Forceps Delivery
Forceps are instruments designed to aid in the delivery of the fetus by applying traction to the fetal head. Many different types of forceps have been described and developed. Generally, forceps consist of 2 mirror image metal instruments that are maneuvered to cradle the fetal head and are articulated, after which traction is applied to effect delivery.Forceps are sometimes described as 'stainless steel salad servers' or 'large sugar-tongs'. They come in two intersecting parts, and have curved ends to cradle the baby's head.
The ventouse has a cup attached to a small vacuum pump. The cup, which fits on top and slightly towards the back of your baby's head, may be made of metal or silicone plastic. The soft cups are less likely to cause damage to your baby's head, but the metal cups are less likely to slip off and have to be reattached. The type of cup used may depend on the baby's position.
Forceps have 4 major components, as follows:
- Blades: The blades grasp the fetus. Each blade has a curve to fit around the fetal head. The blades are oval or elliptical and can be fenestrated (with a hole in the middle) or solid. Many blades are also curved in a plane 90° from the cephalic curve to fit the maternal pelvis (pelvic curve).
- Shanks: The shanks connect the blades to the handles and provide the length of the device. They are either parallel or crossing.
- Lock: The lock is the articulation between the shanks. Many different types have been designed.
- Handles: The handles are where the operator holds the device and applies traction to the fetal head.
Your midwife or doctor will explain to you why they think a forceps delivery is necessary. You'll have to put your legs in stirrups or supports at the side of the bed (the 'lithotomy' position) and the end of the bed will be removed. A thin tube called a catheter, attached to a bag, will be put into your bladder to empty it (this procedure can be slightly uncomfortable), and your legs will be draped in sterile green sheets. Your doctor will need to make a cut (episiotomy) through the back of your vagina to enlarge the opening so that the forceps can be put round your baby's head. Once the forceps are in place, the doctor will pull while you push during a contraction to help your baby move down through the birth canal and be born. Women have reported greater discomfort associated with forceps than ventouse delivery.
It's usual for a paediatrician (baby doctor) to be called to the delivery room for any birth which requires instruments, so don't worry too much if one suddenly appears.
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