We’ve discussed one form of assisted childbirth in this blog — forceps delivery. Now, it is time to tell you a bit about vacuum-assisted delivery, sometimes called vacuum extraction or ventouse.
Why Is Assistance Needed?
An assisted delivery means that your doctor of midwife needs to use an instrument of some kind to help deliver your baby through the birth canal. This type of delivery may be needed if the second stage of your labor is not progressing. You are having contractions and pushing, your cervix is dilated and the baby’s head has descended, but you and your baby are just not getting anywhere. Vacuum extraction may also be needed if your baby’s heartbeat indicates that is or she is having a problem and the delivery needs to happen right away.
Your doctor or midwife may choose to use a vacuum device rather than forceps because of personal preference, but neither type is widely used in childbirth in the United Sates today. Vacuum extraction is used in under 3% of births in the United States, according to the National Center for Health Statistics, while forceps are used in less than 1% of births. The use of either method has been dropping. In 1990, more than 5% of births in the United States involved the use of forceps and under 4% involved vacuum extraction.
The use of either method in childbirth has been greatly reduced because cesarean sections have become far more common. At one time, using forceps was the only choice for delivering a baby when labor had stalled. Until the introduction of anesthesia, sterile surgical technique, and later, blood transfusions, a cesarean was almost always deadly to the mother and was usually tried only after she had died during the childbirth; the surgery was the only hope of delivering a living infant. Vacuum extraction is much newer than using forceps and its use for stalled labor became widespread in the 1950s.
How Is Vacuum Extraction Done?
If an assisted birth is needed, your doctor or midwife will discuss the situation with you. If you have not already had an epidural, you may need to be given some anesthesia. You may also need to have an episiotomy done.
In a vacuum extraction, your health provider will reach into the birth canal and place a small plastic suction-cup device on the top of your baby’s head. This device is linked to a small hand pump that produces a vacuum in the cup, attaching it to the scalp. This allows your health provider to put some traction on your baby while you push. After your baby’s head appears, the suction is released and the cup removed.
You can see a video of what happens on a mannequin here.
If vacuum extraction does not work, you will probably be prepped for a cesarean section.
Possible risks to your baby include a wound to the scalp or the formation of a temporary swelling where the suction cup was attached. This swelling goes down within a day or so. Serious injury to the baby from a vacuum extraction is very rare.
The risks to you include the possible need for an episiotomy or of a tear to your vagina occurring. After the delivery, you may have some pain or short-term difficulty with urinating or emptying your bladder. These are complications that may occur with any vaginal birth, but the risk is slightly increased with a vacuum extraction. If you suffer a tear or have an episiotomy, there is the chance of excess bleeding or infection.
Discuss any possible need for an assisted birth in advance with your obstetrician or midwife. Ask how often they use forceps or vacuum and whether they prefer one method over the other.