An infant is delivered with the use of forceps. what should the nurse assess for in the newborn?

If your baby is struggling to make his way down the birth canal, your doctor may use forceps to guide his head out during delivery.

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In This Article

• What is a forceps delivery?
• When and why is a forceps delivery done?
• How do doctors deliver a baby using forceps?
• Are there any risks to the baby or complications with a forceps delivery?
• Are there any downsides or risks to the mother with a forceps delivery?
• How often are forceps used during delivery?

If your labor has stalled, there’s a small chance that your doctor will use forceps to gently coax your baby’s head through the birth canal, speeding up baby’s entrance to the world.

What is a forceps delivery?

A forceps delivery is a type of assisted delivery. During labor, doctors use a pair of forceps (which resemble large salad tongs) to guide the baby’s head through the birth canal.

Your doctor may decide on a forceps delivery to speed up the labor — particularly if mother or baby are showing signs of distress or if you have been pushing for too long.

When and why is a forceps delivery done?

A forceps delivery is done during the second stage of labor — i.e. the pushing phase — after your baby has already descended past the midpoint of the birth canal.

If baby is still struggling to make his way out, and your labor is prolonged, your doctor may decide to use the forceps to speed up the delivery. Doctors will sometimes opt for a forceps delivery in the hopes of avoiding C-section.

Specifically, your doctor may decide to use forceps if:

• Your baby needs to be delivered in a hurry because he's experiencing fetal distress
• Your baby is in an unfavorable position during the pushing stage (the forceps can be used to rotate the baby's head)
• Your baby is stuck in the birth canal
• You're having trouble pushing (for example, you're exhausted or you have a heart condition or very high blood pressure, and pushing would be detrimental to your health)

How do doctors deliver a baby using forceps?

Before a forceps delivery, your cervix needs to be fully dilated and your membranes must be ruptured. You’ll also have to empty your bladder before the procedure and be numbed with an aesthetic (unless you’ve already had an epidural).

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If necessary, you may also receive an episiotomy — an incision to the tissue between the vagina and anus — to enlarge the vaginal opening for the placement of forceps. Then, the doctor will perform the following steps:

• Between contractions, the forceps are inserted one at a time around each side of your baby’s head and locked into position. If your baby’s head is face up, the doctor may rotate your baby’s head so that he’s facing your back.
• As you push during the contractions, your doctor will use the forceps to gently guide your baby through the birth canal.
• After the baby’s head is delivered, you can push the rest of the baby's body out.

Are there any risks to the baby or complications with a forceps delivery?

Luckily, when forceps are used correctly by an experienced practitioner, the risks to the baby are low. These include:

• Some bruising on the baby’s scalp from the forceps — though this usually goes away within a few days after birth.
• Some temporary swelling of the baby’s head; it may appear cone-shaped at first, but it should return to normal a few days after birth.
• Very rarely, a baby can experience temporary nerve loss damage in the facial muscles.
• Also very rarely, an injury can occur from the forceps themselves, including bleeding inside the head.

Keep in mind that there’s no evidence that having a forceps delivery has any effect on a child’s development, according to the American College of Obstetricians and Gynecologists (ACOG).

Are there any downsides or risks to the mother with a forceps delivery?

While safe to perform, forceps deliveries do carry some risks to the mother. These include:

• Tears to the vagina, which may take time to heal
• Trouble urinating after delivery
• Pain in the perineum area (i.e. the area between the vagina and anus)
• An injury to the bladder or urethra
• Weakening of the muscles and ligaments that support the pelvic organs, which can cause sagging (or pelvic organ prolapse)
• You may receive an episiotomy to enlarge the vaginal opening for delivery

There’s also a chance that the forceps delivery won’t be successful. In that case, your doctor will recommend a C-section.

How often are forceps used during delivery?

According to a recent Centers for Disease Control and Prevention (CDC) report, forceps are used in 0.5 percent of live births in the United States. 

If your baby is struggling to make his exit or if you’re having trouble pushing, forceps can help guide him through the birth canal and make his — much anticipated! — entrance into the world.

From the What to Expect editorial team and Heidi Murkoff, author of What to Expect When You're Expecting. What to Expect follows strict reporting guidelines and uses only credible sources, such as peer-reviewed studies, academic research institutions and highly respected health organizations. Learn how we keep our content accurate and up-to-date by reading our medical review and editorial policy.

• What to Expect When You’re Expecting, 5th edition, Heidi Murkoff.
• WhatToExpect.com, Having a C-Section (Cesarean Section), July 2021.
• WhatToExpect.com, Giving Birth by Vaginal Delivery, April 2021.
• WhatToExpect.com. Vacuum Extraction During Delivery, May 2021.
• American College of Obstetricians and Gynecologists, Assisted Vaginal Delivery, May 2021.
• Centers for Disease Control and Prevention, Births: Final Data for 2019, March 2021.
• Mayo Clinic, Forceps Delivery, August 2020.
• National Institutes of Health, National Library of Medicine, Medline Plus, Assisted Delivery With Forceps, April 2022.

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