Forceps and vacuum tools have been commonly used for difficult births for many decades.
Although they can be beneficial when used appropriately, there is an increased risk of birth injuries to babies and complications for women following instrumental birth.
Around 1 in 8-9 births in the UK, Australia and the US are assisted. The most common reason for using instruments to help the baby to be born is because the mother is unable to push the baby out herself.
Sometimes it is necessary for babies to be born quickly for safety and an instrumental birth helps to avoid a c-section.
Yet there are a number of things that contribute to instrumental birth which can be avoided.
4 Ways To Avoid A Forceps Or Vacuum Assisted Birth
Here are 4 ways to avoid a forceps or vacuum assisted birth.
#1: Avoid Having An Epidural
Epidurals are the most popular form of pain relief used during labour, with over half of all women birthing in hospital having one.
The anaesthetic used in an epidural prevents your muscles from working, as well as blocking the nerve impulses which send pain messages to the brain. This means you are unable to move and need to lie on the bed while the epidural is in place.
Women with an epidural in place are three times more likely to need forceps. This can be for a number of reasons:
- She can’t move her legs and is unable to work with her body during contractions, finding the positions which assist her baby to get into a good position for birth
- Epidurals interferes with the production of oxytocin, the hormone which controls the rate and intensity of contractions. This can cause contractions to slow down or stall.
- Epidurals numb the nerves that control the pelvic floor muscles, which guide the baby’s head into a good position for birth. This can lead to a longer second stage or failure to progress
Find out everything you need to know about epidurals so you can make an informed decision about having one.
#2: What’s The Rush?
In hospital, the second or pushing stage of labour is expected to be complete after 2 hours. If this stage extends past this time, in most cases labour will be considered stalled or arrested.
The options are usually to try and assist the baby to be born by the use of forceps or vacuum, and failing that perform an emergency c-section.
During the first stage of labour, contractions are dilating the cervix. Once this is completely dilated, the contractions push down onto your baby, pushing him downwards.
If your baby is in the perfect position for birth (bottom facing your belly and chin tucked), the second stage usually progresses well. However not all babies are in the optimal position for birth and need time to tuck in their chin and rotate through the pelvis. Two hours might not be enough time for this to happen and this is where patience is needed, if baby is not distressed.
A study published in 2014 found that of 42 000 women who gave birth in San Francisco, 95% who were having their first baby had a second stage lasting 3 hours 20 minutes without an epidural. This research shows the standard 2 hours for second stage is not enough time and is likely leading to care providers taking over, assuming labour is not progressing.
#3: Have Continuous Birth Support
History tells us traditionally women cared for women during labour and birth. However as birth shifted from home to hospital over 100 years ago, this continuous support during labour became less common.
Continuous support during labour has a positive effect on the outcomes of birth. Women who have the support of a known and trusted person during labour have a greater chance of an intervention free birth and report feeling more satisfied with their experience.
A Cochrane review of studies involving 15,000 women found those with continuous support during labour were less likely to have forceps, vacuum or c-section, less likely to use pain medication and has shorter labours.
The review looked further and found the best results occurred when women had continuous support from a doula – someone who was not a staff member of the hospital or someone from her social network (partner, mother, sister, friend).
#4: Have An Active Birth
Most women today are aware of the benefits of an active birth.
Being free to move during labour allows you find positions which best help you to cope during contractions. Your baby is able to find the best position to be in for birth, and gravity can help your baby descend when you are in an upright position, such as hands and knees or squatting.
Unfortunately, lying down during labour and birth is still incredibly common in many hospital settings. This can be due to care provider preference, continuous fetal monitoring, use of artificial oxytocin leading to epidural, lack of knowledge and support.
Lying down can cause labour to slow down, appearing to be lack of progress. Pushing may be less effective, as you are trying to push your baby out on an uphill angle. It is also a lot more tiring to be working against your body, which can lead to less effective pushing. All this can contribute to needing forceps or vacuum to assist your baby to be born.
Having an assisted birth is may be unavoidable but being informed about the factors which increase your chances can go a long way to avoiding this. Choose a birth place and care provider who genuinely supports an undisturbed labour. Prepare for birth by becoming informed about active birth and learning natural labour techniques.