Share This Article
When labor doesn’t progress as expected or complications arise during delivery, your healthcare provider may recommend an assisted vaginal delivery using forceps or vacuum extraction. While these interventions can be lifesaving for both mother and baby, understanding what they involve can help expectant mothers feel more prepared and informed about their birth experience.
Used When Labor Stalls or Complications Arise
Forceps and vacuum extraction are primarily used for the prolonged second stage of labor, suspicion of fetal compromise, or when there’s a need to shorten the second stage for maternal benefit.
Your doctor will only recommend these interventions when the baby’s head is very low in the birth canal and delivery is imminent. The vacuum device is only safe to use when the baby is very close to being born, and if the head is too high, a cesarean birth will be recommended instead.
Typical scenarios include when you’ve been pushing for an extended period without progress, if your baby shows signs of distress during delivery, or if you have a medical condition that makes prolonged pushing dangerous for your health. The main advantage of trying an operative vaginal delivery is that it could save you from having major surgery that you may not need, as a second-stage C-section is more difficult.
Carry Specific Risks for Mother and Baby
Understanding potential complications helps you make informed decisions about your care. For mothers, both interventions carry increased risks compared to unassisted vaginal delivery. One in four attempted forceps deliveries and one in eight attempted vacuum deliveries result in maternal trauma, most commonly obstetric anal sphincter injury. There’s a higher chance of having a vaginal tear that involves the muscle or wall of the anus or rectum, known as a third- or fourth-degree tear.
Vacuum extraction birth complications can affect your baby differently than forceps-related issues. Using a vacuum can increase the risk of certain complications, such as retinal hemorrhage and cephalhematoma (excess blood between the skull and tissue of the child’s head). The vacuum extractor can cause caput succedaneum, when your baby’s scalp swells into a cone-like shape, though this gets better in a few days, as well as bruising that may lead to jaundice.
Vacuum Extraction Is More Common But Has Higher Failure Rates
Forceps deliveries now make up about only 1.1% of vaginal deliveries, while vacuum extraction is more frequently used compared to forceps delivery because it’s easier to use. However, there’s a necessary trade-off to consider.
While vacuum is the more common option, the failure rate for vacuum deliveries is higher than that of a forceps extraction, and vacuum use is less likely to result in a successful vaginal delivery when compared to the use of forceps.
The choice between forceps and vacuum often depends on your specific situation and doctor’s expertise. If you’re giving birth at less than 36 weeks pregnant, forceps may be recommended over vacuum because they are less likely to damage your baby’s head, which is softer at this point in pregnancy.
Recovery May Take Longer Than Expected
Women who deliver with forceps are at risk for pelvic organ prolapse, extended perineal tears, and vaginal lacerations, which causes the mother to have a longer recovery time than usual, resulting in pain and discomfort.
After an assisted birth, there’s a higher chance of blood clots forming in the veins in your legs or pelvis, which you can help prevent by moving around as soon as your healthcare provider clears you for activity.
The healing process for tears or episiotomies performed during assisted deliveries often requires additional care and attention. You may need stronger pain management, more frequent follow-up appointments, and potentially pelvic floor physical therapy to address any lasting effects from the delivery.
Endnote
While forceps and vacuum deliveries aren’t part of every birth plan, they are valuable tools when complications arise. Being informed about these procedures empowers you to participate actively in decisions about your care and helps you prepare mentally for various birth scenarios. Remember that your healthcare team’s primary goal is ensuring your and your baby’s safety, and these interventions are recommended only when they offer the best chance for a positive outcome.
