I too have noticed a decline in the use of forceps. Time was that Kiellands
were fairly common, and in experienced hands, quite effective for a POP.
EXPERIENCED hands being the operative (no pun intended) word. One Ob
recently said that these days he would opt for a c/s rather than a
'difficult' forceps and I can see the sense in that - having witnessed some
truly horrific forceps births in the past, feet bracing the foot of the bed
when extreme force was used, and one where the mum was taken to theatre with
a forceps blade still stuck alongside the baby's head resulting in long term
damage for mum and a baby that only lived for 48 hours. Extreme force should
not be used - if the bub will not move then the attempt should be abandoned.
However, one off shoot of the current rise in c/s is that drs are not
experienced in instrumental deliveries, and even those that are tend not to
go for it if there is any doubt. Depends on the doctor and his/her level of
comfort I think - the next generation will have little 'comfort' in use of
forceps at all methinks!
Wrigleys and ventouse really only have a place in births where the bub is
close to the door but either needs out quickly or mum is exhausted, one of
our obs uses wrigleys very effectively in these situations, does not put mum
in stirrups and is very gentle. Have also seen times when doctor will bring
bub to crowning and then remove instruments letting mum finish the birth
herself, which in the right circumstances can be very empowering.
The birth Mary spoke of sounds like it was perhaps an injudicious use of
ventouse given the circumstances?? Do you think this mum and baby might have
been less damaged given a C/S? ( Hindsight being such a wonderful thing )
Sue
"The only thing necessary for the triumph of evil is for good men to do
nothing"
Edmund Burke
----- Original Message -----
From: "Mary Murphy" <[EMAIL PROTECTED]>
To: <[email protected]>
Sent: Wednesday, May 31, 2006 5:30 PM
Subject: RE: [ozmidwifery] Keillands Deliveries
I recently was present where a ventouse was used to turn a baby from POP,
asynclitic position. It was very difficult, with extreme force and a very
"generous" episiotomy. The baby was extremely shocked and had a head like
a
bowl of port wine jelly. It stayed 6 days under the Bili lights with high
levels of jaundice.I believe that this was the ideal situation to use a
Keillands for rotation and descent. Wriggley's was usually used to "lift
out" the baby. This ventouse delivery has led to anguish and exhaustion
for
the mother, breast feeding interruption and confusion, formula feeding and
a
lack of connectedness with the baby. I haven't seen anyone use a
Keillands
or wriggly's for a long time. M
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