Delivery control

JennMof3 · October 2014

My baby will be 10 when the little man arrives so my memory fails me on decisions "control" during the delivery process. Can patients flat out refuse the use of forceps and/or the vacume "thing" and opt for a c-section? I have no interest in trying these options. He is measuring pretty big and has been for a while so I feel his ability to make it out on his own may be an issue. Just curious about other people's experiences. TIA

BayCamp · October 2014

JennMof3 said:
My baby will be 10 when the little man arrives so my memory fails me on decisions "control" during the delivery process. Can patients flat out refuse the use of forceps and/or the vacume "thing" and opt for a c-section? I have no interest in trying these options. He is measuring pretty big and has been for a while so I feel his ability to make it out on his own may be an issue. Just curious about other people's experiences. TIA

I'm a FTM but you totally have the right to refuse anything and everything you don't want done.

amieeyoung · October 2014

I ended up using a vacuum with my son, but they asked me first, so I would assume you could refuse. I think it if had helped I would have had a different view on the matter, but since it didn't I do not want to do that again

, so I completely get you. My son will be 1 month from being 10 as well, sometimes it feels like the first go around b/c everything is so different. Maybe something you should bring up at your next appointment - mention your concerns for size and that you do not wish to use the vacuum or forceps. Ask if you need to put it in writing or anything.

BabyRN2009 · October 2014

Of course you can! The Dr must ask and you must give informed consent before they can proceed. Just make it known from the get go that you'd rather have a c/s than an operative vaginal delivery (the term used for vacuum or forceps delivery).

BUT, if you've already delivered vaginally once, I wouldn't be too concerned about size yet. I'd at least want to labor and try another vaginal delivery. Much easier recovery! :-)

JennMof3 · October 2014

@amieeyoung - I agree everything feels so different this time around for sure! I'm definitely going to ask the dr and see what she says. I'm not about taking any chances with the healthy and safety of this little one and if he doesn't come out relatively easy I'm not taking unnecessary risks. I'm hoping given that I'm designation as AMA and have a known heart condition she'll be more prone to see things my way.

JennMof3 · October 2014

My last 2 were 7 pounds 15 oz and were a few days late. This little guy at the 31 week ultrasound was measuring at 4 pounds 6 oz. I was shocked with 9 weeks left

ColeyCannoli · October 2014

Unless you are passed out and there is no other family to ask, you can say "no" to anything in the hospital. If you or baby are dying, it would be different but I can't imagine why they would fight you over this.

Still, remember that those ultrasounds are notoriously off at this point. I wouldn't assume your LO is too big just yet. But the decision is totally yours to make.

RayRay007 · October 2014

Of course you can refuse any thing. On the other hand, I don't know if you can demand a c/s if there are alternatives available. And who in their right mind would like an unplanned c/s after hours of labour over a little vacuum assist. Not saying there aren't risks with vacuum/forceps, but really, you'd rather throw in the towel and have major abdominal surgery instead?

hellopartyof5 · October 2014

lol at my 32 week ultrasound my baby was measuring at 6 lbs. I'm just hoping that like pp said the numbers are off (as they've been known to be with u/s). If not, my vag is in for quite the surprise lolol. It's good that you're thinking about this, but I wouldn't worry about it too much

byrne15 · October 2014

Sure you can refuse....

But with that said, I didn't want much intervention with my 1st. I didn't want an episiotomy (I got one), I didn't want forceps (they tried them). I did want a C-section (I got one under general anesthesia). At that point, I was willing to do whatever needed to be done to save his life.

CandEChicago · October 2014

Talk to your doctor about preferences and the risks of each procedure. Then you can also have it documented in your chart.

However, I would get to understand why the doctor is recommending something (like medically necessary) before I refuse a procedure.

mammatoomc · October 2014

Im not too sure about vacuum-- I believe its still fairly common practice with minimal risks. But I can tell you that from my very first appt, my OB told me he will NOT even touch forceps. Never has, never will.. this because I told him I want to take every measure to avoid a C/S. So its vaginal w/ vac assist or C/S for me. But I believe most OB's these days dont go near forceps. He actually called them "barbaric"

ColeyCannoli · October 2014

stefdolly said:

Im not too sure about vacuum-- I believe its still fairly common practice with minimal risks. But I can tell you that from my very first appt, my OB told me he will NOT even touch forceps. Never has, never will.. this because I told him I want to take every measure to avoid a C/S. So its vaginal w/ vac assist or C/S for me. But I believe most OB's these days dont go near forceps. He actually called them "barbaric"

It takes a lot of training and practice to use forceps correctly and they do pose a greater risk to the mother. "Barbaric" is a stretch to me but they are a lot harder to use than a vac and not as safe or standard anymore so it makes sense to just not touch it these days. Lots of kids are born with vacuum assist without any issues. Personally I'd be A.Okay with a vac or forceps (and epostomy, epidural, and many other things not on my "birth plan") long before I asked for abdominal surgery, but I can't decide that for anyone else.

PhDMomma · October 2014

DS (now 3 was born with forceps). I went into labor at just shy of 34 weeks, and my blood pressure was too low for an epidural. He went into distress, and the forceps were a faster option than a C/S. I might keep in mind that vacuum assist isn't considered safe for the baby if they are under 36 weeks gestation. Not to say that yours will be, but once he went into distress all I was concerned about was getting him out as fast and as safely as possible.

That said, if you would rather have C/S (than other sort of intervention) I would talk to them about it beforehand. It never hurts to ask.

AlwaysForgetful · October 2014

I know you can say no to forceps and no to a vacuum (kiwi is what it was called when they asked me). They told me they were using one during a Csection and I told them no. They told me they would need to create a larger incision then and I told them to go ahead, not like I will be wearing a bikini. And then lots of pressure up on my chest because my 9lb 2oz chunky baby didn't want to come down. I think the talk scared her. lol ;-) So they did press harder on my chest to push her down.

DoctorWorm222 · October 2014

I didn't read the other comments carefully, so this may have been covered previously....

I would definitely talk to your OB about your concerns, and let him/her know your preferences beforehand. I have the sense that the tools you mentioned can be used in situations when the baby goes into distress when its almost out and they just need to hurry things up a bit. If this is the case, it may not be the best idea to stop everything and demand a C-section.

If you talk to your doc, you may be able to come up with a plan to go the c-section route earlier if it looks like you're having trouble. Or he/she may be able to give you some information on those tools to put your mind at ease if it looks like they'd be a good option for you during labor.

lionyloo32 · October 2014

From what I understood, the vacuum is only used if baby is already far enough down the birth canal but you've become too tired or baby isn't progressing after a certain amount of time. Doesn't seem like c-section would be an option at that point, would it? From MedlinePlus "Before the vacuum can be used, your baby needs to be far enough down the birth canal. Your doctor or midwife will check you carefully to make sure it is safe to use the vacuum. This device is only safe to use when the baby is very close to being born. If the head is too high, a cesarean will be recommended"

JennMof3 · October 2014

Thank you ladies. This has given me more to think about and I'll definitely be talking to my OB. Hoping for a normal vaginal delivery with no meds like I've done before.

Kmm1023 · October 2014

I honestly would take the measurements from an ultra sound as a grain of salt! I was told DD would be 9 pounds. She was a peanut at 6pds 6 ounces!

rshamos · October 2014

I agree with others that communication with your OB is critical. I have talked to each OB that has the potential of delivering my baby to make sure we are on the same page when it comes to the delivery day. I am pretty chill when it comes to what I will/won't do, but everyone knows what my ideal birth experience is.

Good luck and hopefully it will be something that you will worry about and never have to actually deal with!

DoctorWorm222 · October 2014

Kmm1023 said:

I honestly would take the measurements from an ultra sound as a grain of salt! I was told DD would be 9 pounds. She was a peanut at 6pds 6 ounces!

Same for me DD1 always measured on the larger size, so I was expecting a whopper. She came out at 6lb8oz. I was totally surprised!

soulcupcake · October 2014

Oftentimes, at the point where a forceps or a vacuum would be used, it could be too late to perform a c-section. The baby is usually at +3 station. Delivery assistance would be a quicker option.

However, a successful vaginal delivery without delivery assistance and a prolonged second stage have more to do with how labor is managed, as well as the second stage. If more women were encouraged to begin the second stage in an upright position, thus increasing the pelvic outlet and using that wonderful thing called gravity, extended pushing times would be reduced, as well as maternal exhaustion and the need for delivery assistance.

Also, making sure baby is LOA at the start of labor is key in the progression of labor and baby's descent. If baby is in an awkward position and mom is lying on her back, ignoring gravity, well, it can make for a very long and difficult second stage. It's often these and other factors that result in arrest of descent and not baby's or mother's size.

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