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Childbirth

Is it possible to totally refuse forceps?

132 replies

RevoltingPeasant · 26/03/2013 17:38

This is a musing rather than urgent Q, as not even pg yet! Am v organised Grin

The Birthrights thread got me thinking: can you refuse in advance one specific procedure, or is this just really not possible?

In an ideal world I'd want a homebirth but would transfer to hospital if any probs. However, once there, would it be possible to say I simply don't want forceps under any circs, and to go straight to CS if it's tending that way?

Or will an NHS hospital not have that flexibility?

I ask because I've seen some forceps horror stories, and that + episiotomy is my real fear during birth!

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Gardentreehouse · 26/03/2013 17:47

Of course, you can refuse anything

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PeoniesPlease · 26/03/2013 17:58

Yes, you have an absolute right to decline any treatment offered to you.

However, I suppose there may be circumstances where it would be more detrimental to your health/your baby's health to go for CS rather than forceps - if the baby is low in your pelvis for example, it may well be more damaging to have to pull it up again for CS.

But even if this was the case, you would still be able to decline - you just might decide differently in those sorts of circumstances iyswim?

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Pendulum · 26/03/2013 18:05

Yes, I did exactly that. Was taken to theatre for trial of forceps. Before she did anything the registrar said the the nurse, this will be a very high forceps. She looked v apprehensive. I said very loudly, I withdraw consent for forceps and she did a cs instead.

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PeoniesPlease · 26/03/2013 18:07

Btw, I am not a midwife/doctor, so this was just my musings!

I am totally with you on fear of forceps/episiotomy - just trying to think through what might be factored in when discussing forceps at hospital.

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JakeBullet · 26/03/2013 18:08

Yes it is....it is utterly your choice and your consent. I am an ex midwife, when I was expecting DS I wrote in capital letters on my notes "I will not consent to a forceps delivery".

In the end it wasn't needed as DS decided to be breech so I had a straightforward caesarean section instead.

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birdsnotbees · 26/03/2013 18:12

Yes it is though like someone said up stream there may be circumstances where it is better for the baby. Best thing is to get as informed as possible, make sure your partner is equally informed & able to speak on your behalf, be willing to fight your corner but also flexible enough to consent if it is entirely necessary.

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badguider · 26/03/2013 18:14

It depends on how far the baby is down the birth canal, if it's too far down then a cs is not an option really. I don't know what they/you could do if you refuse forceps (venouse only i guess?)

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PastaBeeandCheese · 26/03/2013 18:16

I think there are also circumstances where it would be better for you. If the baby has descended into the birth canal it would need to be moved back up to be born by CS which sounded more horrendous than forceps to me.....

I put that I would not consent to high or rotational forceps on my birth plan. The midwife said that was fine and they weren't really used at the hospital where I gave birth anyway.

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FrillyMilly · 26/03/2013 18:18

I was going to refuse forceps but it wasn't required in the end. Dd was head down but head to the side, facing my hip. If she hasn't moved during labour it would have needed keillands forceps which I would not have allowed.

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BackforGood · 26/03/2013 18:20

When I needed them, I was only glad that I was in the right place (a hospital in the Western World) with trained medical staff who knew what they were doing. If you need them, I can't imagine any circumstance where you would then choose to refuse them if it gives a chance of your baby getting out alive and well, now. Of course it's not a particularly nice thought but the circumstances where they are telling you that's what's needed, then there just isn't any question, IME

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PeoniesPlease · 26/03/2013 18:23

BackforGood, but she doesn't have to have them, even if the baby is in danger - she still has an absolute right to decline.

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munchkinmaster · 26/03/2013 18:24

If the baby is low in birth canal and needs dragging back up for a c section there is a high risk of anoxic injury and damage to the baby as others have said above. I had failed forceps and then a c section. Baby managed to ping herself back up but a scary moment for all when we realised had to go for a cs. I think it's so hard as you can put a strong view across then things just happen during birth.

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SatsukiKusukabe · 26/03/2013 18:30

I do not give consent first ventouse or forcepts delivery, if the baby cannot be delivered naturally I will need a cesarean. that's what my plan said,

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BackforGood · 26/03/2013 18:31

I think that's the key point though if the baby is in danger - why wouldn't you do whatever you could to ensure a safe delivery ? Confused

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PeoniesPlease · 26/03/2013 18:34

I don't think you need to understand why someone would make a decision in order to support their right to make it. I'm sure most people would accept a forceps delivery if that was their only option to save the life of the baby, but that doesn't mean that they are under any obligation to do so.

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propertyNIGHTmareBEFOREXMAS · 26/03/2013 18:38

Yes it is, I wrote 'no consent to forceps' on all my birthplans. I would have gone to CS if absolutely necessary. Ended up with 4 very easy births though so it was all unnecessary.

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Zoomania · 26/03/2013 18:44

You can refuse anything but you may need to accept this may harm the baby. What if baby was low down and suddenly dropped his heart rate/ became distressed. If they could pull him out in a few minutes would to take the risk of waiting 10 mins to be prepared for theatre and a c section, with the risk of further damage as he was pushed up the birth canal?

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JollyYellowGiant · 26/03/2013 18:54

Yes, I think it is.

However, if my spinal block had failed then forceps would have been the only option as I could not have had a general anaesthetic.

Thankfully the spinal worked and the forceps worked.

Although you can refuse them, if there are really dire circumstances (I had a punctured lung) then not many people will be looking at your birth plan - they will just trying to get you and baby through the process alive.

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RevoltingPeasant · 26/03/2013 19:06

Jake did you really? That is v interesting! May I ask what moved you to do that?

BackFG the backstory is, our local hospital had a bit of fuck up recently where a woman was advised to go for a high forceps delivery. Will spare you gory details but she is now doubly incontinent and baby brain damaged. Hence, I'm not sure I'd listen to a dr there saying you need forceps!

Of course if it really was the only only option, whatever. But I might put 'no Keillands/ high forceps' as an insurance policy.

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RevoltingPeasant · 26/03/2013 19:08

Also very reassuring to hear how many women apparently do this. Am glad I am not the only lunatic alone.

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Jemimapuddleduk · 26/03/2013 19:10

I requested no high forceps (keillands) on birth plan. To be honest if I had got to that stage I would prob have changed my mind as I was so desperate to meet baby and get her out. As it was I ended up with c sec as she wasn't descending.
Good luck

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SergeantSnarky · 26/03/2013 19:11

Would personally not consent to forceps unless it was a last resort/life or death but would and have consented to ventouse with no consequences for my DC, not even a conehead: episiotomy once, not ideal but wanted DC out and safe and daresay me being cut was unpleasant but the healing certainly no worse and probably a hell of a lot easier than cs abdominal surgery (and frankly my pain tolerance is zilch)

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RevoltingPeasant · 26/03/2013 19:15

Sarge may I ask, did you write that in your birth plan or just keep it stored in your head in case?

I am a bit jittery about this as my local hosp seems v high intervention: the two women I know personally who have given birth there have had 3 sections between them, and then this woman with the poor damaged baby is the only other one I know about (on the grapevine). Obviously not a statistically significant sample, but they seem very gung ho!

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Toptack · 26/03/2013 19:16

Just noticed that you mentioned a fear of having an episiotomy as well - I was on the brink of needing forceps when the midwife gave me an episiotomy, baby slithered out in 3 pushes (after 24 hours of labour) and everything healed up nicely with very little discomfort and no lasting damage. So for me, the episiotomy helped me avoid any further intervention and was well worth it.

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Flisspaps · 26/03/2013 19:17

I refused forceps with DS - they were already prepping me for CS as they were fairly sure forceps would fail, and I'd had forceps with DD. The Dr was Hmm but I'd heard her and the MW suggest that DS was transverse.

Anyway, after discussion with DH I agreed to one attempt with forceps in theatre, with spinal in place ready to go to CS, and they worked, with none of the damage I suffered first time round.

It would have been possible to go straight to CS though, the Dr wasn't 'happy' when I was refusing forceps but she didn't have any option but to accept my choice. I don't know what made me change my mind to this day - there was no pressure placed on me to try, even with the Drs Hmm face!

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