Effect non-invasive low forceps delivery on pelvic floor muscle strength and postpartum depression in singleton full-term pregnant women

Abstract

BACKGROUND

Traditional low forceps midwifery requires lateral episiotomy, which affects the delivery experience of the parturient, impairs the recovery of postpartum pelvic floor muscle strength, and is associated with complications such as perineal pain and infection. These factors impose physical and psychological burdens and may increase postpartum depression. Non-invasive low forceps midwifery controls the delivery speed of the fetal head and applies traction during intervals between uterine contraction to assist gradual delivery without lateral episiotomy, thereby facilitating recovery of postpartum pelvic floor muscle strength.

AIM

To investigate the effect of non-invasive low forceps midwifery on postpartum pelvic floor muscle strength and postpartum depression in singleton full-term pregnant women.

METHODS

Clinical data from 70 parturients who underwent forceps-assisted delivery at Suzhou Ninth People’s Hospital (Affiliated with Soochow University) from January 2024 to June 2025 were retrospectively collected. According to the midwifery method, patients were divided into a control group (n = 35; traditional low forceps midwifery with episiotomy) and an observation group (n = 35; non-invasive low forceps midwifery). Baseline data, perioperative indicators, complications, delivery experience [Childbirth Experience Questionnaire (2.0)], pelvic floor muscle strength, and depression scores [Edinburgh Postpartum Depression Scale] were compared between groups.

RESULTS

There were no significant differences in baseline data, number of forceps tractions, or duration of the second stage of labor between groups (P > 0.05). However, the observation group had less intrapartum bleeding and lower bleeding at 24 hours postpartum than the control group (P < 0.05). Postpartum pain intensity was also lower in the observation group, with reduced Visual Analogue Scale scores at 12 hours and 24 hours (P < 0.05). Regarding complications, the severity of perineal tears was greater in the control group (Z = -2.368, P = 0.018) and the incidence of postpartum urinary retention was higher in the control group than in the observation group (χ² = 3.968, P = 0.046). Compared with the control group, the observation group reported better delivery experience scores (P < 0.05). Follow-up at six weeks, three months, and six months postpartum revealed higher pelvic floor muscle strength and lower Edinburgh Postpartum Depression Scale scores in the observation group than in the control group (P < 0.05).

CONCLUSION

Compared with traditional low forceps midwifery with episiotomy, non-invasive low forceps midwifery effectively reduces bleeding, postpartum pain, and complications, improves delivery experience, and promotes recovery of pelvic floor muscle strength while alleviating postpartum depression.

Keywords: Non-invasive forceps midwifery; Natural childbirth; Childbirth experience; Pelvic floor muscle strength; Postpartum depression

Core Tip: Traditional low forceps-assisted delivery requires episiotomy, which may negatively affect childbirth experience and recovery of postpartum pelvic floor muscle strength, potentially contributing to postpartum depressive symptoms. This study highlights that non-invasive low forceps-assisted delivery facilitates the recovery of postpartum pelvic floor muscle strength and helps alleviate postpartum depressive symptoms compared with traditional low forceps-assisted delivery with episiotomy.