The Push and Pull of Forceps and Vacuum Deliveries

By on August 3, 2023

Dr. Stephanie Melka returns to Healthful Woman to discuss forceps and vacuum deliveries, which are known medically as operative vaginal deliveries. In this episode, she and Dr. Fox cover common concerns and misconceptions, explain why obstetricians turn to forceps or vacuum deliveries, and more.

Forceps and vacuum delivery, also known as operative vaginal delivery, is a technique used to quickly deliver a baby in certain circumstances to avoid a C-section. There are certain instances in which this technique may be recommended, including when the baby needs to be delivered quickly or in emergencies. Examples may include when someone is in labor and has pushed for a long time, but something needs to be done to help the baby out, or if someone is fully dilated and the baby’s heart rate drops. In these instances, medical instruments such as forceps or a vacuum suction cup are used to help deliver the baby in a quick fashion.

There are certain criteria that must be met before a forceps or vacuum delivery is performed. For example, if the baby is too high up in the pelvis, is exceptionally big, or is in a certain position, these techniques may not be used. The doctor will always make sure it’s a safe situation for both mother and baby.

Overall, using forceps or a vacuum helps to deliver the baby quickly without the use of a C-section, which comes with its own complications. “With a forceps or vacuum, the baby is going to be born within minutes, four minutes, two minutes, a matter of a couple of minutes,” explained Dr. Fox. “Whereas at the same decision point, if you decide to perform a C-section, it’s probably 10 to 30 minutes based on exactly what happens.”

About Forceps

Forceps are a medical tool that looks similar to metal salad tongs. “They’re like little spoons that you put on the side of the baby’s head and while mom is pushing, we’re giving a little pull and a lift from below to help the baby out,” said Dr. Melka. “In order for the baby to deliver, they have to maneuver through the pelvis and they have to come down under the pubic bone and then come up, almost like a J shape,” added Dr. Fox. “And when they’re pushing, sometimes it doesn’t happen so well.” That is where forceps come in to help maneuver the head through the pelvis for delivery.

One concern many mothers have when it comes to the use of forceps is that they are afraid the instrument will harm their baby. In truth, this tool is considered safe for the baby during delivery.
“An interesting fact that I love when we talk about this is explaining that forceps are riskier to the mom and not the baby,” said Dr. Melka. “The way we use them most of the time if there’s any issue, it’s temporary little marks, like a little bruise almost.”

While it comes down to preference, many OB/GYNs choose forceps as a tool of choice, which is true for Dr. Melka. “I find it has a very high success rate, meaning you don’t have to worry about it falling off or anything,” she said.

About Vacuum Extraction

Vacuum extraction is a technique that involves the use of a vacuum extractor to help guide the baby out during delivery. It consists of a suction cup that is attached to an electric or mechanical pump. The cup is applied to the baby’s head, and the pump then provides traction to pull while the mother pushes.

One thing that doctors must pay attention to is the position of the vacuum on the baby’s head. While there is a wider range of areas where the vacuum can be placed on the baby’s head compared to forceps, it is still important that the suction is placed correctly. The baby’s head must also be placed low enough in the birth canal for a vacuum extractor to be able to successfully guide them out.

The Option of Using These Tools

So, at which point during the birthing process does the doctor discuss the option of using forceps or a vacuum? While this discussion does not have to take place during prenatal visits, patients who are sure that they do not want these tools used during their birthing process should be sure to let their doctor know during a prenatal visit when there is plenty of time for discussion.

For those who are open to the use of these tools, this discussion may occur once the patient has been pushing for a while and some progress is made. Your doctor may decide to ask the mother if they are open to using forceps or a vacuum to avoid the need for a C-section.

What to Expect During Recovery

Many women are interested to know what recovery would look like for a forceps or vacuum-assisted birth compared to a natural vaginal birth. Ultimately, this depends on the circumstances of the delivery such as how long the woman was in labor, how long they were pushing, if there is a tear, etc. “You know, if two people delivered babies without any tearing and one had forceps and one didn’t, they probably would recover exactly the same,” explained Dr. Fox. “They wouldn’t notice the difference.”

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Maternal Fetal Medicine blogs are intended for educational purposes only and do not replace certified professional care. Medical conditions vary and change frequently. Please ask your doctor any questions you may have regarding your condition to receive a proper diagnosis or risk analysis. Thank you!

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