Assisted Vaginal Birth
What is assisted vaginal birth?
How can having an assisted vaginal birth affect my pelvic floor?
What are other ways of helping a baby come through the birth canal?
When might an assisted vaginal birth be recommended?
What are some important considerations if my caregiver offers an assisted vaginal birth?
If I have an assisted vaginal birth, does it matter whether I have vacuum extraction or a forceps delivery?
In an assisted vaginal birth, the caregiver uses vacuum extraction or forceps to help bring the baby out. The vacuum extraction
device uses suction to hold a cap onto the baby's head. The cap is
attached to a handle. The caregiver then pulls while the mother pushes.
In a forceps delivery, the doctor inserts curved blades on either side of the baby's head, locks them together, and pulls.
Assisted vaginal birth increases the likelihood of having a tear into or through the anal muscle, especially when used in combination with a midline episiotomy
(cutting the back of the vaginal opening straight back to enlarge it
for birth). Anal muscle tears can lead to leaking gas - and more
rarely, feces - or a sense of urgency about elimination (bowel incontinence) as well as increased likelihood of pain during sexual intercourse.
and trying various pushing positions - especially upright positions
that allow gravity to assist the process - will work in most cases.
A vacuum extraction or forceps
delivery may be recommended when progress in bringing the baby down
during the pushing phase of labor has come to a halt, and the pushing
phase of giving birth has gone on for a very long time. (Most
first-time mothers take about 2 hours to birth the baby once they begin
pushing, and women who have had a vaginal birth before take about an
hour. When an epidural is in place, the time may be much longer than these norms.) Sometimes assisted vaginal birth
is recommended when the baby is close to being born and an urgent
problem develops or when the head needs to be shifted into a better
position for birth.
If you will be having an assisted delivery, speak with your caregiver about avoiding an episiotomy with this procedure. If no episiotomy is performed, tears into the anal muscle rarely occur.
When a difficult assisted vaginal birth
is anticipated, you are at greater risk for pelvic floor injury. In
this case, you may wish to weigh the respective pros and cons of assisted delivery and having a c-section.
Vacuum extraction is much less likely to result in deep tears and other tissue injuries compared with forceps delivery. For this reason, most assisted vaginal births are with vacuum extraction in the U.S. at this time.
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Childbirth Connection is a national not-for-profit organization founded in 1918 as Maternity Center Association. Our mission is to improve the quality of maternity care through research, education, advocacy and policy. Childbirth Connection promotes safe, effective and satisfying evidence-based maternity care and is a voice for the needs and interests of childbearing families.
Most recent page update: 2/21/2006