Forcep Delivery Injuries

Forceps Delivery and Injuries that may Result from It

Forceps delivery is one type of assisted birth wherein forceps are used to deliver a baby. These forceps are surgical instruments that resemble a pair of tongs designed to cradle the baby's head. Medical practitioners often resort to forceps delivery to overcome dystocia, to quickly deliver a baby experiencing fetal distress, to shorten normal labor, in the advent of mother exhaustion or to avoid delivering via a caesarian section.

Prerequisites

A forceps delivery should only be done when the mother is already in the second stages of labor. Before attempting a forceps delivery, there are some prerequisites that should be present such as full dilation of the cervix, engagement of the fetal head, certain knowledge of the position of the head, and ruptured membranes. It is also important to know what type of pelvis the mother has and that the size of the baby’s head and the size of the pelvic inlet and mid pelvis should all be proportionate to each other.

How a Forceps Delivery Performed?

The mother must be given adequate anesthesia. The forceps’ blades will be placed inside the vagina one by one and placed symmetrically to the opposite sides of the baby’s head. The handles of the forceps will then be pulled together to firmly hold the head in between the blades, if necessary the head of the baby will be rotated to either the occiput anterior or occiput posterior position then traction is applied to slowly draw out the baby’s head from the passage. Once the head is out, the forceps will be removed and the baby’s delivery will be completed manually.

Forceps Delivery Injuries

They may be rare but forceps delivery may result in injuries—either temporary or permanent to both mother and baby. These injuries are sometimes caused by improper use of the forceps, less experience with the procedure and failure to recognize and manage potential complications. The use of forceps during delivery puts the baby at risk of facial nerve damage, skull fractures, subdural hemorrhaging and cerebral palsy while mothers are at risk of lacerations, urinary tract infections, and rectum injuries.

The use of forceps during delivery may lead to a baby having facial nerve palsy. It is a condition characterized by the loss of controllable muscle movement in the baby's face due to pressure on the facial nerve just before or at the time of the delivery.

A skull fracture otherwise known as cranial fracture is one of the cranial injuries that an infant could suffer during birth as a result of pressure exerted on the infant’s head by the use of forceps.

Pressure from the forceps may also lead to subdural hemorrhaging which frequently results from torn veins associated with tears of the dura of the falx or tentorium cerebella.

The resulting damage to the areas of the brain that control movement and posture as a result of the pressure exerted by the forceps can lead to cerebral palsy. Babies with cerebral palsy are often slow to roll over, sit, crawl, smile or walk.

There are several other factors that can lead to the injuries listed above; the use of forceps during delivery is just one of them.