What is an assisted vaginal delivery?

An assisted vaginal delivery involves using a ventouse (vacuum cup) or forceps (like large tongs) to guide your baby as you push with your contractions.

Why may I need an assisted vaginal delivery?

• You have been pushing for too long.
• You may have run out of energy to deliver your baby safely.
• Your baby’s heart rate may be going above or below normal levels or they may not be getting enough oxygen.

Sometimes, if you have high blood pressure, your obstetrician may recommend an assisted vaginal delivery if the second stage of labour goes beyond a certain time and your blood pressure goes higher.

Are there any alternatives to an assisted vaginal delivery?

You can continue pushing and try to deliver your baby without a ventouse or forceps.

Another option is to have a caesarean section (procedure to deliver a baby by a surgical operation).

What does an assisted vaginal delivery involve?

If you are already having an epidural and there is enough time, you will be given more anaesthetic through the epidural. Otherwise, local anaesthetic may be injected either into the skin at the opening of your vagina or through your vagina.

Your legs will be put in ‘stirrups’.

Forceps delivery

Your obstetrician will place metal forceps either side of your baby’s head. When the forceps are in position, your obstetrician will hold them together.

They will pull gently as you push with your contractions to guide your baby’s head out. This can take several pulls and usually involves an episiotomy (a cut on the skin between your vagina and back passage) to help reduce the risk of you getting a severe tear.

Ventouse delivery

Your obstetrician will place the ventouse cup onto your baby’s head.

Your obstetrician will guide your baby out, as you push with your contractions. This can take several pulls and you may need an episiotomy.

Once your baby’s head is delivered, your obstetrician will remove the forceps or ventouse from your baby’s head and your baby will be delivered onto your abdomen.

What complications can happen?

The healthcare team will try to reduce the risk of complications.

Any numbers which relate to risk are from studies of people who have had this procedure. Your doctor may be able to tell you if the risk of a complication is higher or lower for you.

Some complications can be serious.

• Pain — you may get pain in your abdomen or around the stitches. However, an episiotomy or any tears usually heal quickly and if any pain continues it can be controlled with simple painkillers.
• Bleeding — if you bleed heavily, you may need more medication or a blood transfusion.
• Tears — minor tears are common.
• Damage to your back passage.
• Healing problems. Sometimes an episiotomy or tear will open slightly.
• Difficulty passing urine.
• Infection.
• Allergic reaction to the equipment, materials or medication.
• Marks and bruises on your baby. These do not usually cause any problems and settle in 1 to 2 days. Sometimes a ventouse can bruise one of the bones of your baby's skull. This does not usually cause any problems and gets better within a few weeks. Serious bruising is rare.
• Shoulder dystocia, where your baby's shoulders get stuck for a short while on the way out. If shoulder dystocia occurs, the nerves in your baby's neck may be stretched.
• Your baby having jaundice (the eyes and skin turning yellow) and having bloodshot eyes after birth.
• Failure to deliver your baby vaginally. This is rare.
• Venous thromboembolism (VTE) — this is a blood clot in your leg (deep-vein thrombosis - DVT) or one that has moved to your lung (pulmonary embolus).

How soon will I recover?

You will be able to go home when you can walk around without any help and are able to care for your baby.

The healthcare team will tell you when you can return to normal activities.

Regular exercise should improve your long-term health. Before you start exercising, ask the healthcare team or your GP for advice.

You should make a full recovery. An assisted vaginal delivery should not affect your ability to become pregnant or deliver a baby in the future.

Summary

An assisted vaginal delivery is a common procedure and is usually a safe method of delivery for you and your baby.

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