BRISTOL, England, Oct. 11 (UPI) -- Obstetricians might be too quick to resort to emergency Caesareans instead of choosing forceps-assisted delivery when a woman's labor becomes blocked by the baby, a new study suggests.
Researchers led by Dr. Deirdre Murphy of St. Michael's Hospital in Bristol came to that conclusion after studying 393 women with obstructed labor.
Women who underwent emergency Caesareans were about twice as likely to have more serious bleeding than women whose babies were delivered with the help of forceps. The study also found the babies of mothers who had Caesareans were twice as likely to need treatment in a neonatal intensive care unit than babies delivered by forceps.
Instrumental delivery, however, is not without its risks, too, researchers pointed out. Babies born by use of forceps experienced bruising, cuts, nerve injuries, and though rare, cerebral bleeding.
"Either way, they're extremely difficult deliveries," Murphy told United Press International. "It's striking a balance and getting the best delivery for that woman and that baby, (but)instrumental delivery should be available to women who want to deliver vaginally."
The findings were published in the Oct. 13 issue of The Lancet medical journal.
The researchers noted that the number of Caesarean deliveries has been increasing in developed nations and suggested that although forceps delivery comes with risks, it still is a vaginal delivery, which often is preferred over a Caesarean section.
Caesarean births require long recovery periods for both mother and baby. A C-section involves an incision in the abdomen, which cuts through several layers of muscle and tissue, which need time to heal. When done with skilled hands, Murphy said, forceps delivery can be quite successful for both the woman and her child.
The researchers said doctors might be hesitant to perform forceps delivery because they do not have as much experience with that as they do with Caesarean deliveries.
Dr. Yvonne S. Thornton, senior perinatologist at St. Luke's-Roosevelt Hospital in New York and a member of the American College of Obstetrics and Gynecology, told UPI that some doctors simply might feel "more comfortable with the scalpel" than with forceps.
Medical schools are trying to change that, she said, by providing medical residents with broader training in all areas of emergency deliveries, including the use of forceps.
Dr. Monica J. Stokes, a fellow of ACOG and an obstetrician in San Francisco, said there may be other reasons why physicians avoid forceps.
"There's a distinct fear of forceps deliveries among many obstetricians because if anything goes wrong, you are liable," Stokes said. "Your forceps are going to blamed whether they were at fault or not."
Women most likely to have problems with obstructed labor include first-time mothers, Murphy said, and particularly women who have a body mass index of 30 or higher, the clinical standard for obesity.
Also, babies who are 9 pounds or larger are at risk of struggling more to pass through the vaginal canal than smaller babies. Stokes said the size of a woman's pelvis also plays a role -- some women may be able to more easily birth a larger infant than others.
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(Reported by Katrina Woznicki in Washington)
