The caregiver may attempt to perform a forceps delivery, with the intention of performing a Caesarean operation, if they feel that the baby will not come down the birth canal easily. This is medically referred to as a 'Trial of Forceps' (or TOF). If the forceps turn out to be too difficult, they are abandoned, and a Caesarean is performed immediately.
Exactly where in the hospital a woman has a trial of forceps (delivery suite or operating theatre), and how the woman is prepared, will depend on the hospital policy, how easy your caregiver thinks the forceps birth will be, and their personal preferences. Aspects to consider include:
Pain relief and an IV
Where?
Shaving
Episiotomy
Pain relief and an IV. If you are having a forceps delivery (or a Caesarean), then you will need to have some good analgesia, such as an
epidural and / or a
spinal anaesthetic. A
pudendal block may be used for forceps, but this would not be appropriate to perform a Caesarean, if needed. A
general anaesthetic is not recommended for a trial of forceps. It can increase the chances of injury for the woman and / or the baby and because of the time involved, can mean that the baby will absorb too much of the anaesthetic before the birth, especially if the forceps are unsuccessful.
Most trial of forceps are done using an
epidural and / or a spinal anaesthetic. Some anaesthetists will give the usual amount of anaesthetic needed for the forceps, and then top up the epidural with heavier medication (if the forceps are unsuccessful and a Caesarean is needed), others will use the heavier medication from the start, just in case.
Where? Where you have the trial of forceps will often depend on the hospital policy and / or your caregiver's preferences. It may also depend on the caregiver's perception of the likely success of the forceps delivery.