An assisted vaginal birth (Ventouse ( Vaccum ) or Forceps)

  • There are several reasons. The main ones are:
    • Your baby is not moving out of the birth canal as would normally be expected
    • There are concerns about your baby’s well-being during birth
    • You are unable to push during birth.
  • The purpose of an assisted vaginal birth is to mimic a normal (spontaneous) birth with minimum risk to you and your baby. To do this, the doctor uses instruments (ventouse or forceps) to help your baby to be born.

  • A ventouse (vacuum extractor) is an instrument that uses suction to attach a soft or hard plastic or metal cup to your baby’s head. The obstetrician will wait until you are having a contraction and then ask you to push while he/she gently pulls to help deliver your baby. More than one pull is often required.
A ventouse (vacuum) delivery

A ventouse (vacuum) delivery

  • Forceps are smooth metal instruments that look like large spoons or tongs. They are curved to fit around your baby’s head. The forceps are carefully positioned around your baby’s head. The obstetrician will wait until you are having a contraction and then ask you to push while he/she gently pulls to help deliver your baby. More than one pull is often required.
A forceps delivery

A forceps delivery

  • Before your baby is delivered with forceps or ventouse, your obstetrician will examine your tummy and perform an internal examination to confirm that an assisted delivery is appropriate for you.
  • Your bladder will be emptied by passing a small tube (catheter) into it.
  • Pain relief for the delivery may be either a local anesthetic injection inside the vagina (pudendal block) or a regional anesthetic injection given into the space around the nerves in your back (an epidural or a spinal).
  • You may need to have a cut (episiotomy) to enlarge the vaginal opening and allow the baby to be born. If you do not have an epidural, the entrance to the vagina will be numbed with local anesthetic.

  • Ventouse and forceps are both safe and effective. There are many different types of ventouse and forceps, some of which are specifically designed to turn the baby around, for example, if your baby has its back to your back in the late stage of labor. Forceps are more successful in delivering the baby, but a ventouse is less likely to cause vaginal tearing. Your doctor will choose the type of instrument most suitable for you, your baby, and your situation.

  • Assisted vaginal birth is less likely to be successful if:
    • You are overweight with a body mass index (BMI) over 30
    • Your baby is large
    • Your baby is lying with its back to your back
    • Your baby’s head is not low down in the birth canal
  • If your doctor is not sure whether your baby can be safely born vaginally, you may be moved to the operating theatre so that you can have a cesarean section if necessary.
  • Rarely, if your baby is not born with the help of a ventouse, your obstetrician may then decide to change to the use of forceps. Depending on your individual circumstances, it may still be necessary for you to have a cesarean section at this stage. An obstetrician will recommend the method that is most appropriate for your situation.

  • A doctor specializing in the care of newborn babies (pediatrician) will be there when you have your baby, to take care of the newborn baby.

  • Bleeding
    • It is normal to have bleeding after the birth of a baby. Immediately after an assisted vaginal birth, heavier bleeding is more common. The bleeding in the days afterward should be similar to a normal birth.
  • Vaginal tears/episiotomy
    • If you have a vaginal tear or episiotomy, this will be repaired with dissolvable stitches. A third- or fourth-degree tear (a vaginal tear that involves the muscle and/or the wall of the anus or rectum) affects 1 in 100 women who have a normal vaginal birth. It is more common following a ventouse delivery or forceps delivery.
  • Pain relief
    • Most women experience some discomfort after they have given birth. If you suffer from discomfort after the birth, you should be offered regular pain relief such as paracetamol and diclofenac.
  • Bowel and bladder care
    • Problems with moving your bowels or passing urine are common immediately after birth, but the majority of women have no symptoms later on.

  • The suction cup used for a ventouse delivery often leaves a mark on a baby’s head. This is called a chignon (pronounced sheen-yon) and usually disappears within 24–48 hours. The suction cup may also commonly cause a bruise on a baby’s head called a cephalohaematoma. This occurs in between 1 and 12 in 100 babies who are born by the ventouse and disappears with time; it rarely causes any problems with babies except for a slight increase in jaundice in the first few days.
  • Forceps marks on the baby’s face are very common and usually small, and usually disappear within 24–48 hours. Small cuts on the baby’s face or scalp are also common (occurring in 1 in 10 assisted births) and heal quickly.

  • After any birth, including an assisted vaginal birth, you may feel a little bruised and sore. The stitches and swelling may make it painful when you go to the toilet. Any stitches will heal within a few weeks. Pain relief will help.
  • You can begin to have sex again after 6 – 8 weeks and when you and your partner both feel that it’s the right time for you.

  • This information aims to help you make the best decision regarding your care. It is not meant to replace advice from a doctor about your own situation.