During a forceps delivery, you'll lie on your back, slightly inclined, with your legs spread apart. You might be asked to grip handles on each side of the delivery table to brace yourself while pushing.
Between contractions, your health care provider will place two or more fingers inside your vagina and beside your baby's head. He or she will then gently slide one tong between his or her hand and the baby's head, followed by placement of the other tong on the other side of your baby's head. The tongs will be locked together to cradle your baby's head.
During the next few contractions, you'll push and your health care provider will use the forceps to gently guide your baby through the birth canal.
If your baby's head is facing up, your health care provider might use the forceps to rotate your baby's head between contractions.
If delivery of the baby is certain, your health care provider will unlock and remove the forceps before the widest part of your baby's head passes through the birth canal. Alternatively, your health care provider might keep the forceps in place to control the advance of your baby's head.
Forceps deliveries aren't always successful. If your health care provider isn't able to properly grasp the baby with the forceps, he or she might use a cup attached to a vacuum pump to deliver your baby (vacuum extraction) or opt for a C-section.
If your health care provider applies the forceps but isn't able to move your baby after three pulls or if delivery doesn't occur within about 20 minutes, a C-section is likely the best option.
After the procedure
After delivery, your health care provider will examine you for any injuries that might have been caused by the forceps. Any tears or incisions will be repaired.
Your baby will also be monitored for signs of complications that can be caused by a forceps delivery.
When you go home
In the meantime, you can help promote healing:
- Soothe the wound. Apply an ice pack to the affected area, or place a chilled witch hazel pad between a sanitary napkin and the wound. You can find witch hazel pads in most pharmacies.
- Take the sting out of urination. Use a plastic cup to pour warm water over your vulva as you're urinating, and rinse yourself with a squirt bottle afterward.
- Prevent pain and stretching during bowel movements. Press a clean pad firmly against the wound when you bear down for a bowel movement.
- Sit down carefully. Tighten your buttocks as you lower yourself to a seated position. Sit on a pillow or padded ring rather than a hard surface.
- Consider complementary treatments. Some research suggests that lavender might help relieve pain after a tear or episiotomy. If your health care provider approves, add a few drops of lavender essential oil to your bath water or apply the oil directly to the affected area.
While you're healing, expect the discomfort to progressively improve. Contact your health care provider if the pain gets worse, you develop a fever or you notice a pus-like discharge.
Pregnancy and birth stretch the connective tissue at the base of the bladder and can cause nerve and muscle damage to the bladder or urethra. You might leak urine when you cough, strain or laugh. Fortunately, this problem usually improves within three months. In the meantime, wear sanitary pads and do Kegel exercises to help tone your pelvic floor muscles.
To do Kegels, tighten your pelvic muscles as if you're stopping your stream of urine. Try it for five seconds at a time, four or five times in a row. Work up to keeping the muscles contracted for 10 seconds at a time, relaxing for 10 seconds between contractions. Aim for at least three sets of 10 repetitions a day.
If fear of pain leaves you avoiding bowel movements, take steps to keep your stools soft and regular. Eat foods high in fiber — including fruits, vegetables and whole grains — and drink plenty of water. It's also helpful to remain as physically active as possible. Ask your health care provider about a stool softener or fiber laxative, if needed.
If you're unable to control your bowel movements (fecal incontinence), frequent Kegel exercises might help. If you have persistent trouble controlling bowel movements, consult your health care provider.
July 18, 2012
- Wegner ES, et al. Operative vaginal delivery. http://www.uptodate.com/index. Accessed April 25, 2012.
- Holcroft Argani C, et al. Management of the fetus in occiput posterior position. http://www.uptodate.com/index. Accessed April 25, 2012.
- Cunningham FG, et al. Williams Obstetrics. 23rd ed. New York, N.Y.: The McGraw-Hill Companies; 2010. http://www.accessmedicine.com/resourceTOC.aspx?resourceID=46. Accessed April 26, 2012.
- American College of Obstetricians and Gynecologists. Your Pregnancy and Childbirth Month to Month. 5th ed. Washington, D.C.: American College of Obstetricians and Gynecologists; 2010:199.
- American College of Obstetricians and Gynecologists (ACOG) Committee on Practice Bulletins - Obstetrics. ACOG Practice Bulletin No. 17. Operative vaginal delivery. Obstetrics and Gynecology. 2000;95:1. Reaffirmed 2009.
- Heart disorders in pregnancy. The Merck Manuals: The Merck Manual for Healthcare Professionals. http://www.merck.com/mmpe/sec18/ch261/ch261i.html. Accessed May 11, 2012.
- Robinson JN. Approach to episiotomy. http://www.uptodate.com/index. Accessed May 4, 2012.
- Lavender. Natural Medicines Comprehensive Database. http://naturaldatabase.therapeuticresearch.com/nd/Search.aspx?cs=MAYO&s=ND&pt=100&id=838&ds=&name=LAVENDER&lang=0&searchid=34422770. Accessed May 2, 2012.
- Sheikhan F, et al. Episiotomy pain relief: Use of Lavender oil essence in primiparous Iranian women. Complementary Therapies in Clinical Practice. 2012;18:66.
- Brubaker L. Patient information: Pelvic floor muscle exercises. http://www.uptodate.com/index. Accessed May 3, 2012.
- DeCherney AH, et al. Current Diagnosis & Treatment Obstetrics & Gynecology.10th ed. New York, N.Y.: The McGraw-Hill Companies; 2007. http://www.accessmedicine.com/resourceTOC.aspx?resourceID=9. Accessed April 26, 2012.
- Gibbs RS, et al. Danforth's Obstetrics and Gynecology. 10th ed. Philadelphia, Pa.: Wolters Kluwer Health Lippincott Williams & Wilkins; 2008. http://www.danforthsobgyn.com. Accessed April 26, 2012.
- You and your baby: Prenatal care, labor and delivery, and postpartum care. Washington, D.C.: The American College of Obstetricians and Gynecologists; 2011;1.
- Lowerdmilk DL, et al. Maternity & Women's Health Care. 10th ed. St. Louis, Mo.: Elsevier Mosby; 2012:470.
- Berens P. Overview of postpartum care. http://www.uptodate.com/index. Accessed May 3, 2012.
- Lewicky-Gaupp C, et al. Fecal incontinence related to pregnancy and vaginal delivery. http://www.uptodate.com/index. Accessed May 3, 2012.