Four views of a Forceps

February 2, 2013


The heartbeat continues to descend, bump, b..bump. There is no sign of the head and immediate delivery. B..bump, b..bump. I reach for the emergency buzzer. I know I need help.  Turning her over onto her left side. I wait. B..bump  B..bump. Then a knock at the door and in she comes. I breathe.  ‘There is a fetal bradicardia. I need the docs’ . She looks around quickly and then leaves.  I hear her ask for the obstetric team to be emergency bleeped. She returns to share the b..bump. with me on either side of the bed.  Still no signs of delivery.

Then the door opens again and in rush the team. An IV is sited in seconds, at the same time the Registrar examines my lady and pronounces her fully and asks for forceps.  We all share the b..bump.b..bump.  The equipment arrives as if by magic and everyone is urging my lady to push.  I feel pushed out,  inadequate, lost.

B…bump.  B…bump.  I watch as the ventouse is attached, but it is difficult and uncomfortable for the mother. It all seems tense and time has slowed. The ventouse abandoned, the forceps applied.  She is encouraged to push with the contraction, coached by my colleague.  The midwife co-ordinator also present, assists the doctor and encourages the woman. They have done this many times before. .


The buzzer sounds and for the umpteenth time that day I knock on the door.  The sound of a decelerating fetal heart is evident. Slow and precise, but slow. The new midwife has wide eyes and alerts me to the problem I have already taken in. I am out of the door quickly and ask for the team to be bleeped. I return to the room as I remember what it was like when I was junior faced with a similar situation. I urge the mother further over on her side.  Within seconds it seems the team have arrived.  The  help the junior doctor site the cannula whilst the mother has an examination by the Registrar. It is all very frightening for the mother. I try and reassure.  She is able to deliver and the ventouse is called for. The equipment arrives quickly but is difficult to apply. I see the sweat on the forehead of the doctor. We share the slow b..bump b..bump sound still eminating from the machine.

The forceps are applied, the woman is frightened and in pain. I hold her hand and encourage the midwife to come closer and encourage her lady to push.  They only met a half an hour ago. This is scary for them both.

The first pull and everyone waits. Little progress was made. The fetal heart recovers and is beginning to sound normal.  The second pull and there is advancement as the mother pushes and the Registrar pulls and cuts the episiotomy. The final pull and the head is born, bloody but out.


I am running from the clinic to labour ward. There is an emergency and I feel my heart racing. I enter the room with my junior colleague and we all hear the noise. B..bump  b..bump slow but regular. I examine the woman quickly introducing myself as i put on gloves. I am breathless and know my voice might be louder than usual as I explain what needs to be done. The examination is clear, she is fully dilated but I cant wait for her to push herself.  I ask for the ventouse and the trolley arrives. My colleague has sited an IV, we may need to go to theatre. My heart rate is far higher than the baby’s.

I try to insert the ventouse, but the woman has had no pain relief, so it is difficult and uncomfortable. She complies as I try again.  I abandon the ventouse as the babies heart rate is still low. I insert the forceps carefully but quickly. I need this baby out. I look at the midwife holding the woman;s hand – she nods. I pull.  Damn. No progress. Maybe we should be doing this in theatre. I wait for a contraction and down I pull. It’s coming. Another push and I pull and the baby’s head is born. I release it from the metal and pull the baby into the world. He cries. I want to cry.  The senior midwife pats my shoulder.


I have seen this before,  women push and babies are born. But I can hear a slow heart beat from the machine. The midwife seems concerned she asks Lily to turn over onto her side. I sit and watch and listen. The midwife presses a button and a loud insistent call fills the room. Another midwife comes in and then out again in seconds. I don’t know what is happening but Lily is crying and in pain. Then the room is filled with lots of people. One has her hand quickly inside Lily and proclaims her fully dilated. A box arrives and Lily is encouraged to push. I urge her to push from where I am at the back of the room. I dont’ know what to do. My hands cling to the chair.

They pull at my baby but it does not come. The b..bump b..bump of the heartbeat from the machine is deafening. Then I hear metal,  it is inserted inside Lily, she screams. I say nothing.  They pull again as Lily pushes, the doctors shoulders slump. Then again and there is movement, again and a bloody head is born. The metal is gone and the doctor pulls again bringing my child into the world. He cries loudly as if suddenly disturbed from sleep. I finally breathe and move forward to be with my family. I clutch Lily’s hand and gently touch my child’s face.


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