Why This Matters to You
Many women worry about needing assistance during delivery, particularly about forceps and the possibility of tearing. These concerns are completely understandable. Traditional forceps delivery has carried a higher risk of severe perineal tears (up to 14% in some studies).
That is why Mr Myriknas dedicated years to refining a gentler, safer approach. The result? A technique that reduces the risk of severe tearing to just 1.9% - less than what you would expect from a completely natural delivery (2-5%). This is not just theory, it has been proven through careful research published in a leading medical journal.
"I was so worried about tearing, especially after hearing stories from friends. Mr Myriknas explained his approach and I felt so much more confident. The delivery went smoothly and my recovery was much easier than I'd feared."
— Patient testimonialWhat Makes This Approach Different?
The technique is built on three simple but crucial principles that work together to protect you:
Gentle, Controlled Delivery
Rather than rushing, Mr Myriknas takes time to allow your perineum to stretch naturally and gradually. This approach makes an enormous difference in preventing tears, additionally minimising the need for episiotomy. You will be guided to breathe gently rather than push forcefully at key moments, giving your tissues time to accommodate.
Following Your Body's Natural Path
The forceps are moved in a smooth, curved motion that follows the natural shape of the birth canal, rather than pulling straight. This distributes pressure more evenly and reduces strain on any single area.
Precise Timing and Support
At the exact right moment, when your baby's head begins to crown, the forceps are elevated in a way that takes pressure away from the most delicate tissues. Throughout delivery, careful hand support protects the perineum.
See How It Works
This educational video demonstrates the technique (shown with medical training models). While it is designed for medical professionals, you can see the gentle, controlled movements that make this approach so effective:
Would you like to discuss how this approach could benefit your delivery? Book a complimentary consultation to learn more about personalised care throughout your pregnancy. Schedule your free consultation
The Results Speak for Themselves
Over more than six years, Mr Myriknas and colleagues carefully documented outcomes from over 500 first-time mothers who needed forceps assistance:
- Just 1.9% experienced severe tears - compared to the typical 14% with conventional approaches
- No routine episiotomies were needed in the research study
- Mothers reported feeling more involved and informed throughout the process
- Babies arrived safely with the same excellent outcomes
It Is Not Just About Technique
The physical skill is only part of the story. What truly makes a difference is the complete approach to your care:
You Stay in Control
You are not a passive participant - you are actively working together with Mr Myriknas. He will talk you through every step, giving clear guidance about when to push and when to breathe. Many women find this involvement empowering rather than frightening. If you have a birth partner, they play an important role too - learn how they can best support you during delivery.
Clear Communication Throughout
Mr Myriknas will explain exactly what is happening and why assistance is needed. You will know what to expect at each stage, and there is always time for your questions. Throughout your labour, careful fetal monitoring ensures your baby's wellbeing is closely tracked, helping to time your delivery perfectly.
Individualised Decision-Making
Every delivery is different. Rather than following rigid protocols, decisions about episiotomy and other interventions are made based on your specific situation, always prioritising your and your baby's wellbeing.
Support Before, During and After
The care does not end when your baby arrives. Before you leave hospital, you will have time to discuss what happened, understand your recovery, and ask any questions about future pregnancies.
What If I Need Forceps Delivery?
Remember that forceps assistance is very common, especially for first babies, about one in eight births in England involves instrumental delivery (forceps or suction cup). There are many reasons why assistance might be needed, most of them completely routine. Preparing for all possible birth scenarios during pregnancy can help you feel more confident and informed.
If forceps delivery is recommended during your labour, you can feel confident that you are receiving a technique that has been carefully developed, rigorously tested, and proven to keep you safer. Understanding your pain management options beforehand can also help you feel more comfortable and in control. Mr Myriknas will ensure you understand why it is needed and what will happen, so you can work together to welcome your baby safely.
Published Research You Can Trust
Mr Myriknas's work on this technique has been peer-reviewed and published in The Obstetrician & Gynaecologist, the official journal of the Royal College of Obstetricians and Gynaecologists. This means other experts in the field have examined and validated the approach.
The technique is now being taught to other obstetricians, helping to improve care for women everywhere. When research leads to real-world improvements in safety and experience, that is something worth celebrating.
Women with high-risk pregnancies, those who undergo induction, or have an epidural, may have a greater likelihood of needing instrumental delivery, making this safer approach particularly valuable.
For Medical Professionals
The Anterior Ninety-Degree Elevation Forceps (ANEF) technique is detailed in our peer-reviewed publication: Myriknas SE, Papadakis K, Hinshaw K. Optimising non-rotational forceps: the anterior ninety-degree elevation forceps (ANEF) approach. The Obstetrician & Gynaecologist 2020;22:155–60.
The technique emphasises timely elevation of forceps handles at crowning (minimum 90° arc), continuous upward traction along the pelvic axis, slow controlled delivery with MPS, and judicious episiotomy use. In our cohort of 516 nulliparous forceps deliveries over 6.5 years, OASI rates were 1.9% with zero episiotomies performed - comparable to spontaneous vaginal delivery in multiparous women.
For training inquiries or further discussion of the technique, please contact the practice directly.