An increase in the UK rate of forceps deliveries

The forceps rate has doubled in the last few years, according to a recent report picked up by the Mail On-line (over 42,000 last year) but is that really a surprise given:

  • The suggestion in 2010 (from within the medical profession) that there be an increase in forceps use if the aim is to reduce the emergency caesarean rate
  • The increased focus on natural birth, seemingly at all costs
  • The drive to reduce the caesarean rate making it ever more difficult to plan a caesarean for border line cases

It would be useful to know how many of these forceps deliveries were performed on women who might actually have been better advised to plan a caesarean? Indeed some of them could well have been advised of this but were so afraid of this ‘unknown evil -the caesarean’ that they actually preferred to take their chances.

Caesareans are regarded as a “last resort, best avoided” and because women are still not given balanced information many will resist a caesarean when it might actually be the safer option for them and their baby. Some of these women will go on to require highly medicalised instrumental births, many of which are truly traumatic, (damaging them both emotionally and physically, not to mention the risks to baby).

Women’s preparation should not simply be driven by the current bias towards natural birth. They need more information across birth modes and their opinions should be respected. Crucially in order to form these opinions in the first place they need to be supported in the development of realistic birth expectations using balanced information. Sadly neither of these can be guaranteed in many antenatal publications and clinics and many women will continue to have traumatic births, some of which could have been better managed, and experienced far more positively, with a planned caesarean.

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