Sometimes, labor doesn’t go as planned, and a baby may need a little extra help making her way out. Your doctor may use forceps to gently guide your baby through the birth canal if your labor has stalled, your baby is in distress, or you're having trouble continuing to push safely.
What is a forceps delivery?
A forceps delivery is a type of assisted delivery. During labor, doctors use a pair of forceps (which resemble large salad tongs) to guide the baby’s head through the birth canal.
Your doctor may decide on a forceps delivery to speed up labor — particularly if your or your baby are showing signs of distress or if you've been pushing for too long.
"When my son was born almost six years ago, he was delivered with the help of forceps and he was born perfect and still is," says What to Expect Community mom CPDPDP.
Get more expert advice and chat with other moms with similar concerns on our free What to Expect app.
When and why is a forceps delivery done?
A forceps delivery is done during the second stage of labor — the pushing phase — after your baby has already descended past the midpoint of the birth canal.
If your baby is struggling to make her way out, and your labor is prolonged, your doctor may decide to use the forceps to speed up the delivery. Doctors will sometimes opt for a forceps delivery in the hopes of avoiding a C-section.
Specifically, your doctor may decide to use forceps if:
- Your baby needs to be delivered in a hurry because she's experiencing distress
- Your baby is in an unfavorable position during the pushing stage (the forceps can be used to rotate the baby's head)
- Your baby is stuck in the birth canal
- You're having trouble pushing (for example, you're exhausted or you have a heart condition or very high blood pressure, and continuing to push would be detrimental to your health)
"The baby's heart rate was dropping and they needed him out ASAP," says Community mom cait01. "We had the choice of an episiotomy/forceps or an emergency C-section. I decided to do the episiotomy/forceps and after a couple of panicked pushes he came out vaginally. I had additional tearing, but thankfully everything with the baby was fine."
How do doctors deliver a baby using forceps?
Before a forceps delivery, your cervix needs to be fully dilated and your membranes must be ruptured. You’ll also have to empty your bladder before the procedure and be numbed with an anesthetic (unless you’ve already had an epidural).
If necessary, you may also receive an episiotomy — an incision to the tissue between the vagina and anus — to enlarge the vaginal opening for the placement of forceps. Then, the doctor will perform the following steps:
- Between contractions, the forceps are inserted one at a time around each side of your baby’s head and locked into position. If your baby’s head is face up, the doctor may rotate your baby’s head so that she’s facing your back.
- As you push during the contractions, your doctor will use the forceps to gently guide your baby through the birth canal.
- After the baby’s head is delivered, you can push the rest of the baby's body out.
Are there any risks to the baby or complications with a forceps delivery?
Luckily, when forceps are used correctly by an experienced doctor, the risks to the baby are low. Those risks include:
- Some bruising on the baby’s scalp from the forceps — though this usually goes away within a few days after birth.
- Some temporary swelling of the baby’s head. It may appear cone-shaped at first, but it should return to normal a few days after birth.
- Very rarely, a baby can experience temporary nerve damage in the facial muscles.
- Also very rarely, an injury can occur from the forceps themselves, including bleeding inside the head.
"I had vacuum assisted and then two attempts with forceps," says Community mom lmamaof2. "Saved my baby's life, and I'm super grateful for that. She had a cut on her cheek and a bit of a conehead but otherwise was perfect."
Keep in mind that there’s no evidence that having a forceps delivery has any effect on a child’s development, according to the American College of Obstetricians and Gynecologists (ACOG).[1]
"My daughter was born in 2014 and was delivered with forceps," reports Community mom captaincolour. "Her head had two small red spots on it. She came out just fine and is still fine to this day."
Are there any downsides or risks to the mother with a forceps delivery?
While safe to perform, forceps deliveries do carry some risks to the mother. These include:
- Tears to the vagina, which may take time to heal
- Trouble urinating after delivery
- Pain in the perineum area (the area between the vagina and anus)
- Injury to the bladder or urethra
- Weakening of the muscles and ligaments that support the pelvic organs, which can cause sagging (or pelvic organ prolapse)
- You may receive an episiotomy to enlarge the vaginal opening for delivery
"I had a forceps delivery and a 4th degree tear," says Community mom mommarian. "I was walking outside four days after that, and I think that helped me recover. However, peeing was always hard. Not pain, but the stitches were bothering me."
There’s also a chance that the forceps delivery won’t be successful. In that case, your doctor will recommend a C-section.
How common are forceps deliveries?
Forceps are used in less than 1% of births. According to ACOG, assisted vaginal births (forceps or vacuum-assisted birth) occur in about 3% of vaginal deliveries in the United States.
Hearing that you may need forceps can feel a little scary, but try not to worry. If your doctor recommends them, it's because they think a little extra help can make delivery safer or get things moving. Your care team will explain what's happening and help you through each step.
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