Assisted Delivery

Near the end of delivery, it may be apparent that mother and baby need a little extra help for a successful delivery. After ensuring anesthesia is working, an obstetrician would gently apply forceps or minimal suction to the baby's head. As you push through the next contractions, your doctor would gently bring the baby's head through the birth canal. It is only in extremely rare circumstances that an obstetrician would recommend an assisted delivery that was not needed.

What are the instruments used in an assisted delivery?

An obstetrician will use forceps or a vacuum extractor to help deliver the baby.

Forceps are similar to tongs, with loops on either side, that are used to gently turn the baby's head or gently pull to assist the baby through the birth canal.

A Vacuum Extractor utilizes suction to turn the baby's head or pull the baby through the birth canal. Usually the suction cup has a controlled amount of suction, so just enough is used to help deliver the baby.

Why would an assisted delivery be necessary? The following are common reasons your caregiver may suggest suction, or what is also called ventouse:

• If you have had an epidural, the pelvic muscles which usually help turn the baby's head and shoulders into the best position for birth, may not be as able to help. It may also be difficult to feel your contractions, so pushing is less effective.
• If your baby isn't in the best position for an easy delivery.
• If your baby is not receiving enough oxygen, which could result in permanent brain damage.
• If you are too tired.
• Your caregivers may suggest forceps if your baby is coming feet first or in a breech position

If I am trying to have a natural birth, is anesthesia necessary during an assisted delivery? If so, what types are recommended?

Usually when assistance is necessary for delivery, some form of anesthesia is suggested.

You will want to discuss Pudendal with your caregiver, as it is a local anesthetic injected directly into the nerves just inside the vagina. Pudendal is most commonly used for women who have made it to 10 centimeters and were hoping for a completely natural delivery, but need a little assistance at the end. However, Pudendal is effective 80% of the time and its effects do not last long.

What should I watch for in my baby if the delivery is assisted?

The following are effects that may occur if your baby's delivery is assisted with forceps:

• There may be a reddened area on the face, which fades within a few days.
• There may be small bruises, which should also fade quickly.
• Though rare, there may be temporary damage to the baby's facial nerves. This is rarely permanent and is gone in a few days.
• Your baby may have a somewhat cone-shaped head, which is normal in any vaginal delivery.

The following are effects that may occur if your baby is assisted with suction:

• There may be a blood blister on the scalp, or cephalheamatoma. This may take 6-8 weeks to completely heal. This does not impact the brain.
• There may be slight bruising on the scalp, which fades within a few days.

Reprinted with permission from American Pregnancy Association