My daughter’s heart rate was dropping when they wheeled a cart full of oddly shaped metal tools into the delivery room. The baby was too big and no longer tolerating the stress of labor. With each passing contraction, her heart rate dropped further and rebounded less. The urgency of the situation became apparent as medical personnel rushed in and out of the room.
The baby was struggling and it became clear an emergency C-section may be necessary to deliver the baby safely. The doctor explained that he would like to attempt delivery with forceps before resolving to a cesarean delivery, and looked to me for consent.
As a first-time mom, a delivery involving forceps or assisted suction wasn’t on my radar. Prior to this moment, I assumed I would either have a vaginal birth or a cesarean birth, but, as naïve as this may sound, I hadn’t entertained the details of each. I knew about pitocin, the drug used to induce labor, and about epidurals to relieve pain. I knew about breathing techniques and various birthing positions, but assisted delivery? Nope, I knew very little.
Rightfully, I was nervous. There wasn’t time to research my options. I had to make a choice now, my daughter’s life depended on it. I asked my nurse, who in only a few short hours had gained my trust, what she would do. She was an angel in scrubs, and had advocated tirelessly on my behalf throughout my entire labor. I told her I was scared. She gave me a quick crash course on assisted delivery, then said, “If you need forceps, this is the doctor you want to do it.” I looked at my doctor, fear and worry no-doubt painted across my face.
“Three pushes and if she’s not out, we’ll go to the operating room.” He said. “Trust me.”
Time was of the essence, and my child’s life was in the balance. I consented. Three pushes later, my baby girl was here, and I cried tears of exhaustion and relief.
When it comes right down to it, we don’t have the ultimate say in our birth experience. There’s a lot left to circumstance, but that doesn’t mean we shouldn’t be prepared to make those decisions when things don’t go according to plan. No one hopes for a delivery with forceps or vacuum-assistance, because that means things aren’t going according to plan. My experience may have been less stressful if I knew a little more about assisted deliveries, so I want to share some facts with you.
Let’s start with the basics, according to the American College of Obstetrics and Gynecology (ACOG), assisted vaginal-delivery only occurs in 3% of deliveries in the United States. Forceps and vacuum-assisted delivery are the two forms of assisted delivery, and both are intended to provided gentle, controlled traction to assist delivery. I know, it still freaks me out typing it, but listen, having a provider who is well-practiced in assisted deliveries is paramount.
My assisted delivery was with forceps, which are essentially giant salad tongs that are inserted into the vagina, and placed on each side of the baby’s head. Gentle traction is applied to guide the baby gently and safely into the world. The objective of vacuum-assisted delivery is the same, but in place of the giant salad tongs, a small suction cup is inserted in the vagina and place on top of the baby’s head.
Assisted delivery is not used to get the baby out faster just for the sake of saving time. If assisted delivery is recommended, it is usually for the one of the following reasons:
- There are concerns about the baby’s heart rate during the labor process.
- Labor has stopped progressing, despite pushing for a long period of time.
- A medical condition or emergency prevent you from pushing safely and effectively.
- A long labor has exhausted you to the point you are no longer able to push effectively.
There are many factors your provider must consider before recommending assisted delivery, so it’s important that you trust your provider with your care and the care of your child. The greatest advantage to an assisted delivery is that it avoids a cesarean delivery, which is a major surgery and carries its own risks and potential complications.
Of course, there are risks with assisted delivery, just like anything else. The risks were what I worried most about. For the mother, the greatest risk is injury to the perineum. Perineum is fancy speak for the area between your vagina/vulva and anus. A very small number of women suffer from incontinence following an assisted vaginal delivery, which could require treatment if it doesn’t resolve on its own. (Like we need another reason to accidentally pee on ourselves.)
Now for the part that scared the hell out of me—the potential risk to the baby. Though the incidence of injury is low with assisted delivery, there’s still a chance that injury can occur to the baby’s head, scalp, or eyes, as well as bleeding inside the brain, or damage to the nerves located in the arms and face. If you’re weren’t holding your breath by the end of that last sentence, go back and re-read it.
But here’s the thing—I was making a choice between one of these complications or potential death. So, while it terrified me to my core, I consented. Because, for me, death was a scarier thought than any of that.
Following her delivery by forceps, my daughter had the tiniest bruise on her cheek, but was otherwise nine pounds of perfection. She broke my tailbone on her way out, and there was a bit of collateral damage to my perineum, but nothing a few stitches and a little rest couldn’t fix. Though I know some of this sounds pretty damn scary, but those forceps likely saved my daughter’s life. I hope you never need this information, but if you do, I hope you feel a little more prepared.