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Assisted Vacuum Delivery and Forceps Delivery: What You Need to Know

Medically reviewed by Regina Victoria Boyles, MD · Pediatrics

Written by Nikita Bhalla · Updated Mar 08, 2023

    Assisted Vacuum Delivery and Forceps Delivery: What You Need to Know

    Pregnancy complications are often dealt with using refined medical techniques. One of them is assisted delivery, more specifically: assisted vacuum delivery or forceps delivery. Though there is nothing to be scared about, it is necessary to know the various ways in which childbirth could possibly happen.

    Assisted Vacuum Delivery and Forceps Delivery, Defined

    As the name suggests, an assisted delivery makes use of additional equipment for childbirth. Also known as instrumental delivery, this form of childbirth occurs vaginally. This does not happen to every mother but is required for cases like when the baby is in the wrong position.

    For example, if the baby has rotated within the womb and cannot come out simply with the mother’s push. The doctor will then use either forceps or a ventouse/vacuum to get the baby out safely. Anesthesia is usually used to numb the pelvic floor area for a vaginal delivery, if an epidural has not been given.

    Some common issues that would require an assisted delivery are:

    • Fetal heart rate changes
    • Prolonged labor and the mother is too exhausted to push anymore
    • The baby is in an abnormal position

    What is assisted vacuum delivery?

    A vacuum delivery requires an air-sucking instrument that can be attached to the baby’s head to bring it out. This is not a typical household vacuum that picks dirt from surfaces. This ventouse is a low-pressure instrument that pulls the baby out.

    While the mother’s uterus contracts, a soft or hard cup with a handle is placed on top of the baby’s head. Vacuum delivery is initiated during the second stage of labor, especially when the delivery needs to be sped up.

    The following are the health complications, which might require a vacuum delivery:

    • The mother is too exhausted to push anymore.
    • The baby is stuck in the birth canal and it leads to stagnant labor.
    • The baby is in fetal distress
    • The mother has a heart condition or uncontrolled hypertension, both of which can be dangerous if the mother continues pushing

    What are the pros and cons of assisted vacuum delivery?

    Pros of Assisted Vacuum Delivery

    • A vacuum delivery requires less anesthesia and epidural than forceps delivery.
    • Chances of a C-section are more post a forceps delivery than a vacuum delivery.
    • As forceps require more grip on the baby’s head, in comparison vacuum delivery is safer for the baby. This means that the baby is less exposed to a head injury in a vacuum delivery.
    • It is easier to place a ventouse or vacuum than forceps on the baby’s head as it can be maneuvered according to the baby’s position. Though, this might not be possible in the case of forceps which require the baby in a particular position.
    • In a vacuum delivery, the mother’s soft tissues aren’t easily injured either.

    Cons of Assisted Vacuum Delivery

    • Vacuum delivery has a higher failure rate than a forceps delivery. If a vacuum extraction fails, a C-section will be required to get the baby out.
    • While forceps delivery can be completed without or very little maternal participation, a vacuum delivery requires uterine contractions for childbirth. Because of this, it can also be delayed.
    • Intracranial haemorrhage is a big risk in vacuum deliveries. This is because the cup’s suction might have created pressure over the baby’s head area, which may lead to internal bleeding.
    • Fetal stroke is another threat in vacuum deliveries. Due to the vacuum cup, it is possible that the blood supply to the baby’s head can be restricted, resulting in stroke.

    assisted vacuum delivery

    What is assisted forceps delivery?

    Forceps are tong-like, metal instruments that hold the baby’s head to pull it out. Sometimes when the baby is too high in the birth canal, a forceps delivery is needed.

    The protocol for labor is the same, the mother needs to be 10 cm dilated and the baby should have descended into the birth canal headfirst. Though there is a possibility for the mother to be unable to push the baby out. Forceps in this case can assist childbirth safely.

    There are different situations when a forceps delivery may be required:

    • Fetal heartbeat is irregular, which means either too fast or too slow. The doctor can then suggest a forceps delivery.
    • As mentioned above, if the mother has been in delivery for a long time and her cervix is also fully dilated. However, she is unable to push the baby out.
    • If the mother has uncontrolled high blood pressure or heart disease, prolonging labor can cause problems as blood pressure is naturally high during childbirth. In this case, the baby needs to be delivered as soon as possible.

    What are the pros and cons of forceps delivery?

    Pros of Forceps Delivery

    • The rate of success for a forceps delivery is higher than vacuum delivery.
    • During complications, forceps delivery is faster to do.
    • Forceps can be used to rotate the baby’s head in the right direct and enable normal delivery.
    • Unlike assisted vacuum delivery, forceps do not detach from the fetal head while delivery.
    • In specific conditions, forceps are a safer option than opting for a vacuum delivery or a C-section.
    • Forceps delivery poses less risk of a cephalohematoma than a vacuum delivery.

    Cons of Forceps Delivery

    • The mother is at a greater risk of perineal or vaginal tear in a forceps delivery than a vacuum delivery.
    • Facial nerve damages on the baby is one of the probable perils of a forceps delivery.
    • Even though the chances are less than a vacuum delivery, forceps delivery does carry the possibility of a retinal hemorrhage and cephalohematoma on the baby
    • Forceps require a certain amount of pressure to be applied to the infant’s head to get it out of the birth canal. This can be a threat to the baby’s nerves, brain, and facial structure.

    Important points to know about assisted delivery

    • Perineal or vaginal tear is common after a forceps delivery. Though vacuum delivery might be slower and only works if the mother is contracting. Therefore, weigh your options and ask your doctor what is the best way forward.
    • If you get a vaginal tear, then recovery time will be slow depending on the degree of tear. It is important to rest as much as possible.
    • If the need arises, a C-section is the answer in both deliveries. A C-section delivery has its own complications.
    • Before an assisted delivery, doctors usually give options for the way forward. Thoroughly understand all the pros and cons of each of these procedures.
    • Fecal and urine incontinence is common post a forceps delivery. This means the inability to control bowel movement and urine.
    • Assisted delivery doesn’t always have a success rate. Ask your doctor every step of the way of how he or she is proceeding.

    This information about assisted delivery will come in handy if you are a mother- or father-to-be. Staying prepared beforehand will help you keep your options ready if the need arises.

    Learn more about labor and delivery here.


    Hello Health Group does not provide medical advice, diagnosis or treatment.

    Medically reviewed by

    Regina Victoria Boyles, MD


    Written by Nikita Bhalla · Updated Mar 08, 2023

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