Assisted delivery with forceps

Even after your cervix is fully dilated (open) and you have been pushing, you may still need help getting the baby out. Reasons include:

• After pushing for several hours, the baby may be close to coming out, but needs help to get through the last part of the birth canal.
• You may be too tired to push any longer.
• A medical problem may make it risky for you to push.
• The baby may be showing signs of stress and need to come out faster than you can push it out on your own

Before forceps can be used, your baby needs to be far enough down the birth canal. The baby's head and face must also be in the right position. Your doctor will check carefully to make sure it is safe to use forceps.

Most women will not need forceps to help them deliver. You may feel tired and tempted to ask for a little help. But if there is not a true need for assisted delivery, it is safer for you and your baby to deliver on your own.

You will be given medicine to block pain. This may be an epidural block or a numbing medicine placed in the vagina.

The forceps will be carefully placed on the baby's head. Then, during a contraction, you will be asked to push again. At the same time, the doctor will gently pull to help deliver your baby.

After the doctor delivers the baby's head, you will push the baby the rest of the way out. After delivery, you can hold your baby on your tummy if they are doing well.

If the forceps do not help move your baby, you may need to have a cesarean birth (C-section).

Most forceps-assisted vaginal births are safe when they are done correctly by an experienced doctor. They may decrease the need for a C-section.

However, there are some risks with forceps delivery.

Risks for the mother are:

• More severe tears to the vagina which may require prolonged healing time and (rarely) surgery to correct
• Problems with urinating or moving your bowels after delivery

Risks for the baby are:

• Bumps, bruises, or marks on the baby's head or face. They will heal in a few days or weeks.
• The head may swell or be cone-shaped. This may not be due to a forceps delivery, but due to a prolonged labor. Swelling most often subsides during the first month of life.
• The baby's nerves may be injured by pressure from the forceps. The baby's facial muscles may droop if the nerves are injured, but they will go back to normal when the nerves heal.
• The baby may be cut from the forceps and bleed. This rarely happens.
• There may be bleeding inside the baby's head. This is more serious, but very rare.

Most of these risks are not severe. When properly used, forceps rarely cause lasting problems.

Pregnancy - forceps; Labor - forceps

Foglia LM, Nielsen PE, Deering SH, Galan HL. Operative vaginal delivery. In: Landon MB, Galan HL, Jauniaux ERM, et al, eds. Gabbe's Obstetrics: Normal and Problem Pregnancies. 8th ed. Philadelphia, PA: Elsevier; 2021:chap 13.

Thorp JM, Grantz KL. Clinical aspects of normal and abnormal labor. In: Lockwood CJ, Copel JA, Dugoff L, Louis J, Moore TR, Silver RM, Resnik R, eds. Creasy and Resnik's Maternal-Fetal Medicine: Principles and Practice. 9th ed. Philadelphia, PA: Elsevier; 2023:chap 40.

Updated by: John D. Jacobson, MD, Professor Emeritus, Department of Obstetrics and Gynecology, Loma Linda University School of Medicine, Loma Linda, CA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.