Forceps

When the joy of a new birth is overshadowed by a preventable injury, families often find themselves searching for answers. Among the various tools used in modern obstetrics, few carry as much historical weight—or as much potential for controversy—as the obstetric forceps. Forceps instrument misuse can lead to devastating, lifelong consequences for both mother and child, and can result in a medical malpractice claim.

Understanding the legal and medical landscape of forceps-assisted delivery is crucial for any family navigating the aftermath of a birth injury.

What are Obstetric Forceps?

Forceps are a specialized medical instrument to assist in the vaginal delivery of a baby. They resemble a pair of large, curved metal “spoons” or “tongs” that are to fit securely around the baby’s head.

Unlike a vacuum extractor, which uses suction on the crown of the head, forceps provide a mechanical grip. This allows an obstetrician to apply traction (pulling). In some cases, rotation to guide the infant through the birth canal.

The Secret History of the Forceps

The invention of the forceps is one of the most curious chapters in medical history. They were developed in the late 16th century by the Chamberlen family, a line of “man-midwives” in England.

For over 100 years, the family kept the tool a strict professional secret to maintain a monopoly on difficult births. They would arrive at a home with a massive, ornate wooden box and require all family members to leave the room. The medical providers would often blindfold the mother so she could not see the “secret” instrument they were using. It wasn’t until the early 18th century that the design became public, eventually evolving into the surgical-grade instruments used in hospitals today.

When and How are Forceps Used?

Doctors use forceps during the “second stage” of labor—the pushing stage. They are typically employed when a vaginal delivery is nearly complete but has stalled, and a C-section is deemed either too slow or too risky at that late stage.

Common Indications for Use

• Prolonged Labor: The mother has been pushing for hours without significant progress (often 2–3 hours depending on whether the doctor has given an epidural).
• Fetal Distress: The baby’s heart rate shows signs that they are not receiving enough oxygen, necessitating an immediate delivery.
• Maternal Exhaustion: The mother is physically unable to continue pushing effectively.
• Maternal Health Risks: The mother has an underlying condition (like heart disease or high blood pressure) where prolonged pushing could be dangerous.

The Procedure

Only a trained obstetrician—not a midwife or general practitioner—should perform a forceps delivery. The process involves:

1. Placement: The doctor slides the “blades” into the birth canal one at a time, positioning them symmetrically on the sides of the baby’s head.
2. Locking: The handles lock together to ensure a firm but safe grip.
3. Traction: During a contraction, the doctor pulls gently while the mother pushes, mimicking the natural rhythm of labor.

When Doctors Should NOT Use Forceps

Medical malpractice often occurs when a doctor ignores “contraindications”—signs that the tool is unsafe for a particular situation. Doctors should generally avoid forceps if:

• The baby is not far enough down the birth canal (the head is not “engaged”).
• The baby’s exact position is unknown.
• The baby has a bone or bleeding disorder (like hemophilia).
• The baby is too large to fit through the pelvis (Cephalopelvic Disproportion).
• The baby is less than 34 weeks premature (as their skull is too fragile).
• The mother’s cervix is not fully dilated.

Potential Birth Injuries – Forceps Medical Malpractice

When used incorrectly—either through excessive force, improper placement, or choosing them when a C-section was the safer path—the injuries can be severe.

Injuries to the Baby

• Skull Fractures: Excessive pressure can crack the infant’s delicate skull.
• Brain Hemorrhages: Bleeding inside the skull can lead to permanent brain damage.
• Facial Nerve Palsy: Pressure on the side of the face can damage the nerves, causing drooping or paralysis.
• Cerebral Palsy (CP): Often caused by oxygen deprivation or physical brain trauma during the delivery process and often resulting in HIE: Hypoxic Ischemic Encephalopathy.
• Erb’s Palsy / Brachial Plexus Injury: If the doctor pulls too hard on the head while the shoulder is stuck, it can tear the nerves in the neck and shoulder.
• External Trauma: Deep lacerations, eye injuries, or “forceps marks” that lead to infection.

Injuries to the Mother

• Severe Tears: 3rd or 4th-degree perineal lacerations extending to the rectum.
• Uterine Rupture: A life-threatening tear in the wall of the uterus.
• Pelvic Organ Prolapse: Weakening of the muscles causing the bladder or uterus to drop.
• Chronic Pain or Incontinence.

Forceps Medical Malpractice Claims

To win a medical malpractice claim, a family must prove that the doctor deviated from the standard of care—meaning they did something a “reasonably competent” doctor would not have done.

Common Types of Forceps-Related Medical Malpractice Claims

1. Failure to Obtain Informed Consent: The doctor did not explain the risks of forceps versus a C-section before proceeding.
2. Excessive Force: The doctor pulled too hard or “yanked” the baby, causing physical trauma.
3. Improper Placement: The delivering doctor placed the blades over the baby’s face or neck instead of the sides of the head.
4. Failure to Abandon: The doctor continued trying to use forceps even after multiple failed attempts, instead of moving to an emergency C-section.
5. Failure to Recognize CPD: Attempting a forceps delivery when the baby was clearly too large for the mother’s pelvis.

Seeking Justice for Forceps Medical Malpractice

Birth injury cases are among the most complex in the legal system. They require expert witness medical testimony to analyze fetal monitor strips, hospital protocols, and the physical evidence of the injury. Because these injuries often require a lifetime of specialized care—including physical therapy, surgery, and educational support—settlements in these cases can be substantial, often reaching into the millions of dollars.

If you suspect the improper use of forceps injured your child, it is vital to act quickly, as “statutes of limitations” restrict how long you have to file a claim.

Visit our free consultation page or video. Then contact the Kopec Law Firm at 800-604-0704 to speak directly with Attorney Mark Kopec. He is a top-rated Baltimore medical malpractice lawyer. The Kopec Law Firm is in Baltimore and pursues cases throughout Maryland and Washington, D.C.