Forceps use during delivery has decreased as cesarean deliveries have increased and vacuum suction has become available. Most forceps deliveries today are low forceps deliveries in which forceps are applied when the baby’s head is visible or low in the pelvis. High forceps deliveries, once used to deliver a baby that was still high in the pelvis, are no longer used since cesarean section is a much better option for delivery in this case. Forceps are used in fewer than 10 percent of deliveries in the United States. Luckily, in the hands of skilled obstetricians, they prevent rather than cause negative outcomes.
Forceps deliveries have some benefits for a fetus. For example, they can be used to quickly deliver a baby in distress, often preventing potential asphyxiation and brain damage, although both may still occur. Negative fetal effects from forceps use include possible facial bruising, lacerations intracranial hemorrhage and skull fracture. In rare cases, death of the fetus can occur. Temporary facial nerve paralysis, with drooping noted on one side of the face, usually resolves within a few weeks, the University of Maryland Medical Center states.
Use of forceps can cause cervical and vaginal lacerations and may extend an episiotomy or tear into the anus and rectum. If the bladder isn’t emptied with a catheter, damage to the bladder may also occur. Infection, hemorrhage requiring transfusions, uterine lacerations and injury to the pelvic nerve are possible complications, according to obstetrician Diaa El- Mowafi, M.D. of the Benha Faculty of Medicine. Long-term maternal effects include the inability to control bowel movements, which is known as fecal incontinence.
Forceps use during delivery has two main purposes: to provide traction to gently pull the baby down the birth canal and out into the world, and rotation of the baby’s head if it’s not facing the right way, according to Dr. El-Mawafi. If the baby is facing “sunny side up,” known as occiput posterior presentation, rather than looking down, he may have trouble navigating the birth canal. Rotating the head and applying traction facilitates delivery. If maternal exhaustion or excessive numbness from epidural anesthesia has occurred, forceps delivery can hasten the delivery.