Forceps delivery
Forceps are tong-shaped instruments that can help ease the baby out of the birth canal. These instruments are used to cradle
the baby’s head in the vagina and turn the baby into a better position if needed, so that he can be guided out. Forceps are
sometimes used if the baby or mother is in distress, or if the mother is having a lot of trouble pushing her baby out. The
use of forceps has decreased in recent years.
Up until the time that the caesarean section became commonplace, forceps were the only route by which a baby stuck in the
birth canal could be safely delivered. The invention of forceps has saved countless lives. Most women have no doubt heard
their share of horror stories surrounding the use of forceps, but these are mostly outdated tales from the days before caesarean
section. These days, forceps are no longer used in risky situations where the baby is not engaged properly in the pelvis,
because caesarean section is widely available to take care of such scenarios.
There are, however, a few risks associated with the use of forceps. About one-third of women who undergo a forceps delivery
develop tears in the area between their vagina and anus. There is also an increased risk of episiotomy, where the doctor feels
it is necessary to make an incision between the vagina and anus, to help the baby come through the birth canal. In rare situations,
forceps can cause injuries to the newborn baby’s face or skull.
Vacuum extraction
In a vacuum extraction, a suction cup is placed on the baby’s head, and the doctor uses this to guide the baby through the
birth canal. Vacuum extraction can also be used to rotate the baby. Generally, vacuum extraction is used in the same circumstances
as forceps: if the "pushing” phase of childbirth is taking too long, or if the baby is experiencing distress. Vacuum extraction
should not be used to deliver a baby who is less than 36 weeks gestation.
The use of vacuum extraction has increased in recent years because of its relative safety and ease of use. Studies have shown
that vacuum extraction is safer for the mother than forceps. Tears in the vaginal and anal area can occur, but they are less
frequent than with forceps. In the newborn baby, facial cuts are uncommon and minor. However, because of the pressure of the
vacuum on the baby’s head, bleeding can occur under the baby’s scalp in that area.
Preparation for forceps delivery or vacuum extraction
In order to have a delivery by forceps or vacuum extraction, the mother and medical personnel must be very well prepared.
A number of things need to happen before such a delivery can be attempted:
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The woman must give her consent to the use of forceps or vacuum extraction.
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The baby’s head should be in the correct position, unless the forceps or vacuum extraction is being used to turn the head
into position, and the head should be engaged in the pelvis.
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There should be no evidence of a condition called fetal disproportion, where the baby’s head is too large to fit through the
pelvis.
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The
cervix must be completely open and
dilated, and there should be contractions present.
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The fetal membranes should already be ruptured.
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The woman’s
bladder should be empty.
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The woman should have an
epidural in place, or another type of effective anaesthesia.
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The medical personnel must be able and prepared to immediately perform a caesarean section if necessary, and resuscitate the
newborn baby after he is born.
