Forceps - Their Role in Childbirth History

Obstetrical forceps is an instrument that looks like a pair of giant tongs. It's meant to assist with the delivery of a baby by pressing the tongs around the infant's head and using the forceps to grab and maneuver the child.

It's important not to confuse obstetrical forceps with other types of forceps. Kelly forceps, for example, are not used in childbirth but are meant to grasp something too small to be picked up with fingers. Outside of medicine these types of forceps are called tweezers, clamps, pliers, tongs or clips. Piercing forceps also have nothing to do with obstetrics and are meant to help hold skin during various body piercing techniques. A hemostat is a surgical forceps-looking tool meant to control bleeding and isn't used in the actual delivery of a child unless surgery is required.

How They're Made

Forceps used to assist in the delivery of a baby have two branches that are meant to be positioned around the unborn baby's head. These branches typically cross at midpoint. This midpoint position is called the articulation and the branches are defined as right or left depending on the side of the mother's pelvis they're applied.

At the articulation is usually a locking mechanism. Some forceps for delivery have a sliding mechanism that allows the two branches to slide against each other. When the unborn child's head is in line with the mother's pelvis a locking forceps is used. Ones with a sliding mechanism are used for any deliveries where more rotation is required to correctly position the baby's head.

Each forceps blade is designed with a special curved portion that's meant to surround the baby's head firmly, but not tightly. The curves are called the pelvic curves and the cephalic curves. The pelvic curve is meant to conform to the birth canal and provide traction. The cephalic curve of the blade is meant to conform to the shape of the unborn child's head so it can be rounded or elongated. Forceps with a sliding mechanism do not have a significant pelvic curve.

The shank is the piece of metal that connects the handles to the blade. Shank length can vary depending on the purpose of the forceps and when they're used in the pregnancy labor time line.

Types of Forceps

There are four main types of obstetrical forceps although they may all be used in every country. Long forceps, for example, are no longer used in most places in the USA because they're meant to reach fetal head in the middle or upper part of the maternal pelvis which many doctors don't consider safe or necessary.

Simpson Forceps: Created in 1858 and used when the fetal head is stuck in the birth canal and becomes substantially elongated.

Elliot Forceps: Created in 1860 and can be used with a rounder fetal head which is common in women how have had previous vaginal deliveries. This forceps has a screw and pin at the end of the handles that allow them to be drawn out and positioned.

Kielland forceps: Created in 1915 and most often used for rotation.

Wrigley's forceps: Created with a safety feature that doesn't allow them to each high in the pelvis.

The History

The first obstetrical forceps were used by Dr. Pierre Chamberlen in the 1500s as a tool to use in difficult deliveries to deliver a living child. Up until then, other tools would be used like hooks, in a difficult labor and these tools often ending up maiming or killing the baby. The forceps were originally used in secrecy once everyone was out of the room and the mother blindfolded. They were carried into the birthing room is a lined box.

Forceps were the Chamberlen family's secret for about 150 years. In 1723 Jean Palfyn presented obstetric forceps to the Paris Academy of Sciences. By the 1740s they were used more frequently with limited sanitary precautions. By the Victorian Age forceps and chloroform became common tools of labor and delivery.

This instrument is still used today, but its use is limited since more c-sections are performed instead if it's estimated the baby won't fit down the birth canal.