Forceps may leave temporary marks, bruising, swelling, or cuts on a baby’s head or face. Many superficial injuries heal without lasting effects, although deeper cuts may need treatment.
Understanding Forceps-Related Birth Injuries
A forceps-assisted delivery uses a curved instrument to help guide a baby’s head through the birth canal when additional assistance is needed. If your baby was injured during this type of delivery, understanding the injury and how the delivery was managed can help you make informed decisions about care and your legal options.
What is a forceps-related birth injury?
Forceps are curved medical instruments placed around a baby’s head during an assisted vaginal delivery. They may be considered when the second stage of labor is prolonged, the mother is unable to continue pushing, pushing poses a medical risk, or the baby needs to be delivered more quickly.
Before forceps are used, the care team should confirm that the baby is far enough down the birth canal and that the position of the baby’s head and face is understood. Most forceps-assisted births are completed safely, but pressure or traction from the instrument can sometimes injure the baby’s face, nerves, eyes, skull, or tissues in and around the brain.
Signs and symptoms
The signs of a forceps-related injury depend on the part of the body affected and the severity of the injury. Some are visible immediately, while others may be identified through a newborn examination or diagnostic imaging.
- Marks, bruising, or swelling on the head or face
- Cuts or bleeding where the forceps contacted the skin
- Facial weakness, drooping, or asymmetry, especially while the baby is crying
- Redness, swelling, or another sign of injury around an eye
- Unusual swelling or a noticeable depression in the skull
- Seizures, pauses in breathing, unusual sleepiness, or other neurological changes that require prompt medical evaluation
What causes forceps-related birth injuries?
A forceps-related injury can occur even when the instrument is used appropriately. The delivery circumstances, the baby’s position, and the amount and direction of pressure placed on the baby may all affect the risk of injury. Possible contributing factors include:
- Pressure from the forceps blades on the baby’s head or face
- A difficult or prolonged second stage of labor
- The baby’s position or station making assisted delivery more complex
- Incorrect placement of the forceps
- More traction or rotation than is appropriate for the circumstances
- Continuing an unsuccessful forceps attempt instead of changing the delivery plan
When a forceps-related injury may be medical malpractice
Not every injury associated with forceps is the result of medical malpractice. Some injuries can occur despite appropriate care, and determining whether the medical team acted reasonably requires a detailed review of the labor and delivery records.
The following circumstances may point to negligence:
- Using forceps before confirming the baby’s head position and station
- Choosing forceps when the clinical circumstances called for a different delivery plan, such as a cesarean delivery
- Placing the forceps incorrectly or applying excessive pressure, traction, or rotation
- Continuing forceps attempts when the baby is not advancing or the procedure is no longer safe
- Failing to respond appropriately when the forceps attempt is unsuccessful
- Failing to recognize, evaluate, or treat signs of an injury after delivery
Wais, Vogelstein, Forman, Koch & Norman, LLC works with medical experts to review the records, the delivery circumstances, and the relationship between the care provided and the child’s injury.
Treatment and long-term outlook
Treatment depends on the type and severity of the injury. A newborn with signs of a forceps-related injury may need a physical and neurological examination, continued observation, or imaging to look for a skull fracture or bleeding.
Minor marks and bruising often improve within days or weeks. Many peripheral facial nerve injuries also improve as the nerve heals, often within the first few months of life. More serious injuries involving the eye, skull, or brain may require care from specialists, supportive treatment, or surgery.
A child’s long-term outlook depends on the location and severity of the injury and how quickly it is recognized and treated. Ongoing pediatric and developmental follow-up can help families identify any concerns and connect their child with appropriate services.
Injury Types: Forceps Injuries
Recognizing the forms of forceps-related injury.
Forceps-related injuries can affect different parts of a newborn’s head and face. Understanding these categories can help families make sense of a diagnosis and the follow-up care their baby may need.
Facial and scalp injuries
Eye injury
Forceps can sometimes cause a corneal abrasion or another injury around the eye. Prompt evaluation can determine whether the baby needs observation, medication, or specialist care.
Facial nerve injury
Pressure on the facial nerve can cause weakness or asymmetry, especially when the baby cries. Many peripheral facial nerve injuries improve as the nerve heals, but medical follow-up is important.
Skull and intracranial injury
More serious forceps-related trauma may include a skull fracture or bleeding in or around the brain. These injuries require immediate evaluation, and treatment depends on the location and severity.
Frequently Asked Questions
Common questions about forceps injuries.
It is understandable to have questions after an assisted delivery, and clear information can help you decide what steps to take next.
Can forceps injuries cause facial nerve palsy?
Pressure from forceps can injure a newborn’s facial nerve, which may cause weakness, drooping, or asymmetry when the baby cries. Many peripheral facial nerve injuries improve as the nerve heals, but the baby should be evaluated and monitored by a medical professional.
Is a forceps injury always caused by medical malpractice?
No. Some forceps-related injuries occur even when the instrument is used appropriately. Medical malpractice may be involved when forceps were not suitable for the circumstances, were positioned or used improperly, or the care team failed to change course or respond to signs of injury.
How are forceps injuries treated?
Treatment is based on the injury. Minor marks or bruises may only need observation, while suspected nerve, eye, skull, or brain injuries may require imaging, specialist evaluation, supportive care, therapy, or surgery.
How long do families have to file a forceps injury claim?
The deadline, or the statute of limitations, depends on the state where the care occurred and may be affected by rules for medical malpractice claims, minors, and when the injury was discovered. Because these deadlines can be complex, families should speak with an attorney promptly to understand the time limits that may apply.
