Can Forceps Cause Brain Injuries?

During a difficult delivery, a doctor may decide to use forceps. However, forceps can cause serious brain injury if used improperly. Sometimes, the effects of a forceps injury are not clear until later in life. Developmental delays or other conditions may not appear until the child is older. 

If your child has a brain injury due to the misuse of forceps, it’s natural to feel overwhelmed, confused, and in need of answers. 

At ABC Law Centers: Birth Injury Lawyers, we understand the emotional toll a birth injury can take on your entire family. We want you to know you have an advocate. Our birth injury lawyers stand ready to help you explore your legal options and pursue the justice your family deserves.

What are forceps? 

Forceps are specialized medical instruments that look like tongs. They are used to facilitate vaginal delivery, but can cause birth injuries when incorrectly used. Forceps are designed to fit gently around a newborn’s head and guide the baby through the birth canal during a vaginal delivery. 

Proper Use of Forceps During Delivery

When used by a skilled physician, forceps can facilitate timely delivery. Physicians must be very careful to properly apply forceps. Too much pressure, pulling on the baby’s head, or misplacement of forceps can result in trauma and brain injury. The injuries can be extensive and permanent.

Forceps may be the right tool to speed up delivery when:

  • The mother has a sudden and major bleed (hemorrhage)
  • The mother is exhausted
  • There is a prolonged second stage of labor
  • The mother has a condition, such as heart disease, high blood pressure, or aneurysm, that makes pushing difficult or dangerous.
  • The baby’s heart rate and/or pattern is abnormal. This is a sign that the baby may be in danger and should be delivered quickly.
  • Breech delivery. A breech delivery is when the baby’s buttocks or legs are the first parts of the baby to appear during birth. Forceps may be used to help deliver the head in a breech delivery.

Physicians typically consider using forceps during the second stage of labor (when the mother is pushing and the baby is moving downward). As each contraction occurs, the obstetrician should use forceps to gently guide the baby’s head downward and out of the birth canal. When used according to standards of care, forceps can generally help deliver babies quickly and unharmed. If used improperly, however, damage can be extensive and permanent.

Doctors must follow established standards of care and be properly trained in forceps use before applying them in the delivery room. Mistakes can lead to devastating outcomes, including: 

  • skull fractures
  • intracranial hemorrhages (brain bleeds)
  • other neonatal brain trauma
    • cerebral palsy
    • seizure disorders
    • long-term developmental delays

Under What Circumstances Should Forceps Be Used?

Forceps are only considered safe to use under certain circumstances. The physician must also have experience in forceps delivery, or the risk of complications rises sharply.

Certain conditions must be in place before a physician may use forceps:

  • The baby’s head must be engaged.
  • The cervix is fully dilated.
  • The membranes are ruptured.
  • The fetal presentation, position, lie, and any asynclitism (tilted head) must be known. If not, an ultrasound must verify. 
  • The baby’s size must be appropriate – able to fit for a vaginal delivery (see Cephalopelvic Disproportion (CPD))
  • The mother’s bladder must be empty.
  • The doctor must fully explain the risks of the procedure to the mother.
  • Physicians must be willing to abandon attempts and switch to a C-section. 
  • The physician must have experience and be skilled in forceps use.

These conditions help reduce the likelihood of improper forceps use. If even one of these factors is missing or overlooked, the doctor may be venturing outside the standard of care.

When Forceps Delivery Should Not Be Used

If any of the above prerequisites are not in place, a forceps delivery should not occur. Doctors should not use forceps in the following situations::

  • Preterm babies: The baby is less than 34 weeks gestation. Preterm infants have more fragile skulls and blood vessels, creating a higher risk of fetal intraventricular hemorrhage.
  • Cephalopelvic disproportion (CPD): This means that the baby’s head is too large to pass through the mother’s pelvis. In these cases, forceps can cause dangerous compression or trauma.
  • Fetal Demineralization, Fetal Bleeding Diathesis, or Connective Tissue Disorders: Conditions that weaken the baby’s bones or connective tissues increase the risk of fractures and other injuries.
  • Operator inexperience: If the doctor is not skilled in forceps application, the standard of care requires a more qualified practitioner or an alternative delivery method.

According to the American College of Obstetricians and Gynecologists (ACOG), a physician should not use more than one delivery instrument during a birth. If forceps did not work, applying a vacuum extractor next can be extremely hazardous. Moving on to a C-section is generally the accepted standard in such cases.

Informed Consent

Informed consent is very important during labor and delivery. This means that the physician must explain all procedures utilized during delivery, including the risks and benefits to the baby and alternatives to the various procedures. 

Forceps should only be used by a physician with skill in their use. If a physician has never used forceps or is otherwise unskilled in their use, this should be conveyed to the mother. This information is part of informed consent.

When explaining the risks of forceps delivery, the physician must also discuss the alternatives, one of which is a C-section delivery. 

Potential Birth Injuries Linked to Forceps

When forceps delivery is performed incorrectly or under unsafe conditions, the following injuries can happen:

  • Infant Head Injuries: Bruises, abrasions, or cuts that can lead to infection or pain.
  • Fractures: Excessive pressure can fracture the baby’s skull or other cranial bones.
  • Spinal Cord Damage: In severe cases, improper manipulation might injure the infant’s spinal cord.
  • Nerve Damage: Facial nerve palsy or other forms of nerve impairment can occur from forceps pressure.
  • Bleeding in the Brain (intracranial hemorrhage): Tearing of blood vessels can lead to neonatal brain trauma, which sometimes results in cerebral palsy or permanent developmental disorders.

Among these, brain injury in newborns is one of the most devastating outcomes. It can require lifelong medical care, therapy, and support.

Brain Injury in Newborns: The Tragic Consequence

A newborn’s skull is delicate. The baby’s developing brain is highly susceptible to pressure or trauma. If a physician applies the forceps with uneven force, slips during the application, or uses excessive traction while pulling the baby out, the resulting injuries can include: 

Brain damage may also result in strokes and developmental delays.

Forceps Injuries and Medical Malpractice

It is crucial for a baby to be very closely monitored during labor and delivery. Forceps may only be used when obstetrical indications are present. 

Failure to Adhere to the Standard of Care

In any birth injury case, the key question is whether medical professionals met the standard of care required in that situation. The “standard of care” refers to the level of skill, caution, and treatment that a reasonable medical provider with similar training would have offered in the same circumstances. Failure to follow guidelines and standards of care is negligence. If this negligence leads to injury to the baby, it is medical malpractice. 

Examples of negligence in forceps deliveries include:

  • Using forceps when contraindications or red flags are present.
  • Applying excessive pressure or traction.
  • Misjudging the baby’s position or size.
  • Failing to abandon forceps delivery and switch to a C-section when necessary.
  • Not obtaining informed consent from the mother about the risks of forceps and the availability of safer alternatives. 

When such errors lead to brain damage or other serious injuries, the physician and/or the hospital may be liable for the resulting harm. 

In birth trauma lawsuits, establishing malpractice can be complex. At ABC Law Centers, our team can help. We have a network of expert witnesses. Our in-house nurses will conduct an in-depth review of medical records and assemble a timeline of your baby’s delivery and care. 

For families already grappling with a child’s disability or health challenges, navigating these legal complexities can be daunting. You are not alone. Our staff is here for you during this difficult time to answer your questions and navigate your options.

Case Experience: The Dangers of Prolonged or Improper Forceps Use

Our firm has direct experience handling cases involving forceps misuse. Our attorneys and medical staff are deeply familiar with the standards of care around forceps delivery as well as the complications that can cause lasting harm, including brain damage. We’re here to support families through this complicated and emotionally-draining situation.

In a past case, the first attempt to rotate the baby with forceps was unsuccessful, and the physician temporarily stopped. However, instead of quickly moving on to a C-section delivery, the physician tried to use forceps again. The baby was delivered; at first, the use of forceps appeared to have been successful. 

She was born with a seemingly normal Apgar score, heart rate, and umbilical cord blood gas levels. However, she had a skull fracture, which was revealed through head imaging. The neurologist indicated that it was evidence of excessive force with forceps. 

As a result of this excessive force, the baby not only had a fracture, but also fluid buildup (edema) and brain tissue death (necrosis). The baby began to show signs of brain damage, including seizures. She was diagnosed with permanent cognitive and motor deficits, also called intellectual and developmental disabilities.

Get Legal Help for Forceps Injury

If you believe your child’s injuries were caused by forceps misuse or negligence, you may be entitled to compensation. A birth trauma lawsuit can help your family secure financial resources for:

  • Medical Expenses.
  • 24-Hour Care
  • Rehabilitation Costs
  • Assistive Devices
  • Pain and Suffering
  • Loss of Future Earning Potential

Contact ABC Law Centers: Birth Injury Lawyers

If your child experienced forceps delivery and sustained permanent damage, our award-winning birth injury lawyers can help.

Whether you’re facing mounting medical bills, needing specialized therapy for your child, or simply feeling lost and betrayed by the very professionals who were meant to protect you, you are not alone.

Our firm helps families throughout the country obtain compensation for lifelong treatment, therapy, and a secure future. We give personal attention to each child and family we represent.

At ABC Law Centers: Birth Injury Lawyers, we believe every child deserves the best chance at a full and healthy life, no matter the severity of their injuries. We aim to help you pursue the compensation you need for your child’s ongoing care and well-being.

Your child’s future—and your peace of mind—matter. Reach out today to learn about your legal options. Let us help you get the support and compensation you need to provide the best possible care for your child. Call us at 248-593-5100 or contact us online at any time, from anywhere nationwide.