As many as one in eight births can require an assisted delivery – also known as an instrumental delivery – when forceps or a ventouse suction cap are used. Forceps, a type of metal tool that has evolved from the 16th century, remains an integral part of modern obstetric care. However, there are risks involved. While in most cases no serious problems occur, where forceps are not used correctly and a mother or baby are injured, a legal claim for compensation may be possible, and a specialist solicitor should be consulted.
There are a variety of reasons why forceps may have to be used. Examples include:
- If there are concerns about a baby’s heart rate or the baby is in distress and needs to be born quickly.
- Where a baby is in an awkward position such as lying facing upwards/back-to-back (occipito-posterior position), to one side (occipito-lateral and occipito-transverse positions) or in the breech position.
- Where labour is prolonged without sufficient progress being made.
- Where exhaustion or the use of a spinal epidural means a mother is not able to push as required.
In these situations, forceps can enable a baby to be born safely, more quickly and help reduce the risk of further complications.
Forceps resemble salad tongs and are curved to fit around a baby’s head. A medical professional needs to carefully position the instrument, join together the handles and pull (when the mother has a contraction) to help the delivery. There are different types of forceps including some that are specifically designed to turn the baby to the exact position to be born.
Injuries to the baby
If forceps are not correctly placed on the skull or if too much force is applied, then serious injuries can result, including haemorrhages and fractures to the skull. Such injuries may in turn lead to permanent brain damage and conditions such as Cerebral Palsy (a group of lifelong neurological disorders that affect movement, muscle tone, and posture).
Excessive force when pulling the baby can injure their shoulders and contribute to shoulder dystocia – where one shoulder becomes stuck behind the mother’s public bone, delaying the birth and potentially causing further complications. Nerve damage may also be caused leading to conditions such as Erb’s Palsy – arm, and hand weakness or paralysis – or facial palsy – weakness or paralysis of facial muscles.
Excessive force combined with rotation can also lead to catastrophic damage to a baby’s spinal cord. I have acted for a child injured in this way and, as a result of the extent of the injuries caused, obtained a compensation award in excess of £20,000,000 (on a capitalised basis).
In order to bring a successful claim for medical negligence it must be shown, through independent expert evidence, that the use of the forceps was below a reasonable standard and that this caused (or materially contributed to) the child’s injuries. Claims may also arise if it can be shown, for example, that there was a delay in moving from an instrumental delivery to a caesarean section, or there was a delay in recognising an injury caused during the forceps delivery.
Injuries to the mother
The use of forceps also increases the risk of vaginal tearing with a higher chance of a 3rd or 4th degree tear – one that involves the muscle or wall of the anus or rectum. This can in turn increase the risk of incontinence. Such injuries unfortunately can occur when forceps are used correctly. However, where there has been incorrect use a claim for negligence may be possible.
At Kingsley Napley, our medical negligence solicitors are highly specialist and have been successful in bringing claims on behalf of injured children for more than 25 years, regularly achieving multi-million-pound settlements. It is important to be aware that birth injury claims for children can be highly complex and may take a long time to reach a conclusion. This is often because it can take many years to clarify what a child’s future needs will be. We fight hard for the best outcome for our clients while seeking to make the process as easy as possible.
If you have concerns relating to medical negligence, please speak to a member of our sensitive team for a no-obligation discussion.
Please see our birth injury and forceps injuries pages for more information
Further information
If you have any questions regarding this article, please contact Dawn Treloar in our Medical Negligence & Personal Injury team.
