Childbirth: Forceps Delivery and Vacuum Extraction

Topic Overview

When childbirth is not progressing in the pushing stage of labor, a health professional sometimes uses forceps or a kind of suction cup (vacuum extractor) to help deliver the baby. This is called an assisted delivery, or an operative vaginal delivery.

Forceps delivery

Forceps are a device that looks like a long pair of spoons or tongs. Forceps can be used to hurry delivery when the mother or baby is in distress during labor and the baby's head is far down in the birth canal.

Forceps are sometimes used when the baby is not turning to face the right way or isn't moving down the birth canal (vagina). This can be because the uterus is not contracting well enough to deliver the baby. Epidural anesthesia makes this problem more likely than does no medicine or an opioid medicine for pain.^{footnote 1}

Before a forceps delivery, the vaginal area is usually numbed by injecting an anesthetic into the lower spine or vagina. Also, an incision in the area between the vagina and anus (episiotomy) is commonly made before a forceps delivery. Forceps are then gently pushed up on either side of the baby's head and used to turn and/or pull the baby out.

See pictures of forceps and vacuum extraction.

Vacuum extractor delivery

In some situations, doctors use a device called a vacuum extractor instead of forceps. The cup-shaped extractor applies a gentle suction to the top of the baby's head and holds the baby in place. The vacuum extractor prevents the baby's head from moving back up the birth canal between contractions and can be used to assist the mother while she is pushing during contractions.

After a vacuum extractor delivery, there may be some bruising or swelling on the baby's scalp.

Both vacuum and forceps delivery can cause tears. Forceps delivery is more likely than a vacuum delivery to damage your vagina, perineum, or rectum.^{footnote 1} But forceps are less likely to affect the baby-there may be some bruising or swelling on the baby's scalp (cephalohematoma) or face where the forceps or extraction cup was applied. But this usually goes away in the days after delivery. In very rare cases, a baby delivered with forceps or vacuum extraction has bleeding inside the skull (intracranial hemorrhage).^{footnote 1}

Discuss the use of forceps and vacuum delivery with your doctor before your delivery. Some doctors have more experience with assisted delivery than others. If your doctor does not have a lot of assisted delivery experience or training, it is important that he or she be assisted by someone who does.