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posted Oct 19, 2010, 2:54 PM by Lisa Baracker   [ updated Jan 11, 2012, 10:54 AM ]
I have always cringed at the used of forceps in childbirth, and I still do, but on Saturday morning I saw a mind-blowing birth.  A mom was laboring very hard to push her baby out and pushed for a very long time.  Something just wasn't working.  This mom was trying for a Vaginal Birth After Cesarean (VBAC) and she was having a lot of pain in her C-section incision scar.  The doctors could have just jumped on it and pushed her into having a C-section, but that wasn't their game plan. 

They were worried about the incision pain that she was having, but they wanted to let her push the baby out on her own.  As much as she tried, she couldn't overcome the pain that she was feeling in her body.  The discussion with the mom turned to options for instrumental delivery assistance and the doctors first choice was to deliver with forceps.  I felt a lump in my throat.  I was very nervous.  I calmed myself down by telling myself that a vaginal birth was possible if she went this route and then she would still have her VBAC.  I knew that the recovery would be better if she had a VBAC, so I supported her through this difficult decision.  When the mom decided to go for it, I was wide-eyed with anticipation.  I was not sure what I was going to see exactly, but I knew that mom was about to have a baby in her arms after more than 21 hours of labor.  It was both nerve-wracking and exciting.

The doctor carefully prepared for the procedure by inserting one side of the forceps at a time.  She placed one carefully next to the right side of the baby's head and the other carefully next to the left side of the baby's head.  With the forceps in place, I was waiting to see the doctor pull the baby out, but that isn't what happened at all. The doctor asked the woman to push with her next few contractions.  She had been pushing for hours, so I didn't see how this was going to work!?!  With me on one leg and her partner on the other we supported her through the next few pushes as the doctor held steady and gentle pressure to bring the babies head down with the pushes!  It wasn't ideal, but what a difference!

Before the forceps, she pushed for hours with hardly any movement; after the forceps, her assisted pushing brought the baby down with ease.  The doctor did not rush and the baby came slowly to the perineum. With the forceps held in place all the way until the baby's head came out, the mom suffered hardly any damage to her perineum.  The doctor didn't even need to cut an episiotomy.

My first experience with forceps has made me realize that training is everything.  This doctor knew exactly what she was doing.  I can only hope that more doctors will be trained as fastidiously as she was and that she will pass her skills on to the doctors of tomorrow.