About one in eight women has an assisted birth, where forceps or a ventouse suction cup are used to help deliver the baby’s head. This can be because:
- there are concerns about the baby’s heart rate.
- your baby is in an awkward position.
- you’re too exhausted
Both ventouse and forceps are safe, and are only used when necessary for you and your baby. Assisted delivery is less common in women who have had a spontaneous vaginal birth before.
If the baby’s head is in an awkward position, it will need turning to allow the birth. A paediatrician may be present to check your baby’s condition after the birth.
If your obstetrician has any concerns, you may be moved to an operating theatre so a caesarean section can be carried out if needed. Sometimes, as the baby is being born a cut (episiotomy) may be needed to make the vaginal opening bigger. Depending on the circumstances, your baby can be delivered and placed on your tummy, and your birthing partner may still be able to cut the cord if they want to.
A ventouse (vacuum extractor) is an instrument that is attached to the baby’s head by suction. A soft or hard plastic or metal cup is attached by a tube to a suction device. The cup fits firmly on to your baby’s head. During a contraction and with the help of your pushing, the obstetrician or midwife gently pulls to help deliver your baby. The suction cup leaves a small swelling on your baby’s head called a chignon. This disappears quickly. The cup may also leave a bruise on your baby’s head called a cephalhaematoma.
A ventouse is not used if you’re giving birth at less than 34 weeks pregnant because your baby’s head is too soft. It is less likely to cause vaginal tearing than forceps.
Forceps are smooth metal instruments that look like large spoons or tongs. They’re curved to fit around the baby’s head. The forceps are carefully positioned around your baby’s head and joined together at the handles. With a contraction and your pushing, an obstetrician gently pulls to help deliver your baby.
There are many different types of forceps. Some forceps are specifically designed to turn the baby in the right position to be born, such as if your baby is lying face upwards (occipito-posterior position) or to one side (occipito-lateral position).
Forceps are more successful than ventouse in delivering the baby, but a ventouse is less likely to cause vaginal tearing.
Your midwife and doctor may recommend an assisted birth if: Your baby is distressed during the pushing stage of labour.
- You are exhausted and can’t push any more.
- Your baby isn’t making progress through your pelvis as would normally be expected.
- There’s a medical reason why you shouldn’t push for too long, such as if you suffer from heart disease.
- Your baby’s head needs gently turning, so she’s facing the right way to be born
Risks of a ventouse or forceps birth include:
- Vaginal tearing or episiotomy
- Third- or fourth-degree vaginal tear
- Higher risk of blood clots
- Urinary incontinence
- Anal incontinence
Most babies recover from an assisted birth very quickly. Though it may look worryied, any marks, bruises or swellings on your baby’s head are usually temporary, and will clear up on their own, usually within a week. However, a blood blister may take a few weeks to disappear completely. Be reassured that eight out of 10 women who have an assisted birth have a normal birth next time around.