of friends having successful forcep deliveries, minus a few stitches, so assumed it was the same process for everyone in this situation.

    I actually asked the consultant and midwives for a C-Section, because I wasn’t prepared to have my baby tampered with – I would have rather suffered the recovery myself; but they wouldn’t even entertain the conversation. Instead they presented me with what I now see as a sales pitch to encourage me to go for the forceps. They made a few comments about clocking off in an hour so I needed to make the decision quickly. The consultant said ‘I’m going off on my shift in a hour so if you want me to do this you have to make the decision now’ followed by the midwife commenting ‘If you want your baby in your arms in the next hour this is what you need to do’

    At this point, I was 48 hours in but 16 hours in ‘active labour’ the baby was back to back, chin up and high up the canal….NOT distressed in any way and I was only just starting to loose control of the pain. I was led to believe that this was the only option for me and there seemed to be a real pressure around the time frame.

    My delivery resulted in my baby having shoulder dystocia, loosing oxygen during the procedure and being completely unresponsive. He was without heartbeat and the neonatal team worked on him for a total of 20 minutes while I waited! The process of resuscitation wasn’t followed correctly and we spent the following 3 weeks in intensive care receiving specialist treatment that I hope will have made a huge impact on the recover for my child. We’ve been told after many scans that he is at high risk of developing cerebral palsy…. which I now realise after extensive research is a high risk under the circumstances in which he was delivered.

    This is the first time I’ve written this down, and I wanted to because these subjects are so taboo with pregnant women…. you just want to think positively leading up to your birth experience and rightly so. But I now believe that information on the birthing options should be more widely discussed..

    Of course, you’d like to think that in the event of needing intervention you can trust the professionals, but this is not always the case. It is your birthing right to make decisions based on your own measured opinion. It’s therefore good to know what options are available.

    Luckily, our Son is doing extremely well and at 3 months is physically stronger than most babies his age, showing no signs of severe CP which is what we have been prepared for, but we’re living in the unknown for what his future may hold atm, and I am now questioning why my wishes for c-section were not considered and discussed. I feel it was my gut instinct telling me that’s what should have happened.

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