Vacuum-assisted delivery

When Is Vacuum-assisted Delivery Needed?

Even after your cervix is fully dilated (open) and you have been pushing, you may need help getting the baby out. Reasons you may need help include:

• After pushing for 2 hours or more, the baby may no longer be moving down through the birth canal. 
• You may be too tired to push any longer.
• A medical problem may make it risky for you to push.

The doctor or midwife may also use this technique when the baby is having a hard time during labor (some fetal heart rate abnormalities).

Before the vacuum can be used, your baby needs to be far enough down the birth canal. Your doctor or midwife will check you carefully to make sure it is safe to use the vacuum. This device is only safe to use when the baby is very close to being born. If the head is too high, a cesarean will be recommended.

Most women will not need the vacuum to help them deliver. You may feel tired and tempted to ask for a little help. But if there is no true need for a vacuum-assisted delivery, it is safer for you and your baby to deliver on your own.

What Will Happen During a Vacuum-assisted Vaginal Delivery?

You will be given medicine to block pain. This may be an epidural block or a numbing medicine placed in the vagina.

The plastic cup will be placed on the baby's head. Then, during a contraction, you will be asked to push again. At the same time, the doctor or midwife will gently pull to help deliver your baby.

After the doctor or nurse delivers the baby’s head, you will push the baby the rest of the way out. After delivery, you can hold your baby on your tummy if he or she is doing well.

If the vacuum does not help move your baby, you may need to have a C-section.

What Are the Risks?

There are some risks with vacuum-assisted delivery, but it rarely causes lasting problems when properly used.

Tears in the vagina or on the perineum may occur. They are much less common than when forceps are used.

For the baby, the risks are mostly about bleeding:

• There may be bleeding under the baby’s scalp (cephalohematoma). It will go away and does not cause serious problems. Your baby may be more likely to have jaundice (look a little yellow), which may be treated with light therapy.
• Another type of bleeding occurs underneath the covering (periosteum) of the skull bone. It will go away and does not cause serious problems
• Bleeding inside the skull can be very serious, but is rare.

References

Nielsen PE, Galan HL. Operative vaginal delivery. In: Gabbe SG, Niebyl JR, Simpson JL, eds. Obstetrics: Normal and Problem Pregnancies. 6th ed. Philadelphia, Pa: Elsevier Churchill Livingstone; 2012:chap 15.

Sakornbut EL. Intrapartum procedures. In: Ratcliffe SD, Baxley EG, Cline MK, Sakornbut EL, eds. Family Medicine Obstetrics. 3rd ed. Philadelphia, Pa: Elsevier Mosby; 2008:chap 18.

Update Date: 5/31/2012

Updated by: Susan Storck, MD, FACOG, Chief, Eastside Department of Obstetrics and Gynecology, Group Health Cooperative of Puget Sound, Bellevue, Washington; Clinical Teaching Faculty, Department of Obstetrics and Gynecology, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.