Assisted delivery
About one in eight women has an assisted birth, where forceps or a ventouse suction cup (ventouse) 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 only used when necessary for you and your baby.
If the baby's head is in an awkward position, it will need turning (rotating) to allow the birth. A paediatrician may be present to check your baby's condition after the birth. A local anaesthetic is usually given to numb the vagina and perineum (the skin between the vagina and anus) if you haven't already had an epidural.
If your obstetrician has any concerns, you may be moved to an operating theatre so that a caesarean section can be carried out if needed, for example if the baby can't be easily delivered by forceps or ventouse. This is more likely if your baby's head needs turning.
Sometimes, as the baby is being born, a cut (episiotomy) may be needed to make the vaginal opening bigger. Any tear or cut will be repaired with stitches. Depending on the circumstances, your baby can be delivered and placed onto your tummy, and your birthing partner may still be able to cut the cord if they want to.
Ventouse
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 onto 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.
A ventouse is less likely to cause vaginal tearing than forceps.
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 to the right position to be born, for example, if your baby is lying facing upwards (occipito-posterior position) or to one side (occipito-lateral position).
Forceps can leave small marks on your baby's face but these will disappear quite quickly.
Afterwards
You will sometimes need a catheter (a small tube that drains your bladder) for up to 24 hours. You're more likely to need this if you have had an epidural because you may not have fully regained sensation in your bladder (and therefore don't know when it's full).
The Royal College of Obstretricians and Gynaecologists (RCOG) has further information on assisted delivery.
