Is forceps birth more dangerous than cesarean section? - Walla! health

2021-09-12T12:29:48.293Z

In recent years, doctors have preferred to perform a caesarean section instead of trying a forceps or vacuum birth, due to the fear of brain or physical injury to the baby. Is this justified? Research reveals

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Is forceps birth more dangerous than cesarean section?

In recent years, doctors have preferred to perform a caesarean section instead of trying a forceps or vacuum birth, due to the fear of brain or physical injury to the baby.

A new study by the Hebrew University reveals that such a fear is not necessarily justified

This is the reason for the most significant difference between cesarean babies and a normal birth

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However, now a new and extensive study, published in the scientific journal The Journal of Maternal-Fetal & Neonatal Medicine, makes it clear that in most cases - forceps births are safe to perform.

What is forceps birth?

Forceps birth is one of two possible actions to be performed in the second stage of labor, and is designed to help pull the newborn when he is not advancing in the birth canal.

The other method is vacuum birth.

Doctors use this method mainly in cases of childbirth before week 34, when there is difficulty in continuing the birth, when the maternal pushing efforts at birth are poor, or due to failure to extract the fetus from the mother's vagina using a vacuum.

Possible risks of instrumental birth include in some cases skull fractures, cerebral hemorrhage, damage to the newborn's brain tissue or vaginal injury in the mother.

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Those who have taken the place of forceps births and vacuum births in recent years are the caesarean section, from the perception that this method could reduce the amount of optional complications in childbirth.

Despite the medical world's preference for cesarean births over instrumental births, cesarean section is also harmless to newborns and also includes risks including bleeding or possible damage to the mother.

Cesarean section is also not without dangers for newborns.

Cesarean section (Photo: ShutterStock)

The current study, led by Dr. Gabriel Levin, a senior lecturer in the Faculty of Medicine at the Hebrew University, and the director of gynecology at Tel Hashomer, Dr. Raanan Meir, examined forceps birth rates that account for less than half a percent of births in Israel. Possible in the mother (possible ruptures for mothers in grades 3-4).

During the study, over 183,191 births of a single newborn were performed in the years 2011-2020, with 861 of them ending in forceps births at Hadassah and Sheba Medical Centers (0.5 percent of all pregnancies were performed with forceps).

9.9 of the mothers had previously had a cesarean birth.

The study took into account various factors such as basic characteristics of the mother including age, index and body mass of the mother (BMI);

Comorbidities and obstetric history;

Pregnancy characteristics include occurrence of hypertension in pregnancy, gestational diabetes, fetal sex and more;

Birth outcomes include gestational age at birth, how to start labor, use of epidural anesthesia, birth weight, neonatal complications and more.

It was not the forceps that caused the complication

The study findings revealed that in 15.2 percent of births defined as forceps birth there was neonatal morbidity that included hospitalization in the neonatal intensive care unit, scalp injuries, fractures (in the skull and clavicle), intracranial hemorrhage, cephalopathy (accumulation of blood between one of the cartilage bones , A common phenomenon after forceps birth or following pressure during the passage in the birth canal), low Apgar scores (less than 5 and 7 in the first five minutes after birth) and measures of asphyxia (disturbance in the supply of oxygen and blood to the baby's body).

Despite these difficult findings, it should be noted that these effects also occur as a result of cesarean section and are not necessarily related to the instrumental birth.

"Consider giving place to forceps birth in clinical practice."

Baby in her infancy (Photo: GettyImages)

When the researchers further processed the data, they found further evidence that instrumental birth is not the main factor that increases the risk of neonatal morbidity. The morbidity was found to be strongly and distinctly associated with preterm birth and low birth weight as well as low weight gain of the mother during pregnancy, and not necessarily with forceps at birth. Even after examining the dependent and independent indices and their effect on the findings, the researchers concluded that forceps birth, however rare, is associated with a relatively low percentage of fetal and neonatal morbidity, and there is no justification to fear it. This is in line with the results of a previous study by researchers, who found that maternal morbidity in Israel is relatively low compared to reported worldwide among forceps births.

"The findings may indicate a need to recalculate the use of forceps at birth, as well as the practice of the method. Consider giving birth to forceps in clinical practice," the researchers explained in their paper. "It shows that there is still some importance to performing forceps births as an alternative to performing a complex cesarean birth. We invite and encourage more students to explore this topic with us in final theses or in work as part of more advanced studies."