No mother wants to have her labor and delivery take a turn for the worse. The use of forceps or a vacuum during delivery is one of the most terrifying things a mother can experience during the already very stressful situation of labor and delivery. Although forceps and vacuum deliveries are infrequent nowadays, they do sometimes have to happen in the cases of extreme emergencies. Read about Jacquline’s experience with a forcep and vacuum delivery below, and how you can help to prevent such an experience for yourself.

A Real-Life Forcep and Vacuum Delivery

“I have always been a bit on the “crunchy” side. When my son was born, I had a non-medicated home birth and it went amazingly. It was gentle and I dare even say, somewhat relaxing. He came 5 days after his due date. I pushed for about 45 minutes but I didn’t have to force it. He was able to make it through the birth canal without much of a fight, and I didn’t even require any stitches from tears.

“My daughter, on the other hand, was difficult the moment I got pregnant. I was terribly sick with her, and I knew I was pregnant before I even was able to accurately test. I spent all of my first trimester and many, many days of my second and third trimester, at home on the couch trying to wrangle my then-toddler and hold some food down. I should have known she was going to be trouble!

“I started with contractions a little after 37 weeks. I tried as much as possible to slow them down and prevent her from coming before 40 weeks. I had planned another home birth with my amazing midwife and doula. I was foolish to think that my daughter would hold off, but since my son was late I figured I had time. I was wrong.

“The day my daughter decided to arrive we hadn’t even set up the birthing pool. My mother-in-law wasn’t scheduled to arrive to help with my son for another 4 days. Nothing was prepared like it was for my son. My candles weren’t in the right spot, I hadn’t finished my labor music playlist, and I felt wholly unprepared even though I had done this less than two years ago.

“My husband called my midwife and my doula. They got there as soon as they could while I tried to labor comfortably. But the contractions would not stop coming. They were back to back, and I felt like I couldn’t catch my breath.

“My midwife did a check of my daughter’s heartbeat and it was slow. For the next hour or so we tried oxygen, turning me on my side, and different positions to help her heart rate pick back up. But it didn’t. At that point I knew we needed to go to the hospital.

“Once we got there I was 8cm dilated. My husband couldn’t come in with me because of COVID regulations, and he still had my son with him because my mother-in-law wasn’t there. I was completely terrified.

“As I was wheeled up as an emergency case, I could feel my daughter’s head pushing against my pelvic bone. It was painful and I screamed that I needed to get her out. I was placed on a bed and the doctor noted that her heart rate had dropped significantly. She was already in the birth canal so an emergency c-section was too late. He explained that her shoulders were stuck in my pelvic bone and he needed to use forceps and maybe the vacuum to get her out.

“My midwife could see the fear in my eyes, and she assured me that this was the best possible thing for my daughter AND me. I reluctantly agreed.

“The doctor grabbed the forceps but I couldn’t see anything going on. He was talking firmly to the nurse and I knew my daughter was in trouble. Her heart rate was extremely slow and they needed to get her OUT. He then reached for the vacuum. Within a few moments (but it felt like years), they were able to get her out.

“After she was born she didn’t cry for what seemed like forever. She had a bluish tint to her and I feared the worst. ‘My husband isn’t even here; he isn’t going to see her’ I kept saying to myself. But she eventually cried and I breathed a sigh of relief.

“The worst outcome of this experience was that her head looked a little funny for a couple of days. It was terrifying and I don’t wish it on anyone. But I am glad that the doctor was able to use the forceps and vacuum for my delivery and save my daughter.”

What Happens During a Forceps and Vacuum Delivery

Although assisted deliveries by forceps or vacuum is extremely scary, it is safe. However, your doctor or midwife should first explain to you why they need to use these instruments and you will need to give consent.

Before the forceps or vacuum delivery occurs, you will likely be given a local anesthetic to numb the area around your vagina and the perineum. This only happens if you do not already have an epidural. If you have already had an epidural you will not have additional numbing medication.

There is always a chance that your doctor or midwife decides that an emergency cesarean needs to occur instead. In this case, you will be moved to an operating room. If there is time, you will be kept away for the procedure. However, if your baby is in distress or you are in distress, you will be put under general anesthesia for the procedure.

In addition to the local anesthesia around your vagina and perineum, your doctor will probably have to perform an episiotomy which is a small cut between your vagina and your anus along your perineum. They will stitch this cut after the baby is born.

Assisted delivery differs between the use of a vacuum or forceps. We explain the difference below.

Assisted delivery using forceps

Forceps are generally made of metal and have two spoon-like ends. They fit around the baby’s head and the doctor uses them, in conjunction with contractions and the mother pushing, to help the baby successfully come out of the birth canal. Forceps can also be used to help turn the baby in the correct direction if they are not facing the right way, which can assist in an easier delivery.

Assisted delivery using a vacuum

A ventose, or vacuum cup, is used during a vacuum delivery. It is attached to the baby’s head using suction. A hose is then attached to that cup, which uses suction power to help pull the baby out during a contraction and with the mother pushing.

Which method is better?

Generally, if your baby is born 36 weeks or earlier, doctors will use the forcep method. This is because before 36 weeks your baby’s head is softer, and damage is less likely to occur when using forceps.

Why You Might Need a Forceps and Vacuum Delivery

There are several reasons why you might need a forceps or vacuum delivery. According to the National Health Institute in the United Kingdom, an assisted delivery using forceps or the vacuum occur in 1 out of every 8 births. It may be needed when:
  • You have been advised not to try and push your baby because of an underlying health condition
  • Your baby’s heart rate is low
  • Your baby is an awkward position, making delivery difficult
  • Your baby is showing signs of distress or fatigue
  • Your baby is premature- forceps can sometimes help protect your perineum so it does not tear.

Side effects after a forceps or vacuum delivery

There are some small side effects to both the mother and baby that are common after a forceps or vacuum delivery.

For the mother this may include:

  • The use of a catheter for up to 24 hours after giving birth
  • Episiotomy
  • Third or fourth-degree tear
  • Urinary incontinence
  • Anal incontinence
  • Higher risk of blood clots

For the baby this may include:

  • A mark on your baby’s head that usually disappears within 24 to 48 hours
  • A bruise on your baby’s head that should disappear within time
  • Marks or small cuts on your baby’s face that go away quickly within time
  • Yellowing of the eyes and skin; it should pass within a few days

Ways To Prevent A Forceps And Vacuum Delivery

Many times a forceps and vacuum delivery can’t be prevented. It is often the final measure to help a baby safely come through the birth canal when they are stuck. But there are a few things you can do during pregnancy to widen your pelvic floor and allow a safer delivery for your baby and a safer labor experience for you.

Exercises to Prevent a Forceps and Vacuum Delivery

Yoga is an all-around great practice to have for a pregnant mother. Not only does staying active always help you and your baby during pregnancy, labor and delivery, and recovery, certain positions can help you widen your pelvic floor for a safer delivery experience.