why are vacuum extractions performed? - Mothering Forums

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Old 01-29-2003, 04:20 AM - Thread Starter
 
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i have two cousins who live overseas who recently underwent vacuum extractions. before them, i'd never known anyone who had one. under what circumstances are they performed? i know at least one of my cousins was fairly traumatized because of it.
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Old 01-29-2003, 04:45 AM
 
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The only woman I have met who told me about having one had a posterior baby that would not turn and finally would not budge. She labored for hours and hours at home. Her mother, who is a professional midwife and delivered my daughter tried everything she had every heard to help that baby move. Finally they went to hospital and ultimately had a vaccuum exctraction. I think it is gentler than forceps but the babe needs to be closer to being born, maybe? Not sure on that.
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Old 01-29-2003, 04:50 AM
 
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Where overseas are your cousins? For example, I am overseas in the Gulf and they try and go as natural as possible as the hospitals are run on the British system which means that there are doctors but the midwives see the patients and deliver the babies and are very supportive when it comes to having natural births. I had my baby completely natural with no drugs, no intervention at all, sitting on top of a birthing ball. The actual labor was on the floor since my transition time was 0 the midwife did not have time to go get a mat for the floor.

Usually intervention causes all sorts of problems and it could cause vaccuum extraction.

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Old 01-29-2003, 05:08 AM
 
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Well I don't know the *whole* story, but I do know my Dh was born with vacuum extraction. I can really see how they are a gentler choice than forceps, both for the mom to not be ripped to shreds, and for the babe to not be bruised so badly. I would *guess* they would be used when the baby was in distress (or at least when they should be used)...

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Old 01-29-2003, 07:09 AM
 
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This would usually be used when baby gets stuck in the birth canal for some reason, but is too far to be delivered by C/S. For example if mom is medicated or baby is positioned in such a way and cannot push baby out. Vaccum extraction is supposedly safer for mom and baby than forceps. Forceps aren't used much these days as far as I have heard.

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Old 01-29-2003, 07:29 AM
 
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first of all I would like to say that not having had a forceps, ventouse or ceaser delivery I am no expert on any of them, but my two cents - whether forceps or ventouse are more common seems to vary from country to country, or even state to state, or even hospital to hospital. A ventouse delivery can still do pretty horrible things to mum and can leave huge hematomas on babies head, so there could be just as much bruising as forceps. As with all things it really depends on the particular situation and the skill of the practitioner which one would be better, or whether you want that OB near you at all :-).

I myself was terrified of needing forceps because my mother had a very nasty forceps delivery with me, when i got pregnant I felt I would prefer a ceaser to forceps. As things moved along and I did some research I came to realise that with a good OB forceps is still probably a better option than a ceaser, as long as they don't keep trying if it ain't working....
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Old 01-29-2003, 08:07 AM
 
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I have been present at many (too many) births where vaccuum extractions were performed. I have also heard through midwives and books that they are suppose to be more gentle than forceps (I've never seen a forceps delivery) but I guess I just have a hard time visualizing that. ALL of the VEs that I've seen the cap has popped off multiple times causing lots of damage to mom's vaginal tissues, lots of bleeding, a horrible noise, and recoil of both doctor and mom. The amount of force that they have to use on the baby's head is almost unbelievable.

I cried the whole time that I first saw one being performed and it was actually being done by a doc who did the most gentle VE that I've seen so far.

I was born via forceps and I had a lot of bruising to my face, but with all of the VE babies that I've seen so far they've all had facial bruising, lots of head bruising (not to mention a lump the same size and shape of the cap), and a good friend of my sister-in-law had a baby who died from injuries sustained secondary to the VE that the doc did.

I've also seen VEs where the docs did not perform episiotomies at all so there was less damage (perineal wise) to mom. They definitely do not HAVE to do episiotomies routinely just to get the cap into the vagina like I've always heard that they do w/forceps.

I'm not trying to side with either one, but I've often questioned is there a better one (they both seem so bad) and pondered the risks vs benefits of each.

I just wish that neither of these instruments were needed, but there have been a few times where I did feel that they were greatly warranted and we were very thankful for their existence.
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Old 01-29-2003, 10:30 AM
 
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I was at a birth as a birth doula intern and the client had a vacume extraction. She pushed for3.5 hours with extremely slow progress. She had labored through the entire night and was exausted. She also had a lot of fear issues that we feel was holding her back. He was terrified of pushing her baby out and in turn her body was just not letting it happen. It is amazing what the mide can do or do against you!

That is one example for the use of this intervention. She had her baby two pushes after they attached the devise. Healty baby very torn up mommy

Shane - Homeschooling mom to three boys (12, 1-, 8) and living the open life with my husband.

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Old 01-29-2003, 11:37 AM
 
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My son was delivered with the help of forceps. He'd been sunnysideup for the labor and was successfully turned but his head just wouldn't come without a little help at the end. He had no bruising from the forceps and his head was round a few hours after birth.

My cousin was born a week later and they used a vaccuum. It left her with a huge hematoma.

The reason one was vaccuum and the other forceps: different doctors.

It was my understanding that if the vaccuum didn't work after one try...like, if it popped off...that it couldn't be tried again. Maybe that was just one doctor's view. Dunno.

They're also used to assist in c-sections.

I can say that when they got the forceps out for my second delivery, I found more strength to push. Hearing that metal ping helped me push like mad. "Okay, Rachelle...just a little pressure" my ass!
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Old 01-29-2003, 11:45 AM
 
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I think that when you are medicated with an epidural and lying flat on your back you often need a little help to get the baby to come out - vacuum extraction from what I've heard is supposed to be more gentle than forceps.

When I had my first ds I had an epidural (big mistake) and had my waters broken at only 4cm (big mistake #2) so my ds got stuck in the birth canal. I pushed for 3.5 hours - towards the end they tried vacuum extraction which didn't work an ended up using forceps - which did make a mark on his face and head, but they were not permanent.

Anyway, I think that normally if you wish to avoid the use of vacuum extraction your best bet is to go as natural as you can. I'm not saying that's a 100% guarantee, but I think it reduces the odds that such extraction will be necessary.
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Old 01-29-2003, 12:19 PM
 
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Had vacuum with ds #1, I had been pushing for almost 4 hours and his head had been right there the whole time, I was squating, standing, on my side, on my back, ect. and he was still in about the same spot.

I didn't think either of us were hurt too badly from it, I did tear, but not too bad and he did have that poofy spot on the top of his head for a few hours, but no visible brusing.
I think mostly I was just so tired, I had been laboring for more than 30 hours and it was the next night and I just wanted that baby out and to go to bed. I can remember saying "just get it out, just get it out" and that was when my doc suggested we try the vacuum, especially since his head was right there.
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Old 01-29-2003, 12:25 PM
 
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My medwife bailed on me and a dr. I never met came in and asked why I wasn't given pitocen (my midwife said I was laboring on my own) and everyone thought the baby's heartrate decelerated too much (bradycardia) (I had a fetal monitor which gave a false alarm as my baby was given 9 & 10 apgar scores - doesn't sound like she was in distress).

First he used forceps and then vacuum. My daughter had a fractured shoulder and a mark on her face from her nose to her cheek but no bump on the top of her head so I'd say the forceps were the most damaging. The shot in my perineum was not enough to lessen the pain from these instruments and I could not sit for 6 weeks afterward. I thought I was crippled for life. I was given percoset afterwards and many strangers at the hospital asked me if I was okay.

I trusted these people that my baby was not doing well and that they knew best. The dr. said "Prep the OR for a section" and my baby was born vaginally with the next push/vacuum extraction. I thought everything was fine except for the monitor apparently saying otherwise.

I have never had a problem in any of my pregnancies either during the pregnancy or with labor/delivery.

My next birth (this June) is at a freestanding birth center (an old converted house in a neighborhood) where they have never used forceps/vacuum and the transfer rate is less than 1%.
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Old 01-29-2003, 12:42 PM
 
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With my ds, I was having a natural birth w/a midwife in a hospital. During my fast labor, she noticed that he was in distress. We tried different things to help w/his heartbeat, i.e. positions. Didn't work. So she did have to call in the OB and they gave me an epis. and used the VE. It hurt more than a contraction did, but it got him out fast. He was very blue and the cord was wrapped around his boy 3 times. But he was o.k.!

Warmly~

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Old 01-29-2003, 02:38 PM
 
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My doctor "offered" to use the vacuum with my son after three hours of pushing. I was really vocalizing (things like "get this kid out of me NOW!") and his comment was "I could get the vacuum out if you want me to, but I'm confident that you can do this yourself, Charlotte." I told him he knew I didn't want an episitomy and I'd push the kid out myself, thank you.

My friend had a VE after ten hours of pushing at home. Her baby was posterior and military presentation. When my friend felt for her daughter's head, she felt her EAR. It's pretty amazing that she had her vaginally at all. According to most books on the subject, military presentation almost always ends in a section. Still, it has been almost two years and she has just now reconciled herself with the VE. The doctor (a woman!) was pretty brutal with the knife before she attached the vacuum. I was not there and don't know what was necessary and what was "punishment" for trying to birth at home, but my guess is there was a lot of the latter going around. Still, despite the gruesome results, my friend *did* successfully avoid a section and birthed a healthy baby.

I think like everything else in the medical birthing community, VE births happen more often than necessary, but there are rare instances when they are necessary. The key to avoiding any unnecessary interventions has ALWAYS been to be educated.

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Old 01-29-2003, 04:41 PM
 
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My ds was born with the use of a vacuum. It was hellishly painful. I had laboured naturally for three days - it took 16 hours to go from 4 cm - 8 cm and then another 5 hours to go from 8 to 10. I was wiped by the end. I didn't take pain meds, just breathed and sat in the tub a lot. I also squatted and did cat/cow (yoga). I had specifically talked with my doctor about how I did not want to have any interventions - unless of course baby was in danger.

At a certain point, after pushing for 1.5 hours, she said the baby had to come out. She ended up giving me a huge episiotomy (and I tore) and used the vacuum. Even afte the vacuum was on my ds's head, I still had to push for over half an hour. After I bled a lot and it took over an hour to stitch me up. But, my son had not markings, started to nurse within seconds and seemed fine.

I am now pregnant again and I am so scared I will have to have it again.

Emma
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Old 01-29-2003, 08:03 PM
 
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i had a c/s with my 1st and a forcept delivery with our 2nd.. I pushed for 4 hours and had 18 hours of labor and i was done.. Done .. DOne... I said i don't care do a section... I literally pushed 4 hours and the kid DID NOT MOVE!!!!

The forcepts did leave a bruise on his head and you could actually see an indent from where he had been stuck inside me.. You could see where i was pushing and he had only moved like 1/2 an inch.. I'm happy they got him out with the forcepts even though he did have a broken collar bone.. I could not push anymore...

Warm Squishy Feelings...

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Old 01-29-2003, 11:38 PM
 
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I had one too (also done overseas) for my daughter 14 years ago.......
I just couldn't push anymore - exhausted!

Chelly
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Old 01-30-2003, 01:53 PM
 
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My last ds had to be helped out with a vacuum. He was coming out fine, then he sorta got "stuck." His heart rate started dropping and the dr. was concerned, so he used the vacuum to help him come out the rest of the way. Logan was fine, but he had a massive "bruise" on the back of his head. My dr. said that it was one of the worst ones he had ever seen. It didn't hurt Logan and it went away in a few days, but it did look something awful! I hope they don't have to do anything like that with this one, but if so I'm not worried about it. As long as my baby comes out healthy I'll be happy.
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Old 01-30-2003, 02:04 PM
 
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I was transported to a hospital from my not so perfect homebirth and after fourty hours of posterior labor had to opt for the vacuum extraction. While it is not ideal the vaccume does leave a low incidence of permenant scarring on both baby and mother. The forceps however have been linked to brain retardation, massive scarring (my brother has this all across his cheeks) and terrible tearing and permenant damage to the mothers perineum. I will say that within hours of my sons vaccume extraction our midwife had a Cranio Sacral practitioner in our room working on my ds and he has no signs of injury to this day, 2 1/2 years later.
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Old 01-30-2003, 03:07 PM
 
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I am very curious about those who had forceps or vacuum for simple "failure to progress", "simple" meaning without the baby being in clear distress, and having had tried different positions (especially squatting) -- what was your second stage like? Were you told to start pushing at "10 cm dilation" or "complete"? Or were you allowed to wait until the urge to push was overpowering and automatic?

The reason I ask is that it is my theory (and apparently some doctors agree, and I know some midwives do) that complete dilation (where there is, according to the attendant, no cervix left) does not mean that the body is ready to push the baby out. I don't know the mechanics of why this would be so -- there has been pretty much no research done on it -- but anecdotally it seems like those who labor according to their bodies' cues (rather than the midwife's or doctor's cues) do not get "stuck".

Has anyone here disregarded information from vaginal exams (or not had them at all) and instead waited until the urge to push was overpowering and automatic, and STILL had to have help with vacuum and forceps?
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Old 01-30-2003, 04:32 PM
 
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When I was 10 cm dilated I was told to push - I had no urge to push. Finally, after pushing for 1.5 hours, she told me that my ds's heart rate was starting to slow and that he had to come out. As I wrote before, even after the vacuum was on his head, I had to push for over 30 more minutes.

What makes me so angry is that my chart says that the vacuum was used because of 'maternal exhaustion'. Yes I was tired, but I could have pushed him out. I was told that he was in danger (heart rate) and needed to get out NOW.

Ugh - obviously I still have anger to get rid of.

I do think there is wisdom to letting a woman push when she is ready. I think that just because you are at 10 cm, doesn't mean the baby is ready to come out.
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Old 01-30-2003, 05:04 PM
 
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I pushed because i felt the URGE to push... I still had a forcepts delivery.. I pushed for 4 hours and was EXHAUSTED!!

Warm Squishy Feelings..

Dyan

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Old 01-30-2003, 08:48 PM
 
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I also had a definate urge to push (despite the epidural).
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Old 01-30-2003, 09:00 PM
 
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I felt the urge to push when I was at six cm. I still felt the urge to push at 10cm. We still had forceps.
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Old 01-30-2003, 09:33 PM
 
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I never did feel the urge to push but I did anyway, because "they said I could." I pushed for 4 hours and became so exhausted and ended up with a forceps delivery. I think if I had just listened to my body I wouldn't have tired myself out to that point. The doctor said vacuum extractors were difficult to fit on a posterior baby.

My sister was born by vacuum and it tore parts of her scalp off, leaving her with permanent bald spots. My dd was born with bruises and some bleeding under the scalp.

I will do whatever I can to avoid instrument delivey next time. Luckily my doctor was skilled at it; many are not.
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Old 01-30-2003, 09:50 PM
 
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Wow. What a thread. Thanks for sharing, everyone, all the details, the good, the bad, the ugly. I didn't know what a vacuum could do to a baby's head besides the giant bruise. Yikes.
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Old 01-31-2003, 03:26 AM
 
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my last child was born using a vacuum. i was 10 cms but did not have the urge to push. they broke my water and had me pushing .. i was so exhausted after a while they used to vacuum to help bring her out. she was posterior.

i wish i had listened to my own body, not broken the water, and not pushed when my body wasn't ready.

but you live and learn.
any other babies born posterior with avacuum? the bruise was on the front part of the head and not the back?

Mel
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Old 01-31-2003, 05:05 AM
 
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I basically grilled my ND/birth attendant about forceps/vacuum. While they do homebirth, they are licensed by the state to use ve.

she told me: VE can be used as high up as forceps, however, since you don't have to get the pincers around the baby's head, between the vag and the head, it can be more effective than forceps if the baby is tightly "wedged" in the vagina. she also said she never used them. even tho they bring them.

i agree with blueviolet that jus cuz you're fully efaced and at 10cm or whatever, you may not be ready to push. Odent describs this in one of his books. Acording to Odent, some women at his birthing center in France will wait between the final expansion/efacement of the cervix and the beginng of the pushing phase - this is what he called transition, so I got confused when some folks called pushing or the last few cenimeters of dialation transition. Anyway, at his center, they never encouraged women to push before their body felt the urge to push. No EFM, just occasional checking. In some cases the baby would get all the way to the opening of vagina before feeling anything, instead of having the mom [forcibly] pushing the baby all the way from the uterus, down the vagina, twisting thru the pelvic inlet and outlet to the opening. He also suggested this interlude between contracting the cervix and pushing the baby out was a sort of break for the mom, esp if she was tired from dealing with the contractions to open the cervix. I think this might be mentioned in Gentle Birth Choices or Choosing Waterbirth - but it was attributed to Michael Odent's comments and clincial data.

cheers,

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Old 01-31-2003, 06:33 PM
 
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I also hear that an episiotomy is needed with the VE. I was able to avoid it with the forceps, and managed to deliver with an intact perineum.
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Old 01-31-2003, 07:01 PM
 
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Here's one way to consider it. I don't think the epis is required by the VE, but by how fast the baby comes out during a VE.

If you consider this scenario, that the 2nd stage of labor, when the baby is making it's way down the birth canal, one of the things that's happening is that the opening of the vagina is becomoing engorged with blood and dealing with the pressure from the baby's head. This is a necessary part of the process and rushing the baby out can interfere with this in that the opening, pelvic floor muscles and tissues and perinium don't have a chance to ready itself for the circumferance of the head. So, if you're using forceps or VE, you're probably in a hurry or at least not in sync with the timing of the mothers body and therefore prepping of the area. So, if things move along out of sequence, perhaps an epis would be required - but, since these are still surgical procedures (whom ever performs them), it's hard to say because a lot of surgeons think this practice is how it's done.

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