When labor doesn't progress smoothly,
some assistance becomes necessary.
Popular procedures involve the use
of instruments such as forceps or
a vacuum extractor. Common reasons
for assisted delivery are -
• Fetal distress - heart beat
slows down in response to contractions
• Maternal distress - the mother
is too tired to push; has heart, muscular
or respiratory complications
• Prolonged labor or prolonged
second-stage labor
• Baby's head is facing the
wrong direction or if baby's head
is too large for the pelvis
Prerequisites
before the Procedures
• Cervix needs to be fully
dilated and effaced and the membranes
ruptured; the fetal head has to
be engaged
• Prep time takes about 30-45
minutes; the birth is over within
2-3 contractions
• An experienced physician
should handle the procedure. Choice
of instrument used will depend after
a vaginal examination to determine
which is more appropriate
• An epidural or a local anesthetic
will be given to numb the perineal
area
• A thin catheter will be
inserted in the bladder to empty
it
• An episiotomy may be performed
to enlarge the vaginal opening
• All necessary preps for
a C-section should be made in case
instrumental delivery fails
Forceps-assisted
Birth
• The instrument is shaped
like a pair of scissors which when
hooked together look like salad
tongs. It may look scary but it
is preferred if your doctor deems
it necessary or to avoid a C-section.
• Forceps are used to help
turn the baby's head if he is facing
the wrong way
• One spoon goes in one at
a time into the vagina to cradle
around the temples of the baby's
head. With the uterine contractions
and the mother pushing, your doctor
gently pulls on the forceps to help
the baby through the canal.
• Forceps delivery will only
be used if the baby's head is properly
engaged in the mother's pelvis.
A cesarean will be performed otherwise.
• Episiotomy may always be
necessary but it is performed in
most instances to help with the
delivery
Vacuum-assisted
Birth
• Also known as venthouse
birth, it is an alternative to forceps.
A venthouse or vacuum extractor
uses suction to guide the baby out.
• A rubber or plastic cup
is pressed against the baby's head;
the cup gets its suction through
a tube from a vacuum bottle attached
to a small pump.
• With each push the obstetrician
will gently pull the cup and guide
the baby out.
• Again, episiotomy may not
always be necessary with this procedure
Instrumental
birth and the Baby
• Baby is able to feel the
blades of the forceps or the vacuum
cup as well as the force which is
applied during the contractions
•
Pressure will only be exerted when
the mother is actively pushing
• Venthouse delivery mostly
leave a prominent reddish purple
colored bump on the back of baby's
head
• Forceps can sometimes leave
two red marks on baby's temples.
Both bruises and bumps take about
a week to subside
• Sometimes bruising cause
babies to become irritable and even
develop jaundice
• Immediate special care services
are usually arranged for babies
who were already in distress prior
to the use of the instruments. The
delivery style has nothing to do
with the need for special care.
Instrumental
birth and the Mother
• The mother is likely to
feel sore and bruised. In case of
stitches special care needs to be
taken to help in the healing.
• Some women may feel a sense
of disappointment but don't forget
baby's safety necessitated the use
of instruments during delivery.
• Once an assisted delivery
doesn't mean always an assisted
delivery. Similar assistance may
not be necessary with the second
delivery because fatigue experienced
will be less this time round and
fetal distress may not even be a
possibility because of a shorter
labor.
