Forceps Delivery Complications Causes

Quick Answer

Forceps delivery is a type of assisted vaginal delivery, also called operative vaginal delivery. The procedure requires anesthesia (such as an epidural) and uses forceps, a tong-like tool, to help guide babies out of the birth canal. Using forceps can be a safe way to help deliver a baby. However, complications may arise. Learn about what causes forceps delivery complications and whether medical malpractice could be involved.

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What Causes Forceps Delivery Complications?

Closeup of doctors hands wearing latex gloves and using forceps.Forceps are a delivery tool that look like oversized tongs. Delivery doctors are trained to use the tool to gently guide a baby out of the birth canal, one side at a time. This is done while the mother pushes as directed.

Doctors need your consent to use forceps during delivery.

While the American Congress of Obstetricians and Gynecologists (ACOG) states that forceps are a safe way to avoid some cesarean sections (C-sections), problems can still arise and cause harm to both mother and baby if too much force is used.

Common Forceps Delivery Complications Causes

Several factors contribute to what causes forceps delivery complications, including the following.

Baby Is Unable to Fit Through the Mother’s Pelvis

If the baby cannot fit through the mother’s pelvis, a doctor may use forceps too forcefully, causing birth injuries such as skull fractures, bleeding in the skull, and head bruises.

This condition may occur if the baby is larger than average, the mother’s pelvis is relatively small, or the baby is not in the proper position for birth.

Baby Has a Bleeding Disorder or Weakened Bones

If a baby has weakened bones or a bleeding disorder, forceps may cause skull fractures and bleeding in the skull.

Baby’s Head Is Too Far In Birth Canal

Obstetricians can easily misuse forceps if a baby’s head is in the middle of the birth canal. This can tragically lead to brain damage, skull fractures, and other injuries.

Doctors Can’t Determine the Position of the Baby’s Head

Similarly, if the delivery team does not know the baby’s head position, they may use the forceps improperly, increasing the risk of complications.

Baby Is Born Arms or Shoulders First

If a baby’s arms or shoulders are the first to come out of the birth canal (breech), the delivery team may use forceps to turn the baby around.

If the team can’t turn the baby around and guide them out in time, the baby may suffer oxygen deprivation, one of the most serious causes of birth injuries. This life-threatening situation can cause epilepsy, cerebral palsy, and developmental delays.

Medical Negligence and Forceps Delivery Complications Causes

Medical professionals are trained to understand the risk of obstetrical forceps delivery. They should also know how to use forceps properly to minimize the risk of injury and avoid common forceps delivery complications causes.

Here are some general forceps delivery guidelines that obstetricians should follow:
  • Know when to avoid forceps deliveries. For example, they should understand that forceps deliveries should be avoided when the baby cannot fit through the mother’s pelvis, the position of the baby’s head is unknown, or the baby has a bleeding disorder or a condition causing weakened bones.
  • Decide when a C-section or vacuum extraction is safer. For instance, a baby’s heart rate and other signs of fetal distress may prompt doctors to use forceps. However, a forceps delivery is only appropriate if it will be faster than an emergency cesarean section. This is because forceps deliveries have a much higher injury rate than C-sections.
  • Have the skill and experience to use forceps properly and safely. If a medical provider uses too much pressure or grips the baby’s head incorrectly, the forceps can cause severe damage to the baby’s head. Similarly, if a provider uses too much force to twist the baby into position for delivery, they may cause devastating injuries to the baby’s spinal cord, resulting in life-long disabilities.

If you think your child may have been harmed by improper or negligent forceps use, talk to one of our registered nurses in confidence.

Nurse Beth Carter

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Forceps Delivery Complications & Birth Injuries

Forceps delivery complications causes may lead to a range of birth injuries, including:

  • Facial palsy: Damage to nerves in the baby’s face that weakens the facial muscles.
  • Hematomas: A buildup or pooling of fluid or blood around the baby’s brain.
  • Hydrocephalus: Characterized by fluid buildup, it can result in permanent damage to the brain.
  • Injuries and cuts: Wounds or injuries to the face and head typically heal within several days.
  • Jaundice: Forceps can cause bleeding and bruising of the baby’s scalp, causing blood cells to release high levels of bilirubin. This can cause jaundice, which is usually seen as the yellowing of the baby’s eyes and skin.
  • Nerve damage: The doctor may tear or stretch the nerves in the baby’s brachial plexus, the network of nerves that controls the arm. Nerve damage can cause Erb’s palsy, a type of arm paralysis.
  • Shoulder dystocia: This happens when one or both of the baby’s shoulders get stuck during vaginal delivery. Shoulder dystocia can cause fractures to the baby’s upper arm bone and collarbones, Horner’s syndrome, and a compressed umbilical cord, which can cause brain injury or death.
  • Skull fractures: Most skull fractures won’t cause long-term damage and will heal on their own.
  • Spinal cord damage: Doctors may cause spinal cord injuries when turning the baby around. Spinal cord injuries can cause paralysis and loss of function in the legs.

Brain bleeds, hematomas, and hydrocephalus can potentially cause long-term neurological injuries to the baby’s brain, which can lead to cerebral palsy and other permanent disabilities.

Treatment for Birth Injuries Caused by Forceps Delivery Complications

Fortunately, treatment options may be available when forceps delivery complications causes lead to a birth injury.

Here are common treatments for injuries caused by forceps delivery complications:
  • HELPERR for shoulder dystocia: HELPERR is a mnemonic device that lists the maneuvers healthcare teams should use when facing shoulder dystocia. The mnemonic stands for:

H – Call for Help
E – Evalauate for Episiotomy
L – Flex and abduct the mother’s Legs and hips
P – Apply Pressure on the baby’s shoulder
EEnter the birth canal to rotate the baby’s shoulder
RRemove the baby’s back arm from the birth canal
RRoll the mother to a hands and knees position

  • Phototherapy for jaundice: Phototherapy involves using a special type of light. It makes it easier for the baby’s liver to remove excess bilirubin from the bloodstream.
  • Skull fracture surgery: If the baby has a skull fracture, doctors may perform surgery to prevent brain damage. They can repair the fracture by lifting pieces of the bone back to their usual place.
  • Surgery for hematomas and hydrocephalus injuries: Doctors may use surgery to drain blood (hematoma) or fluid (hydrocephalus) from the brain. They may also fix broken blood vessels to treat hematomas.

Forceps Delivery Injuries and Medical Malpractice

If your child was harmed by any of these forceps delivery complications causes, you may be able to pursue financial compensation by filing a birth injury lawsuit. By working with an experienced medical negligence attorney, you may be able to recover financial compensation.

Compensation from a forceps delivery lawsuit can help cover:

  • Economic damages such as life-long medical expenses, out-of-pocket costs for special education and medical equipment, and loss of income for parents who miss work or change careers to care for their child
  • Non-economic damages such as mental anguish, pain and suffering, and diminished quality of life

If you suspect your baby was harmed due to medical malpractice, get a free legal consultation now. We may be able to connect with one of the best birth injury law firms in the country.

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A free case review is the first step in pursuing compensation for you and your family.

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Get Help for a Birth Injury Caused by Forceps Complications

Your delivery team had the responsibility to keep you and your baby safe. They should be armed with the expertise to appropriately respond to all situations.

If forceps delivery mistakes were made, it is not your fault, and you should not have to pay the price. Fortunately, birth injury lawyers may be able to help you get the compensation you need to get your family’s life back on track.

Get a free case review to find out if we can help. You don’t have to face your child’s birth injury alone.

Causes of Forceps Delivery Complications FAQs

Can a forceps delivery cause problems later in life?

Yes. Serious forceps delivery complications can cause lifelong or long-term conditions in children, such as cerebral palsy and brain damage.

The use of forceps in vaginal birth can also cause problems later in life for the mother, including chronic pain, urinary incontinence, pelvic organ prolapse, and pain during sex.

What are four complications of forceps delivery?

Four maternal complications of forceps delivery include:

  1. Blood clots, especially in the veins of the pelvis or legs
  2. Pain in the perineum (the tissue between the vagina and anus)
  3. Pelvic organ prolapse
  4. Short or long-term urinary incontinence or difficulty urinating

What is the most common injury with forceps delivery?

Nerve damage is the most reported type of forceps-induced birth injury. In severe cases, this can lead to Erb’s palsy.

How long does it take for a baby to recover from a forceps delivery?

According to Cleveland Clinic, serious complications to babies from forceps delivery are rare. Most risks are temporary and mild. However, in some cases, serious injury can occur.

If health care providers misused forceps or chose to use them when a less risky option was available, you may have legal rights. Get a free consultation to see if you can get connected with an experienced birth injury attorney to learn more.

Birth Injury Support Team
Reviewed by:Beth Carter, RN

Registered Nurse, Legal Nurse Consultant Certified

  • Fact-Checked
  • Editor

Beth Carter has over 18 years of experience as a Registered Nurse. She spent nearly half of that time working in labor and delivery units. This, combined with her own experience giving birth to a premature baby, ignite Beth’s passion for helping new mothers access the information and resources they deserve.

The Birth Injury Justice Center was founded in 2003 by a team of legal professionals to educate and empower victims and families affected by birth injuries. Our team is devoted to providing you with the best resources and legal information for all types of birth injuries.

View Sources
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  2. Cleveland Clinic (2022 January 23). “Shoulder Dystocia.” Retrieved April 13, 2023 from https://my.clevelandclinic.org/health/diseases/22311-shoulder-dystocia.
  3. Johns Hopkins Medicine. (n.d.) “Episiotomy.” Retrieved April 13, 2023 from https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/episiotomy.
  4. Lee, C.-C., Chou, I.-J., Chang, Y.-J., & Chiang, M.-C. (2020, September 29). Unusual presentations of birth related cervical spinal cord injury. Frontiers in pediatrics. Retrieved May 1, 2023, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7550748/.
  5. Mount Sinai. “Jaundice.” (n.d.) Retrieved April 13, 2023 from https://www.mountsinai.org/health-library/diseases-conditions/jaundice.
  6. National Library of Medicine (2023 January 25). StatPearls. “Erb Palsy.” Retrieved April 13, 2023 from https://www.ncbi.nlm.nih.gov/books/NBK513260/.
  7. NHS (2020 June 9). “Forceps or vacuum delivery.” Retrieved April 13, 2023 from https://www.nhs.uk/pregnancy/labour-and-birth/what-happens/forceps-or-vacuum-delivery/.
  8. NHS (2022 February 3). “Treatment.” Retrieved April 13, 2023 from https://www.nhs.uk/conditions/jaundice-newborn/treatment/.
  9. Stanford Medicine. (n.d.) “Acute Spinal Cord Injury (SCI) in Children.” Retrieved April 13, 2023 from https://www.stanfordchildrens.org/en/topic/default?id=acute-spinal-cord-injury-in-children-90-P02590.
  10. University of Alberta (2021 October 19). “Canada should limit use of forceps in childbirth to prevent lifelong injuries to women: study.” Retrieved April 13, 2023 from https://www.ualberta.ca/folio/2021/10/canada-should-limit-use-of-forceps-in-childbirth-to-prevent-lifelong-injuries-to-women-study.html.