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Assisted Birth: What You Need To Know About Forceps And Ventouse

Have you heard the term ‘assisted birth’ but are not really sure what it’s all about or when it might happen? We’ve got you covered. Scroll on down so you’re fully clued up (and remember to ask your midwife about it too)…

What is an assisted birth?

There are two main types of assisted birth: forceps birth and ventouse birth (also known as vacuum extraction or vacuum cup). A forceps birth involves the use of forceps to help guide the baby out of the vagina. A ventouse birth  involves using a soft or rigid cup-like device attached to a vacuum pump to create suction on the baby’s head.

The use of either forceps or ventouse may be recommended in situations where there is prolonged labour, baby is in distress, mother is exhausted, or certain medical complications that warrant the need for assisted delivery. In the UK, approximately 1 in 8 women have an assisted vaginal birth and this is more likely for women having their first baby.

What is a forceps birth?

Forceps are specialised medical instruments that look similar to a pair of tongs or large spoons. They are typically made of stainless steel and are designed to be smooth and rounded to minimise the risk of injury to the baby’s head.

During a forceps birth, the midwife or obstetrician carefully positions the forceps around the baby’s head. They then gently guide and rotate the baby’s head to help them navigate through the birth canal. A forceps birth is only performed after you’ve given consent and only after careful consideration of the potential risks and benefits.

What is a ventouse birth?

Ventouse birth involves the use of a vacuum cup. This is a soft or rigid cup-like device attached to a vacuum pump to apply gentle suction to the baby’s head. The suction helps the midwife or obstetrician guide and assist the baby’s descent.

During a ventouse birth, the cup is carefully positioned on the baby’s head. When a contraction occurs, gentle traction is applied to guide the baby’s head through the birth canal. The cup remains attached to the baby’s head until the head is delivered, and then it is carefully removed.

Why might I need an assisted birth?

Assisted births are considered when there are certain complications or difficulties during labour. The use of instruments is only used when considered necessary to speed up the delivery for the well-being of the baby or the mother. Some of the situations where assisted birth may be needed to speed things up include:

  • Prolonged labour: If labour is prolonged, you’re experiencing exhaustion or the baby shows signs of distress.
  • Baby in distress: If there are indications that the baby is experiencing distress during labour, such as abnormal heart rate patterns.
  • Difficulty with pushing: If you’re having difficulty with pushing the baby through the birth canal or you or the baby are becoming tired.
  • Baby in awkward position: if baby is not in the right position to come through the birth canal.

What are the risks of an assisted birth?

As with any medical procedure, there are risks associated with assisted delivery. Some of the risks include minor bruising or swelling on the baby’s head, and the possibility of tears to your perineum. An assisted birth usually does mean a greater chance of requiring an episiotomy or having a vaginal tear. A third or fourth degree tear (a tear which involves the muscle and/or the wall of the anus or rectum) affects 3% of women who have an assisted vaginal birth.

If you experience an episiotomy or vaginal tear during birth, dissolvable stitches will be given soon after birth to repair the wound. The repair will be done in a theatre setting (by a surgeon) if you experience a third or fourth degree tear. If an assisted birth isn’t possible, an unplanned C-Section might be necessary to help deliver baby safely.

What is the recovery like after an assisted birth?

Recovery after an assisted birth can vary from woman to woman and depends on various factors, including the specific circumstances of the delivery and the overall health of the mother. Generally, the recovery process is similar to that after a vaginal delivery without forceps or ventouse, however you are likely to have to stay in hospital for longer whilst you recover. Here are some aspects of recovery to consider:

  • Vaginal discomfort: It is common to experience significant soreness and discomfort in the vaginal area after an assisted birth. If the instruments resulted in any tears or episiotomy (a surgical cut to widen the vaginal opening), proper perineal care is essential. You may find it challenging to move around initially due to soreness and the aftereffects of labour. Postpartum check-ups with healthcare providers are essential to monitor the healing process and address any concerns or complications.
  • Pain management: Pain management may be necessary in the immediate postpartum period. Over-the-counter pain relievers or prescribed medications can help manage any pain or discomfort experienced during recovery.
  • Infection risk: Studies have shown that the risk of infection after an assisted birth are higher and so it’s important to take all medication as advised by your medical team, especially any prescribed antibiotics.
  • Postpartum bleeding: Like any vaginal delivery, there will be postpartum bleeding (lochia) after an instrumental delivery. This bleeding may be heavier initially and gradually decrease over a few weeks.
  • Pelvic floor exercises: Pelvic floor exercises, commonly known as Kegel exercises, are often recommended to aid in recovery and strengthen the pelvic floor muscles.
  • Emotional recovery: The emotional aspect of recovery is also crucial. Some women may have mixed feelings about the delivery experience, especially if the use of forceps or ventouse was unexpected. It’s essential to talk to your midwife or support networks if needed.
  • Breastfeeding: If breastfeeding, the recovery from an instrumental delivery may impact positioning and comfort. Lactation consultants can provide guidance and support in such cases.

Each woman’s recovery experience will be unique, and it’s essential to follow the specific advice and instructions provided by your medical team. As with any birth, it’s essential to be aware of warning signs of potential complications, such as excessive bleeding, severe pain, or signs of infection. If any concerning symptoms arise, seeking medical help promptly is important for a smooth recovery. With proper care and support, most women recover well after an assisted birth and are able to care for their newborns with time and rest.

Can the baby be hurt by an assisted birth?

If an assisted birth is considered necessary, whether it be forceps or ventouse, there is a small risk that the baby could experience an injury to their head or face. These injuries are usually minor and temporary, but in rare cases, they can lead to more serious complications.

How can I avoid an assisted birth?

While it’s not always possible to predict or prevent the need for an assisted birth, there are certain things that could potentially reduce the likelihood of requiring any interventions. Here are some tips to try:

  • Perineal massage: Prepare the perineum in advance by doing perineal massage. You can do this yourself or with the help of your partner. Read more about how to do perineal massage here.
  • Prenatal care: Attend all recommended prenatal check-ups to monitor the health of both the mother and baby. Regular prenatal care allows healthcare providers to identify and address any potential complications or risk factors early on.
  • Stay healthy during pregnancy: Maintain a healthy lifestyle during pregnancy, including a balanced diet, regular exercise, and avoiding harmful substances like smoking and excessive alcohol consumption.
  • Create a birth plan: Discuss your preferences and expectations for labour and delivery with your midwife and create a birth plan. While birth plans may need to be flexible, expressing your desires can help ensure those caring for you are aware of your wishes.
  • Labour support: Consider having a support person, such as a partner, family member, or doula, to provide emotional and physical support during labour. Continuous labour support has been associated with improved birth outcomes.
  • Labour at home (if appropriate): If your healthcare provider approves, consider labouring at home during the early stages of labour. Being in a comfortable and familiar environment can help reduce stress and promote progress in labour.
  • Opt for natural pain management techniques: Use natural pain management techniques, such as breathing exercises, relaxation techniques, walking, changing positions, and hydrotherapy (showering or using a birthing pool), to help cope with labour pain.
  • Stay mobile during labour: Move and change positions regularly during labour. Staying active can help encourage optimal positioning of the baby and facilitate progress in labour.
  • Educate yourself on medical interventions: Understand the indications and potential risks and benefits of medical interventions, such as induction of labour. Discuss these options thoroughly with your midwife to make informed decisions.

It’s important to remember that each labour and birth is unique, and sometimes unexpected situations arise. Trusting and communicating with your midwife and being flexible with your birth plan can help navigate any challenges that may arise during childbirth. The ultimate goal is a safe delivery for both the mother and the baby.

Sources

https://www.rcog.org.uk/media/kpkjwd5h/gtg_45.pdf

https://www.nice.org.uk/guidance/ng121/evidence/s-previous-caesarean-section-pdf-241806242808

Birthbabe does not provide medical advice, diagnosis, or treatment. The resources on our website are provided for informational purposes only. You should always consult with a healthcare professional regarding any medical diagnoses or treatment options.

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