Study Finds Forceps Delivery
Safer Than C-Section
Excerpt By Melissa Schorr, Reuters Health

NEW YORK (Reuters Health) - Women with arrested labor who went on to deliver their babies by Caesarean section had a greater risk of complications than women who delivered with the aid of instruments such as forceps, a team of British researchers reports.

``Obstetricians should continue to be trained in instrumental delivery methods in order to be able to offer the full range of safe obstetric interventions to women who want to achieve vaginal delivery,'' lead author Dr. Deirdre J. Murphy, an obstetrician at St. Michael's Hospital in Bristol, UK, told Reuters Health.

The researchers followed 393 women who got stuck in the second stage of labor, after their cervix was fully open, or dilated, who were directed either to have a C-section or to deliver by forceps.

``We wished to establish whether there is any place for complex instrumental deliveries in modern obstetric practice,'' Murphy explained. The findings were published in the October 13th issue of The Lancet.

The investigators found that women who had a Caesarean delivery were more than twice as likely to suffer major bleeding and were more than three times as likely to require a prolonged hospital stay.

For example, 10% of the women who delivered by C-section suffered significant blood loss, compared with 3% of women who delivered by forceps. Similarly, 16% of the women who delivered by C-section required six or more days in the hospital, compared with only 5% of the women who delivered by forceps.

However, the babies who were delivered by forceps had an increased chance of suffering trauma such as bruising, cuts, nerve injuries and a small chance of cerebral bleeding.

The doctors noted that the women who went on to have C-sections were not more likely to be deemed in a more critical condition originally than the women who had been allowed to deliver using forceps. The researchers also took into account influencing factors such as the mother's body weight and the infant's birth weight.

Murphy's team also found that women were less likely to have a C-section and to endure adverse outcomes if they were handled by a highly experienced obstetrician.

``Women should be offered the choice of instrumental delivery by an experienced obstetrician, where there is a reasonable chance of achieving safe vaginal delivery,'' Murphy concluded.

SOURCE: The Lancet 2001;358:1203-1207.

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