Forceps and ventouse delivery in childbirth
Sometimes, despite all your hard work, labour just doesn't go as you hoped. When this happens, no matter how long you've spent on your birth plan, you may have to bin the entire tome and let your medical team take over. Two of the options for helping your baby out are a ventouse deliery, or a forceps delivery.
Reasons for having forceps or ventouse delivery include:
- Foetal distress – your baby's health is at risk, possibly because they're not getting enough oxygen
- Your health – you may be too tired to push or your health may be at risk if labour continues
- Epidural use – if you can't feel a thing it can sometimes be very difficult to know how hard you're pushing or when to push (ideally, your midwife will time things so that your epidural begins to wear off as you near the second stage, but labour isn't great at clock-watching)
- Poor positioning – sometimes your baby just doesn't get in the right position to be born without outside help
- Cephalopelvic disproportion (CPD) – your baby might be too big or your pelvis too small for your baby to be born naturally and so caesarian section is usually the only option
When complications occur in the second stage of labour – the point where your cervix is fully dilated and you're pushing for all you're worth – your obstetrician may suggest an assisted delivery using ventouse or forceps (the choice of which is down to the practitioner, based on their preference and the position of your baby).
If you haven't already had an epidural or spinal block, you'll be given a local anaesthetic to numb the birth canal.
You'll also have a catheter (a thin tube attached to a bag) placed in your bladder to empty it and you may also require an episiotomy, particularly if you're having a forceps delivery
If there's any concern that these methods might prove unsuccessful, it's possible you'll be moved to an operating theatre before the doctor attempts them. If this happens, you might be prepped for a caesarian section (given an epidural or spinal anaesthetic) beforehand, to save time just in case an emergency C-section proves necessary.
The ventouse is a round plastic or metal cap that attaches by suction to your baby's scalp. You'll have to put your legs in stirrups and then, once the ventouse is in place, your obstetrician or midwife will pull on the handle attached to the ventouse as you push through a contraction. Hopefully, this combined effort will help your baby be born.I ended up having both ventouse and forceps to get the baby out. After 26 hours in labour I didn't care what they did as long as he came out safely.
If your baby's born using a ventouse, it's likely they'll have an area of swelling on their head caused by a build up of fluid, but this usually disappears within a day or so.
Less commonly, they may have what's called a cephalhaematoma. It sounds terrifying, but it's essentially just a big blood blister, which will go away, although it can take several weeks. This bruising may make your baby jaundiced. There may also be some grazing, but this too should go within a few days.
Ventouse is generally considered to be less painful and safer for women than forceps; plus, you may not require an episiotomy. But, if the ventouse delivery fails, your doctor may decide to try again using forceps.
Metal instruments that look like a giant pair of salad servers with hollow centres, forceps are put around your baby's head so it's cupped between them and the two intersecting parts are then locked together at the handles.
Again, you'll have to put your legs in stirrups and the forceps will then be positioned. As you push through a contraction, the obstetrician will pull on the forceps handles and, hopefully, help your baby be born.
Forceps can cause bruising and grazes to your baby's head and face, but these should calm down over several days and eventually disappear. There's also a small risk of damage to your baby's facial nerves, but this usually self-corrects in a couple of days. In very rare cases, the baby can suffer a broken collar bone.
Recovery after a forceps delivery
As for you? Unsurprisingly, you may be a bit sore and bruised afterwards and find going to the loo difficult. All this should pass with time, but ask your midwife for advice if you experience any problems.
That said, forceps births are associated with an increased risk of damage to the vagina, bladder and the anal sphincter – the muscle surrounding the back passage.
If you've had an episiotomy or suffer a bad vaginal tear this will be repaired immediately after the birth using dissolvable stitches and you should be given advice on hygiene and self-help measures to reduce any subsequent pain, as well as information on follow-on pain relief.
Countless Mumsnetters have had ventouse and forcep deliveries, so if you want more information or need to discuss your, er, ragged bits, then there's lots of support and advice on the childbirth Talk boards. Just search or start your own thread.
What Mumsnetters say about assisted deliveries
- “The idea of ventouse or forceps terrified me throughout pregnancy, but when it came to the crunch and the midwife said 'we need to get this baby out', I couldn't have cared less how they did it as I'd been in labour for hours.”
- “Something to bear in mind if you have a ventouse is that it's not unusual for the vacuum seal between the ventouse cap and the head to be broken. This makes the most terrible noise and sounds like something ghastly has happened but it's nothing at all to worry about – they just have another go!”
- “My first son got stuck for an hour and a half: my pelvis is misaligned and he had a massive head and didn't want to budge. I'd been having strong contractions for 18 hours and I was knackered and in pain. I ended up having an emergency c-section when they realised he was in MEGA distress and all ended well.”
- “When I made no progress in the second stage I was taken into the assisted labour room, put in stirrups and given an episiotomy for the ventouse, which worked very well. It's rather undignified but you don't care at that point. I had two midwives, two paediatricians, a doctor, a teacher and several students all looking on. I didn't feel a thing due to the epidural I'd had earlier being so strong. My son had a slightly pointy head for a day or so and was a bit bruised for a while, but he didn't seem to suffer any problems and always slept well as a tiny baby. I got a slight infection from my scar and I'm not quite the same down there as I was before but it hasn't caused major problems.”
- “The baby did have a bit of a swelling on the back of his head for 24 hours, and a scab, which dropped off after about a week, but other than that he was absolutely fine. It did mean we had to stay in hospital for an extra night though.”
- “My son had a bruised, elongated head and I blamed his poor sleeping on the forceps and tried cranial osteopathy, but my second son and my daughter turned out as bad and they had normal deliveries, so it's just the way I make them!”