Forceps Injuries

When used by an obstetrician who is careful and competent, the use of forceps during childbirth can be relatively quick, painless and usually safe. Although many expectant parents are aware of the potential dangers of forceps, these tools are sometimes necessary if delivery is difficult or in certain emergencies.

However, the possible damage caused by these instruments cannot be discounted.

At Jeffrey Glassman Injury Lawyers, our experienced Boston birth injury lawyers have successfully handled cases wherein the negligent use of forceps by medical professionals resulted in serious and permanent injuries to the child.

Forceps are a type of surgical instrument. They look like a pair of salad tongs, but their intended use is maneuvering, grabbing or removing things from the body.

One of the most common uses of forceps is during childbirth. Once a physician determines these tools are needed, he or she will position the two sides around the baby’s head. The sides are usually curved in order to cradle the infant’s head firmly.

The original design is believed to date back to at least the 1500s in Europe, though they did not become widely used until the mid-1600s.

In the centuries that followed, forceps enabled a faster, safer delivery in cases where labor was obstructed and prolonged, which puts the child at risk.

But that does not mean these instruments are inherently safe. In fact, most physicians do acknowledge that there is an injury risk associated with the use of forceps. Physicians today tend to favor cesarean sections in difficult births, as opposed to the use of forceps.

The biggest reason forceps are used during delivery is that the mother is unable to push the child out on her own.

• Catalysts for this may include:
• Maternal exhaustion
• Infection or illness that makes pushing difficult or dangerous
• Hemorrhage
• Preterm birth
• Breach delivery
• Fetal distress
• Drugs that inhibit mother’s ability to push

In these situations, doctors may be in a race against time. Waiting too long to use an appropriate intervention can result in severe consequences to mother and child, including permanent injury and death. On the other hand, the use of forceps is known to be quite risky.

If injury results in these situations, the question will be whether the physician acted reasonably for someone of his or her profession under those circumstances.

Forceps must be applied carefully and used correctly in order to minimize the potential for injury to mother and child. When used properly, these tools aid the physician in guiding the baby through the pelvis.

There are a number of conditions under which forceps shouldn’t be used. These include:

• Mother’s cervix is not yet fully dilated
• Membranes are not ruptured
• Fetal presentation and position is unknown
• Baby’s head is not engaged
• Mother has inadequate anesthesia
• Mother’s bladder is full
• Fetal size is too large to safely fit through the cervix
• Risks have not been fully explained to the mother
• Doctor does not have adequate experience or skill in usage of forceps

If forceps are used improperly, potential injuries may include:

• Facial Nerve Palsy
• Skull Fracture
• Brain Damage
• Cerebral Palsy
• Brachial Plexus Injuries (Erb’s Palsy)
• Bruising or lacerations to the vagina or cervix
• Bruising or lacerations to the child’s head
• Intracranial hemorrhage
• Developmental delays

One of the more common injuries associated with negligent use of forceps is facial nerve palsy. This condition is characterized by an inability to move certain facial muscles.

This condition may sometimes manifest without any known cause. A 2009 study in the Journal of the American Medical Association indicated 0.8 to 7.5 of 1,000 live births overall were associated with facial nerve palsy. On the other hand, of 8.8 of every 1,000 live births in which forceps were used resulted in a facial nerve palsy diagnosis.

The injury is the result of the blade of the forceps inside the mother’s pelvis placing pressure on the baby’s head in the area of the facial nerve.

In that study of 28 babies diagnosed with the condition between 1989 and 2005, all were either mild or moderate. The majority recovered within 24 days without extensive treatment. However, there was still one case in which ongoing treatment was necessitated.

Infants who do suffer permanent paralysis may require specialized therapies.

If your child has been delivered with forceps, it may be a good precautionary idea to initiate an examination of the child’s head and brain to ensure that no birth injuries might pose any serious health issues.