When the forceps are in position, your caregiver will wait for the next contraction. If you have an epidural in place, the midwife will feel your belly and let the doctor know when a contraction begins. You will then be asked to push, while the doctor pulls. Once the contraction eases off, you will be told to stop pushing. It may take more than one contraction to deliver your baby.
If the delivery requires using mid forceps, your caregiver will use downward traction until the baby's head can be felt below the pubic bone. As the head starts moving up under the pubic bone, then upward traction is used. As the upward traction is commenced, the perineum starts to stretch, and it is often at this point that an
episiotomy is performed. If you are having outlet forceps, then only upward traction will be needed to help the head emerge.
Once the baby's head is delivered, the forceps are removed and the baby's body is delivered in the usual way.
Things to consider
Partial use of forceps
No episiotomy
Partial use of forceps. If the baby is not distressed, you could negotiate for a partial use of the forceps. Some caregivers will remove the forceps once the baby's head is crowning, allowing you to push your baby out from there.
If your baby is in a posterior position, you could ask your caregiver to turn your baby, but to then remove the forceps so you can push your baby out. (Be aware that the pushing may take a while, as usually the head is further up the vagina in this case. Some caregivers may not be happy to 'wait' or leave and come back. There is also the chance that the baby's head will turn back to a posterior position after this is done). Some caregivers will try and turn the baby with their hands first (called a 'manual rotation') to see if that will work.
No episiotomy. It is debatable as to whether an episiotomy is absolutely necessary.