Complications following Forceps Delivery of a Baby

Forceps delivery is the application of a instrument called the ‘forceps’ to the fetal scalp during the time of labor to augment the labor process and to swiftly deliver the baby before certain complications sets in. The process require certain amount of skills and having failed to meet the pre-requisites to apply the forceps, as well as faulty techniques, have been blamed for many of the complications that may arise from this procedure during labor.

What are the indications for applying forceps?

The indications to apply forceps will be a determined by the obstetricians or a suitable health care professional and could be based on following reasons.

-Delay in the second stage of labor due to poor uterine contractions or else when the fetal head is visible in the perineum but the progress is delayed for 20 – 30 minutes.

-Feral distress in the second stage of labor

-Cord prolapse

-In order to deliver the fetal head after a breech delivery

-When the baby is having a low birth weight

-Maternal medical conditions such as risk of pre-eclampsia, heart disease, maternal distress, pregnancy after a caesarian section…etc.

Apart from these, there are several other indications for applying forceps based on the findings related to current process of labor.

What are the possible complications after forceps application?

Although the procedure has many advantages in reducing risks of dangerous complications of prolonged or delayed labor, forceps delivery will have its own set of complications and these include,

-Injury to the birth canal and the need to put a wider episiotomy than usual.

-Excessive bleeding or more specifically post partum hemorrhage.

-Introduction of infections during the process.

-Trauma to the fetus such as in the case of intracranial hemorrhage, hematoma formation of the scalp, facial or brachial nerve paralysis, fractures and sometimes fetal death in very rare instances.

Furthermore, stress incontinence or involuntary passage of urine, genital prolapse and lower back pain are some of the other complications related to forceps applications.

What are the pre-requisites to apply forceps to reduce complications?

As mentioned before, there are several pre-requisites for the application of forceps and these include,

-fully dilated cervix

-Favorable presentation

-Emptied bladder

-Good uterine contractions

-Ruptured membranes…etc

-Lastly, the forceps are applied to living fetuses.

But it should be noted that, the clinician’s experience will also play a major role in application of the forceps and its timing. Therefore, as mentioned before, having a good technique, applications at the right time and knowing when to abandon the procedure will determine the level of complications which may arise following application of a forceps technique.