_Description of the straight and curved forceps.--Mode of action.--
Indications.--Rules for applying the forceps.--History of the
forceps._
Before describing the various species of dystocia, or faulty labour, it
will be necessary to consider the different means with which the
increasing experience of years has furnished us, of giving artificial
assistance in such cases. These may be brought under two heads, first,
where delivery can be effected with safety to the mother and her child;
secondly, where this can only be effected at the expense of the infant's
life. Under the first head come the forceps, turning, the Cæsarean
operation, and artificial premature labour; under the second are
craniotomy or perforation, and embryotomy.
Of these the forceps is by far the simplest and safest means of artificial
delivery, and is therefore an operation which should always be had
recourse to in preference to any of the others wherever it is possible.
The forceps is the simplest imitation of nature, for in fact it is nothing
more than a pair of artificial hands introduced one on each side the head.
It is impossible to define any precise limits of pelvic contraction,
within which the forceps can, or beyond which it cannot, be safely
applied, for the difference in the size and hardness of the child's head,
and in the condition of the soft parts, will greatly modify the degree of
resistance to the progress of the labour: hence the attempt to fix the
exact degree of contraction beyond which the forceps becomes inapplicable
is quite impracticable, as in some cases we might be led to make a trial
of it where it would be quite improper, and in others have recourse to the
perforator where a cautious application of the forceps would have been
attended with success. For the farther consideration of this subject we
must refer to the chapter on DYSTOCIA PELVICA.
The forceps consists of three parts--the blades, the lock, and the
handles.
The blades of the present forceps are not solid, but are merely elongated
bows of polished metal, by which they are not only rendered much lighter,
but allow the most prominent parts of the head to project between them,
and thereby take up no additional room when introduced into the pelvis. In
the simplest form, viz. the straight forceps, the blades have only one
curvature for adapting them to the convexity of the head. The degree of
curve varies a good deal in different instruments: the greater the curve
the more firmly will the blades hold, because they act more or less as
blunt hooks, and do not require much pressure upon the head for the
purpose, but on the other hand, they are more difficult to introduce;
whereas, blades which are slightly curved can be applied with greater
ease, but require much more pressure upon the head in order to hold fast.
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