NURSING JOURNAL

Student’s Name: __Claire Alyssa M. Gido______________ Date:_January 4,2022

Year/Block/Group:__UP-FC1-2BSN-21____________ Area of Assignment:__________________

Clinical Instructor:________________________

Forceps delivery: potential benefits and a call for continued training

By: B L Shaffer & A B Caughey

Summary of Journal Reviewed

Forceps delivery is an operative delivery conducted with the help of obstetric forceps to
assist the extraction of the fetal head thereby accomplishing delivery of the fetus. Healthcare
practitioners have the optimal care for mothers and their babies. Cesarean delivery is becoming
more common in the United States, accounting for 30.2 percent of all births in 2005.
Furthermore, the main cesarean rate, which was 20.6 percent of all births in 2004, is continuing
to rise, following a five-year pattern of 5% rises. Operative vaginal births account for 9 to 12
percent of all deliveries, according to current statistics, but they are becoming less common.
The Operative vaginal delivery, using a single instrument, affords no increased risk of major
neonatal injury compared with a cesarean. For instance, intracranial hemorrhage was not
increased in neonates delivered by forceps or vacuum compared with those delivered by C-
section.

The operative vaginal is at risk of morbidity and with an increased rate of risk in a perineal
laceration to the mother. Cesarean birth has been related to longer hospital stays, an increased
risk of infection, and a greater probability of maternal mortality after delivery. Women who
intend to have more children are more than 90% likely to deliver through repeat cesarean
section, which comes with its own set of dangers. Additionally, there are elevated chances of
placenta previa and unexplained intrauterine fetal mortality in these future pregnancies.
Choosing an instrument for operative delivery is determined by several factors including the
complications and potential benefit to the mother and the baby. Vacuum-assisted delivery with
increased rates of complication to the mothers and babies when dong it. It also has been noted
to be a higher risk in shoulder dystocia. Moreover, the risk of a failed surgical delivery with
forceps is two times higher than with a vacuum.

The number of surgical vaginal births with forceps has decreased during the previous decade,
because of improved equipment. According to Dr. Powellet al, reported that only about a half
of graduating fourth-year residents felt competent in doing forceps deliveries and they want to
train more in performing a forceps delivery. However, many attending practitioners are
teaching the use of vacuum deliveries than forceps delivery. The resident's program is the only
one to teach the use of forceps. They recommend the use of the sophisticated simulator to
become comfortable with basic forceps application and traction. At the end, they have the duty
to women to train obstetricians skilled in operative delivery to help the increasing trend toward
cesarean delivery for all but most of all vaginal deliveries.
 The journal talks about the potential delivery and a call for continuing training in forceps
delivery. The author mostly indicated the comparison on potential benefits and the
complication of the forceps delivery to the cesarean delivery. The operative delivery is with risk
of morbidity and risk in a perineal laceration. While the cesarean birth with a higher risk of
infection and a greater possibility of maternal mortality after the delivery. The women that
have primary cesarean who intend to have more children are more likely to deliver through a
repeat cesarean section, but there are elevated chances of placenta previa and unexplained
intrauterine fetal death in future pregnancies. They also choose an instrument for operative
delivery to determine by the several factors included the benefits and complications to the
mother and infant. But the number of using forceps delivery is decreased over the years,
because of well-improved equipment and trained in an operative delivery. Half of graduating
fourth-year residents felt competent in doing the forceps deliveries and they want to continue
to train more in doing forceps deliveries. Additionally, the attending physicians are always want
to teach the use of vacuum delivery than to teach the use of forceps delivery, so that few
health practitioners can do it, and doing the procedure of the forceps delivery is decreasing
because they prefer more vacuum-assisted delivery. Also, they may only teach the forceps
delivery to the resident's program.

Reference: https://www.nature.com/articles/7211735