Forceps look like large sugar tongs and are designed so that they will fit snugly over the sides of the baby’s head, covering the ears. They are rather like a cage and protect the head from any pressure within the birth canal.

The decision to use forceps is a medical one. Forceps are only applied when the first stage is complete, the cervix is fully dilated and the head is in the birth canal

Why it is done

Forceps are used when the baby`s head has descended into the mothers pelvis but fails to descend further; when the baby is presenting in a posterior position; in a breech delivery (see opposite); when the uterus fails to maintain contractions; and when the mother lacks the strength to push out her baby. Nowadays, nearly all premature babies are delivered by forceps to protect their delicate skulls from being compressed in the birth canal.

How it is done

You will be asked to lie on your back and your legs will be put up in stirrups. A local anaesthetic will be injected into your perineum, and an episiotomy performed. Then the forceps will be inserted into your vagina one at a time. A few gentle pulls on the forceps, 30-40 seconds at a time, will bring your baby`s head out. The rest of his body will be delivered as usual

Episiotomy Wound

The pain from an episiotomy wound gets worse before it gets better. The wound is positioned where fluid can accumulate in the cut edges. These then swell, with the result that the stitches become tighter and bite into the sore skin around the wound

if you are bruised or if the stitches are really painful, it will help to sit on an inflatable rubber ring (some hospitals have these). Good hygiene is vitally important while the wound is healing, so make sure that it is kept clean. Most stitches will dissolve after five or six days.

Warm baths and showers are soothing and encourage the healing process, as do pelvic floor exercises. You may also find that ice packs or local anaesthetic creams are helpful There are special perineal pads that fit between your sanitary towel and the wound. Your doctor or midwife will advise you about these.

Don’t use antiseptics or perfumed bubble liquid in your bath water because they can cause irritation. After bathing if you can, dry the area with a hairdryer instead of a towel, which can be painful.

Urine, which is strongly acid, will make the raw skin sting Standing up to urinate may help. You could also try pouring warm water over yourself as you’re urinating to dilute the acid and reduce the sting.

Certain procedures historically associated with childbirth are being re-evaluated. Some have been found to be unnecessary, others unjustified. However, most of today`s obstetricians believe that they can guarantee that childbirth is a safer and happier experience for a mother and her baby with the help of modern technology.

By drawing your attention to the arguments con­cerning some standard medical practices, this will help you to question them assertively with your medical and nursing attendants. More often than not, your wishes will be complied with, especially if you have written a birth plan in advance, but occasionally you will be told that to continue with a particular option will put you or your baby at serious risk — for instance, if your baby is showing signs of distress and you fight to continue with a totally natural childbirth. Be prepared to adapt your ideas.

Shaving

Nowadays, shaving is unnecessary unless you are having a Caesarean section. Any chance of infection can be eliminated by wiping the vulva with gauze and simply spraying with an antiseptic.

Nil by mouth

Many modern obstetric units have aban­doned the old custom of nil by mouth but some hospitals may still practice it. There is no medical nor scientific rationale for starving a woman during labour. In fact, quite the opposite: the hard work of labour uses up much energy, which causes sweating, and a woman must replace the fluids that she has lost.

Before epidurals became commonplace for Caesarean sections, if a general anaesthetic became necessary it could not be given to a woman who had eaten recently as she might have inhaled vomit. But, even so, there is no reason why every woman should still suffer simply because a small number need surgical intervention.

Moving to a delivery room

In some hospitals a woman still has to undergo the physical and emotional upheaval of leaving the room in which she had so far laboured in order to have her baby in a delivery room. Ideally, labour should proceed smoothly in peaceful surroundings, and as long as a room is equipped with good lighting, oxygen in some form, and a suction apparatus to clear out the babys air passages, if necessary, I can see no reason why a woman in normal labour should be forced to move to a delivery room. Many progressive hospitals now have more congenial all-in-one labour and birthing rooms and, if possible, you should choose a hospital with these.

Induction

Starting off labour artificially is not a new idea, but it only became an easy procedure in the latter half of the twentieth century. Labour is usually induced for medical reasons such as pre-eclampsia, high blood pressure or post-maturity, when induction can save the lives of mothers and babies.

An induced labour may involve the use of a Syntocinon drip, which will restrict your movements. Such a labour can be shorter and sharper and probably will increase your need for heavy-duty painkillers.

Amniotomy

This is when the membranes (the bag of waters) surrounding the baby are artificially ruptured. It may be carried out in a high-tech birth, and if so, is usually done early in labour for three reasons. The first is so that electronic fetal monitoring equipment can be set in place; the second is to check if the amniotic fluid contains meconium (this is the baby’s first bowel movement and its presence may indicate fetal distress); the third is that once they are ruptured, the baby’s head can press down hard on the cervix, helping dilatation of the cervix and speeding up the first stage.