Assisted Birth

Although most labours go smoothly without any problems, sometimes complications arise and medical intervention may be needed to speed up the labour. Around one in eight women have an assisted birth using forceps or a Ventouse suction cup.

There are three main methods used to assist birth; these include:

• Forceps
• Ventouse
• Caesarean section

Forceps

Forceps are a pair of spoon-shaped instruments, which are used to help the delivery of the baby’s head. The forceps are placed on either side of the baby’s head and then the doctor or midwife pulls the baby’s head out gently. If you have to have forceps, you will usually be given a local anaesthetic (if you haven’t already had an epidural) and your legs may be placed in stirrups; this will allow the midwife or doctor to see clearly. If you have a forceps delivery, the chances are that you will end up having an episiotomy (where the skin of the perineum is cut to allow room for the forceps to grip the baby’s head); the incision will be stitched up once the baby has been born and the placenta delivered and it should heal quickly.

The baby may have marks where the forceps have been placed on its head but these should fade over the course of time.

Ventouse

Delivery using Ventouse is also known as vacuum extraction; it involves using a suction pump to encourage the delivery of the baby. The Ventouse cup is attached to the top of the baby’s head as the mother continues to push with the contractions. The suction helps to speed up delivery. If you have Ventouse, you will be given local anaesthetic to numb the birth canal; you will usually have to have an episiotomy, which involves cutting the skin of the perineum to allow room for the baby to come out; this will later be stitched back up and will heal naturally over time.

After the birth, the baby may have a mark where the cup has been attached to its head; this should fade in time.

It is not possible to use Ventouse before 34 weeks because the baby’s head is too soft at this point.

Caesarean section

A caesarean section is a surgical procedure, which involves making an incision in the front wall of the abdomen and the womb in order to deliver the baby. Some women are advised to have a caesarean section by doctors during their pregnancy (this is known as a planned caesarean); this is usually due to having multiple babies or having an existing health condition (such as preeclampsia or HIV), which could make labour difficult or cause problems for the baby.

In some cases, doctors will recommend an emergency caesarean; this usually occurs as a result of needing to deliver the baby quickly. An emergency caesarean section may be recommended if the baby is in an awkward position (such as the breech position), or if the baby is becoming distressed. Caesarean sections typically last between thirty and forty five minutes.

For more information visit our caesarean section area.

Why would I need forceps or Ventouse?

If you have a difficult labour, you may be advised to have an assisted birth using Ventouse or forceps; in some cases, if the baby is becoming increasingly distressed and needs to be delivered quickly, you may be advised to have caesarean section. Possible reasons for assisted birth include:

• The labour is progressing slowly and you are struggling to continue pushing
• The baby is becoming distressed (this is usually characterised by changes in their heart rate but the presence of meconium may also be a sign (this is the baby’s first stool).
• The baby is breech (this means their feet or bottom is set to come out first, rather than the head)
• Your contractions have become slower and more faint
• You have a small pelvis and the opening is too small
• The baby is being born prematurely and needs to be delivered quickly

The use of forceps or ventouse is known as ‘instrumental delivery’; these instruments are predominantly used during the second phase of labour when the labour is failing to progress at a suitable speed and the baby is showing signs of distress.

Recovering from an assisted delivery

It can take longer to recover from an assisted delivery than a natural birth; to begin with you may feel very sore and uncomfortable but this should soon wear off and your midwife or doctor should be able to prescribe you some pain relief.

After giving birth, you may feel exhausted and emotional; you should take time to rest and get your head around everything before you throw yourself into life as a mother.

After the birth, you may have a catheter fitted; this is particularly common if you have had an epidural. You may also be prescribed antibiotics and medication to help reduce the risk of clotting and thrombosis.

If you have had a caesarean section, it may take up to six weeks for you to feel ‘normal’again and during this time you should try to get plenty of rest; you should not drive, walk up and down stairs or have sexual intercourse during this recovery period.

Preventing the need for assisted delivery

In many cases, it may be impossible to avoid having assisted delivery; however, it may help to change positions during labour. Sometimes, being in an upright position, such as kneeling or squatting can help to encourage the baby to move into a more comfortable position and these positions may help you to control the pain brought about by contractions.