Forceps Delivery Complications & Injuries

Does the sight of obstetrical forceps might make you shudder? These long, curved tongs used to help deliver babies almost look medieval. Granted, they’ve been around long before medieval times. But what place do they have in modern medicine? Is the risk of forceps delivery complications too high to warrant their use? We’ll answer those questions and more below. 

OBGYN doctor holds stethoscope.

What is a Forceps Delivery?

Forceps are tong-like medical instruments. Doctors sometimes use them during difficult vaginal deliveries during the final stages of labor. 

During a forceps delivery, a doctor applies the tool to the baby’s head. Using great care, they use the forceps to help guide the baby’s head through the birth canal. Meanwhile, the mother pushes. Sometimes doctors perform an episiotomy (an incision in the tissue between the anus and vagina) to create room for the forceps.  

Forceps deliveries don’t come without risks. This is why doctors should use them only when there are concerns about the progress of labor, the well-being of the baby, or the health of the mother. Correct use can prevent forceps delivery complications and potential life-long injuries. 

How Common Are Forceps Deliveries?

These days, forceps deliveries are becoming more and more rare. You might say they’re “going out of style”. They only make up around 1% of all vaginal births. 

Many doctors see these tools as antiquated or outdated. But others still choose to use them in certain situations. There are situations where they might be beneficial. For example, when used correctly, forceps can eliminate the need for a C-section. C-sections can be riskier and more painful, so forceps are sometimes the “lesser evil”. 

When Should Doctors Use Forceps?

Doctors should decide to use forceps on a case-by-case basis. They’re trained to assess the situation, monitor the progress of labor, and consider alternative methods or interventions if necessary. They also must get consent from the patient before using forceps. 

Some common situations where doctors might consider using forceps include:

  • Second stage of labor goes on too long
  • Baby is showing signs of fetal distress and needs intervention
  • Mother isn’t able to push 
  • The baby is in a certain position, such as facing upward (occiput posterior position), and doctors can’t turn the baby manually.
  • There are maternal health concerns, such as heart conditions, that would make a shorter labor beneficial.
  • The mother is pushing but the baby’s head isn’t moving through the birth canal.
Woman experiences difficult childbirth.

When Should Forceps Not Be Used?

Forceps can be a valuable tool in certain situations. But their misuse can lead to dangerous forceps delivery complications. 

Here are some scenarios in which forceps use isn’t recommended when:

  • A baby isn’t in the right position for a forceps delivery (such as feet-first).
  • The baby’s head is large and the mother’s pelvis is small.
  • A mother has severe heart disease or certain bleeding disorders.
  • There’s an uncontrolled maternal infection.
  • The mother can’t receive adequate anesthesia for a forceps delivery. 
  • There are signs of fetal distress.
  • A baby’s head isn’t halfway through the birth canal.
  • The baby has a bleeding disorder like hemophilia or bone demineralization (bones are too brittle).

These aren’t the only situations where forceps should be a no-go. In every situation, doctors need to decide whether the benefits of forceps delivery outweigh the risks. They have an obligation to make the right choice and prevent a forceps birth injury. 

Most Common Forceps Delivery Complications

Many forceps deliveries are successful without significant issues. But studies show they are a major cause of injuries to mothers and babies.

One study found that:

  • The maternal trauma rate after a forceps delivery was 25.3%
  • The infant trauma rate after forceps delivery was 9.6%

This study and others found that forceps delivery complications are much more common in mothers than in infants. 

It goes without saying that doctors should be well-trained and know what they’re doing when attempting a forceps delivery. After all, forceps invade a very sensitive place in the woman’s body. 

Also, these tools clamp around a baby’s head, a highly sensitive area. Too much pressure on a baby’s head from forceps can cause bruising, bleeding, and even brain damage. 

Forceps delivery complications and injuries to mothers may include:

  • Maternal tears and lacerations
  • Blood clots in legs
  • Episiotomy (a surgical cut made to widen the vaginal opening) and pain/complications that result from it.
  • Postpartum hemorrhage (excessive bleeding after childbirth)
  • Bladder injuries and urinary incontinence (the mother experiences difficulty controlling urine flow.)
  • Weak pelvic muscles and pelvic organ prolapse.
  • Rectal injuries and difficulty controlling bowel movements.
  • Uterine rupture (especially where there’s a history of uterine surgery or C-section).

Possible forceps complications and injuries to babies include:

  • Facial bruising
  • Scalp injuries (like bumps and bruises)
  • Skull fractures
  • Intracranial hemorrhage (bleeding in the brain)
  • Facial palsy
  • Seizures
  • Brain damage 
  • Cerebral palsy and other disorders that brain damage may cause
  • Jaundice 
  • Damage to nerves in shoulders and neck

One more complication that can come from a forceps birth is that the delivery fails. In other words, doctors aren’t able to deliver the baby with forceps. They may have to resort to another method such as vacuum extraction or C-section

Baby boy in Neonatal Intensive Care Unit.

Can I Sue for a Forceps Birth Injury?

You may be able to sue your healthcare provider over a forceps birth injury if the following is true:

  1. Your healthcare provider failed to meet the standard of care. This means that they didn’t do what was acceptable for a medical case like yours, either by action or inaction. 
  2. Your provider’s negligence was the direct cause of your forceps delivery complications or a forceps birth injury. 
  3. The statute of limitations hasn’t expired. (Consult a lawyer in your state to find out how long you have to file a lawsuit after an incident has occurred. In most states, it’s just 2-3 years.) 

The above are general guidelines for filing any type of medical negligence lawsuit. But keep in mind that medical malpractice lawsuits require a careful evaluation of the facts, expert testimony, and legal considerations. Also, the laws governing medical malpractice vary by jurisdiction.

Circumstances that could lead to a lawsuit for a forceps-caused birth injury include:

  • The doctor didn’t ask for the mother’s consent before using forceps. Doctors are legally required to do so. 
  • The doctor applies excessive force while using forceps.
  • Doctors delay performing a forceps delivery when it’s needed
  • Healthcare providers fail to adequately monitor the mother and the baby during a forceps delivery
  • Using improper techniques during the forceps delivery.
  • There are clear contraindications to performing a forceps delivery, such as an unfavorable fetal position.
  • The person performing the forceps delivery doesn’t have the proper training to do it safely. 
  • Failing to address and treat forceps delivery complications. 
  • There is negligence in providing post-delivery care.

When negligent actions like the ones above lead to a forceps birth injury, there may be grounds to sue. With malpractice lawsuits, patients can hold doctors accountable for negligence. They can also obtain funds to pay for costs related to their injuries. Compensation for forceps delivery complications claims can cover medical expenses, therapy, pain and suffering, lost wages, and more. 

 Have you or your child developed complications or injuries from a forceps delivery? If so, we invite you to schedule a free consultation with our experts. We’ll assess the specific details of your case, and tell you whether there are grounds for pursuing legal action.