Assisted Vaginal Birth
Most of our clients have an end goal of an uncomplicated vaginal birth. This is exactly what happens most of the time but there are some situations where a provider might want to use use forceps or a vacuum extraction to help facilitate a vaginal birth. The use of these tools during the end of the second stage of labor is called an assisted vaginal birth, or, assisted vaginal delivery.
A provider may decide to use a vacuum or forceps for a few reasons. The majority of the time we see providers offer an asisted birth if the birthing person has been pushing for several hours and seems to be running out of steam or the baby hasn’t made much movement in the birth canal. Other reasons a care provider might suggest an assisted vaginal birth is if the baby is showing signs of distress but is low enough in the birth canal to still proceed with a vaginal birth. Assisted vaginal birth is typically offered as an alternative to a Cesarean section.
Most providers in our area seem to prefer vacuum extraction, also known as VE or ventouse. Here’s what this might look like. After discussing the option with the birthing person and then getting their consent for the procedure, an OB will do a quick cervical exam to assess the position of baby’s head. After that the OB will place the cap of the vacuum on baby’s head. When you are having a contraction the OB will pump the vacuum cap to create suction. They will then pull on the cap while you push. They may be able to do this for a few pushes but once your baby’s head is delivered they will take the cup off and continue with a normal delivery. If the cap pops off 3 times before baby is born., a provider will generally recommend a Cesarean. More common risks of a vacuum extraction include swelling or bruising to the baby’s head or potentially more tearing to the birthing person’s perineum. In some cases the OB may need to do an episiotomy but we have only seen this done in once case.
Forceps can also be used in an assisted vaginal birth. Forceps are long metal tongs with large spoons on the end that are inserted into the vagina and the ends of the forceps are placed on each side of the baby’s head. After the forceps are placed the OB will then lock the forceps into place. Your provider may then try to turn baby’s head between contractions. While you are pushing, the OB will pull on the forceps to help guide baby’s head and gently bring baby through the rest of the birth canal . Once the baby’s head is delivered then the forceps will be set aside and the delivery will continue as normal. If the use of forceps doesn’t work then your OB may recommend a vaccum extraction or a C-section. The most common side effects of forcep use include bruising and swelling on the baby’s head, tearing to the mother’s perineum, and some providers may perform an episiotomy. Some providers prefer to use forceps in an assisted vaginal birth, however, the use of forceps is evident in currently less than 1% of births.