Assisted Delivery

What is an assisted delivery? Near the end of the pushing stage, it might become apparent that mother and baby need a little extra help during the delivery. After ensuring that the anesthesia is working, the health care provider will gently apply forceps or a small amount of suction to the baby’s head. As the mother pushes through her next contractions, the health care provider will gently assist the baby’s head through the birth canal.

How is an assisted delivery performed?

Your health care provider will normally use forceps or a vacuum extractor to help deliver the baby. Forceps are similar to tongs with loops on either side that are used to gently turn or pull the baby’s head in order to assist the baby through the birth canal.

A vacuum extractor uses suction to turn the baby’s head or pull the baby through the birth canal. The suction is controlled so the amount of suction used to help deliver the baby is kept to a minimum.

Why might an assisted delivery be necessary?

The health care provider might suggest assisted delivery for the following reasons:

  • If the mother has had an epidural, the pelvic muscles which normally help turn the baby’s head and shoulders into the preferred position for delivery might be ineffective. An epidural can also make it difficult to feel contractions, making pushing less effective.
  • If the baby is in a difficult position for normal delivery.
  • If the baby is not receiving enough oxygen. Lack of oxygen increases the risk of brain damage.
  • If the mother is physically exhausted.

The health care provider might suggest using forceps if the baby is coming feet first or is in a breech position.

If I am trying to have a natural birth, is anesthesia necessary during an assisted delivery? If so, what types are recommended?

When assistance becomes necessary for delivery, the health care provider will usually suggest some form of anesthesia.
In this regard, the mother might want to consider having a pudendal block.  In this procedure, the health care provider injects a local anesthetic directly into the nerves just inside the vagina. A pudendal block is most commonly chosen by women who have made it to the 10-centimeter stage and had been hoping for an unmedicated delivery but now desire a little assistance to complete the childbirth.
A pudendal block is effective 80% of the time, and its effects do not last long.

What should I watch for in my baby if the delivery is assisted?

The following side effects are possible if the delivery is assisted with forceps:

  • There can be a reddened area on the face. The discoloration normally goes away within a few days.
  • There can be small bruises. These normally disappear quickly.
  • Although rare, there can be trauma to the baby’s facial nerves. However, the damage is rarely permanent and the effects normally disappear within a few days.
  • The baby might be born with a somewhat cone-shaped head. This effect is considered normal and can occur in any vaginal delivery.

The following side effects are possible when delivery is assisted with suction:

  • A blood blister on the scalp, or cephalhematoma, can develop. It can take up to 6-8 weeks for the baby to completely heal.  This condition does not impact a child’s brain.
  • There can be slight bruising of the scalp. The bruising normally disappears within a few days.

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Compiled using information from the following sources:
William’s Obstetrics Twenty-Second Ed. Cunningham, F. Gary, et al, Ch. 23.
Planning Your Pregnancy and Birth Third Ed. The American College of Obstetricians and Gynecologists, Ch. 9.

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