Forceps Delivery: Procedure, Benefits, Risks and Recovery

Introduction

Most parents-to-be hope labour will go as planned, but sometimes your medical team recommends a procedure you haven’t come across in pregnancy books and Google searches. Forceps delivery is one of those procedures. It is a type of assisted vaginal birth in which your doctor uses a spoon-shaped metal instrument to gently cradle and guide your baby's head through the birth canal when labour needs extra help in its final stage.

Doctors usually consider this when the pushing stage of labour goes on longer than expected, when you are too exhausted to push effectively, or when your baby's heart rate signals that birth needs to happen sooner. It is used only in specific situations, after your doctor confirms it is safe for both of you. Understanding the procedure, its benefits and its risks can help you feel more prepared for the decisions ahead or better understand a birth that didn't go exactly as planned.

What Is Forceps Delivery?

A forceps delivery is a birth where your doctor uses an instrument called forceps to help deliver your baby through the vaginal canal. The word ‘forceps’ refers to the two curved, spoon-shaped blades that fit around your baby's head. A forceps delivery means a hands-on way to complete a vaginal birth when pushing alone is not enough.

This procedure is a form of assisted vaginal birth, sometimes called operative vaginal delivery. It helps your baby move down and out through the birth canal when labour has stalled, or a faster delivery becomes necessary. Once the blades are positioned, your doctor applies gentle traction, timed with your contractions and your pushing, to guide your baby through the last part of the birth canal.

Forceps deliveries have now decreased in number and accounted for only 0.98% of vaginal births in 2023, according to a 2025 resource published in the StatPearls collection of the National Library of Medicine. Yet, forceps remain part of modern maternity practice today, serving as a safe alternative to caesarean deliveries.

What Are the Types of Forceps Used During Delivery?

Different types of forceps are used in different situations, depending on how far your baby's head has moved into the birth canal.

Outlet Forceps

Outlet forceps are used when your baby's head is already visible at the vaginal opening, and no rotation is needed. This is the most straightforward use of forceps.

Low Forceps

Low forceps are used when your baby's head has moved well down into the pelvis but has not yet reached the vaginal opening. Your doctor may need to rotate the head slightly before guiding it out.

Mid Forceps

Mid forceps are used less often today, when your baby's head is engaged in the pelvis but has not descended as far as in a low forceps delivery. This type carries more risk and suits situations where a caesarean is not safer.

Specialised Forceps

Some forceps are used according to particular circumstances. Piper forceps support the head of a baby born bottom-first, in a breech birth, while Kielland forceps rotate a baby's head facing the wrong direction before guiding it down.

When Is Forceps Delivery Recommended?

Doctors recommend forceps delivery only when specific conditions are present during labour. Common indications for forceps delivery include:

• Prolonged second stage of labour: If you have been pushing for a long time without your baby moving down, your doctor may suggest a forceps delivery. A prolonged second stage is generally defined by the American College of Obstetricians and Gynecologists (ACOG) as three or more hours of pushing for a first birth, or two or more hours for individuals who have given birth before. This is one reason doctors turn to forceps delivery for prolonged labour.
• Maternal exhaustion: After hours of labour and repeated pushing, you may have no energy left to keep pushing. In such cases, forceps can help deliver the baby safely rather than prolonged pushing.
• Foetal distress: If your baby's heart rate pattern suggests they are not tolerating labour well, forceps can shorten the time to delivery when your baby is already low in the canal.
• Medical conditions in the mother: In certain heart, lung or neurological conditions, pushing hard for a long time can be unsafe, and your doctor may recommend forceps to reduce the strain of pushing.
• When pushing needs to be limited: Some conditions, such as high blood pressure disorders of pregnancy, mean prolonged pushing could raise health risks. Forceps let your medical team help your baby out while limiting how much you push.

How Is a Forceps Delivery Performed?

A forceps delivery follows a structured process:

Preparation Before the Procedure

Your doctor examines you to confirm your cervix is fully open and your baby's head is low enough. You will be provided pain relief, often an epidural or a local anaesthetic. Your doctor also explains the procedure and asks for your consent before continuing.

Placement of the Forceps

Your doctor gently places one blade, then the other, around the sides of your baby's head. The blades lock together in the middle, cradling the head without gripping the skull tightly.

Assisting the Birth

With your next contraction, your doctor applies gentle, controlled traction, pulling in rhythm with your own pushing, to guide your baby's head down and out.

Delivery of the Baby and Placenta

Once your baby's head is delivered, the forceps are removed, and the rest of the birth continues much like an unassisted delivery, followed shortly by the placenta.

Immediate Monitoring After Delivery

Your medical team checks you for tears and your baby for marks or signs of distress, then places your baby on your chest for skin-to-skin contact once both of you are stable.

What Are the Benefits of Forceps Delivery?

A forceps delivery offers practical benefits when used at the right time and in the right situation.

• Helps avoid an emergency caesarean section when your baby is already low in the birth canal.
• Assists in a safe,vaginal delivery when your baby has stopped moving despite your pushing.
• Shortens the second stage of labour, reducing strain on both you and your baby.
• Offers a faster way to deliver your baby in urgent situations, such as a sudden change in heart rate.
• May reduce complications linked with a very long labour, including exhaustion and foetal distress.

What Are the Risks of Forceps Delivery for the Mother?

Like any birth procedure, forceps delivery carries risks for the mother. Knowing the complications of forceps delivery in advance helps you ask informed questions during labour.

• Vaginal and perineal tears: Tears in the vaginal wall or the perineum, the area between the vagina and the anus, are more common with forceps delivery than with an unassisted birth. Your doctor may perform an episiotomy, a small planned cut, to reduce the risk of a larger tear.
• Pelvic floor injuries: The pelvic floor is the group of muscles supporting your bladder uterus and bowel. Forceps delivery carries a higher chance of injury to these muscles than an unassisted birth.
• Postpartum pain and discomfort: Sitting down, walking or using the toilet may feel sore for the first week or two after forceps delivery, particularly with a tear or episiotomy.
• Urinary or bowel problems: Some women notice urine leaks when they cough, laugh or sneeze after forceps delivery. Most of these problems improve with recovery and pelvic floor exercises.
• Postpartum bleeding: According to a 2023 study published by BMC Pregnancy and Childbirth, heavy bleeding after birth, known as postpartum haemorrhage, is significantly more common after an assisted vaginal birth than an unassisted one.

What Are the Risks of Forceps Delivery for the Baby?

Forceps delivery also carries some risks for your baby, most of which are minor and settle on their own.

• Temporary facial marks or bruising: Your baby may have red marks or light bruising on the cheeks where the forceps rested. These usually fade within a few days to about two weeks.
• Minor facial nerve injury: Occasionally, pressure from the forceps affects a facial nerve, causing temporary weakness on one side. This usually resolves within weeks without lasting effect.
• Scalp and head injuries: Some babies develop bruising or swelling on the scalp, known as a cephalhaematoma. However, a 2024 resource published by the National Institutes of Health's StatPearls collection found this was less common with forceps, at around 6.4%, versus 11.1% with vacuum-assisted birth.
• Rare serious complications: Serious injuries, such as skull fractures or bleeding inside the skull, may occur but are uncommon. Per a commentary on ACOG guidance published in Contemporary OB/GYN, neurological complications occur in roughly 1 in 220 to 385 instrumental births.

Can Forceps Delivery Affect Future Pregnancies?

Most women who have a forceps delivery go on to have healthy future pregnancies and births. Long-term maternal outcomes are generally reassuring, though the risk of pelvic floor problems, such as urinary leakage, can be slightly higher over time.

A forceps delivery in one pregnancy does not rule out a vaginal birth in a later one. Many women who had an assisted birth previously go on to have an unassisted delivery next time. Your doctor looks at what led to the forceps delivery, since this affects what to expect in a future birth.

If you have concerns about a past forceps delivery or what it might mean for a future pregnancy, raise them directly with your doctor. They can review your birth history and talk through what is likely for you specifically.

Conclusion

A forceps delivery is one of the tools doctors use to help a baby through the final part of a difficult labour. It is used only when your medical team believes it is the safest way to help deliver your baby. It carries both benefits and risks, and your medical team weighs them all before recommending it. If you are recovering from a forceps delivery, most physical effects settle within weeks. Ongoing support, including pelvic floor exercises and honest conversations with your doctor, can help you heal fully. When preparing for an upcoming birth, knowing what forceps delivery involves means you can ask clear questions and feel more prepared for whatever your labour brings.