Forceps are metal tongs used in childbirth. They are used to apply traction to the baby’s head, in an attempt to move the infant out of the birth canal and into the world. Forceps deliveries, once common, have been on the decline in the United States in the past few years. This is largely due to the increase in the rate of cesarean section in the U.S. – deliveries which once would have been done using forceps (or vacuum extraction) are now routed to c-section, instead.
The choice of c-section over forceps-assisted delivery is often a difficult one for mothers, many of whom fear surgery, and have been dreaming of a traditional childbirth since they learned they were expecting, or before.
But, from a medical perspective, the choice is easy. In fact, the use of forceps, rather than a c-section, can often result in birth injury medical malpractice.
The high risk of severe injury or death to infants delivered using forceps is now well-documented. One roughly one of every three malpractice cases based upon birth injury involves the use of forceps in delivery – a figure hugely disproportionate to the percentage of births in which forceps are used, which is currently around 5 percent. And in those cases, in around one-half of cases forceps were found to have been used in delivery in spite of the presence of warning factors or contraindications. Indeed, a high forceps delivery (use of forceps when the infant’s head is not yet deeply engaged) is extremely risky, and often causes both death of the infant and injury to the mother. This procedure is now always outside the standard of care.
Yet obstetricians continue to insist that the choice to use forceps should be entirely left to the physician, in his or her own experience and preference. This assertion is startling, in light of the evidence that forceps are often used when they should not be, and used negligently. This negligent use can lead to severe complications for both infant and mother. For the mother, complications can include:
- Vaginal lacerations
- Cervical lacerations
- Perineal lacerations
- Blood loss and/or hemorrhage
- Bladder or urinary tract injury
- Anal sphincter injury and/or fecal incontinence
For the infant, complications can include:
- Facial bruising
- Facial lacerations
- Facial palsy
- Brain injury
- Shoulder dystocia
- Skull fractures
- Intracranial hemorrhage
- Tentorial lacerations
- Cerebral palsy
Delivery with forceps should only be attempted when the factors calling for this delivery method are present. It is almost certainly medically negligent to use forceps in delivery if any of the following conditions is not met:
- The head of the fetus is engaged, ideally deeply (so that a low forceps delivery can be performed).
- The fetus is positioned properly – head down (not breech) and not transverse.
- The physician knows precisely where the head is located.
- The mother’s cervix is completely dilated (10 centimeters or more).
- The membranes have been ruptured (the water is broken).
- The fetal head is small enough to pass through the mother’s pelvis.
The use of forceps when all of these conditions are not met is may constitute medical malpractice. In addition, certain problems in forceps deliveries are almost always the result of medical negligence. For example, physicians now agree that the forceps slipping off the infant’s head (often, but not always the result of unruptured membranes) is almost always the result of medical negligence.
If you are expecting, you should talk to your obstetrician about his position on the use of forceps in delivery. If your doctor favors the practice, you may wish to consider changing obstetricians. Whatever you decide, you should be prepared to insist that only safe practices be used if your physician attempts to use forceps in the delivery-room.
If forceps were used in your delivery, and you or your child suffered serious birth injury or disability, you should talk to an attorney. An experienced birth injury attorney can help you to determine if you have a legal claim.
For a free consultation with an experienced Chicago birth injury lawyer at Passen & Powell, call us at (312) 527-4500.