Vacuum Birth – Risks and Benefits

You might have heard of assisted birth and wondered what it was. An assisted birth is when your baby needs some help being born, right towards the end, usually during the pushing stage of labour. The two most common methods of assisted birth are forceps and vacuum extraction (also known as ventouse). This article is about the risks and benefits of vacuum birth.

A vacuum or ventouse is an instrument that’s like a suction cup. The soft plastic cup is attached to the baby’s head with suction, and the care provider uses a handle on the cup to move the baby down the birth canal.

Why Would I Need a Vacuum Assisted Birth?

Ventouse births are used for a number of reasons. The most common reason is when the baby has become distressed and is close enough to birth that a ventouse can speed up the process. During normal labour, it can take an hour or more for a woman to push out her baby without any assistance. If there’s a need for the baby to be born in a matter of minutes, a vacuum assisted birth might be the solution.

Reasons for a ventouse assisted birth include:

Pushing for several hours after dilation is complete
Being exhausted from pushing
Baby is showing signs of distress and might need to be born more quickly than the mother can push
Medical reasons that make pushing risky
Mother can’t push effectively due to a medical condition, epidural or spinal block
Time restrictions on pushing, based on hospital policy, or care provider preference
Baby’s head isn’t in the optimal position for birth.

If a vacuum assisted birth is suggested, your care provider needs to assess whether your baby is low enough, and close to being born. If the baby’s head is still too high, a c-section will be recommended.

How Is A Vacuum Assisted Birth Performed?

If your care provider has assessed you and determined the baby is low enough for an attempt at vacuum extraction, you’ll be given an anaesthetic for pain relief. This can be either via an epidural, or locally inserted into the vagina. Depending on the situation, your doctor might perform an episiotomy, although this procedure is becoming less common with vacuum assisted birth.

You’ll need to lie on your back, or slightly inclined, with legs up in stirrups or special supports. This allows your healthcare provider to assess baby’s position and place the vacuum cup.

The vacuum cup is then placed on your baby’s head, and suction applied so the cup doesn’t fall off. When you have your next contraction, your care provider will ask you to push. While you are pushing, the doctor or midwife will pull, to help birth the baby’s head.

Once the baby’s head is out, the cup can be removed and you can push the baby the rest of the way out.

Vacuum Birth Side Effects and Risks

Babies who are born by ventouse develop a swelling or bump on their head where the suction cup was attached. Although this bump (called a chignon) does cause discomfort, it usually disappears within 48 hours of birth.

Other risks associated with vacuum assisted birth are:

Bleeding under the baby’s scalp, which doesn’t cause any long term problems and goes away with time.
Bleeding under the covering of the skull, called a cephalhaematoma. This can cause swelling on the side of the baby’s head and might last for weeks, but doesn’t cause any complications.
Bleeding inside the skull, called a subgaleal haemorrhage, which is rare but very serious.

Babies who are born with the help of ventouse can be quite unsettled and grumpy in the first days, especially when handled by strangers. Lots of cuddles and skin to skin with their mother will help, as well as having some cranial therapy to deal with any misalignment or headache.

Women who have a vacuum birth might experience pain and soreness if they have had an episiotomy or a tear. You might like to read our article, 6 Ways To Heal Your Perineum After Giving Birth.

Other risks for women are:

Risk of infection, if episiotomy is performed
Damage to the vagina and cervix, if the cup is not attached correctly to the baby
Pelvic joint pain, caused by position during delivery

To avoid the procedure being performed incorrectly, or causing any harm, only an experienced and skilled practitioner should undertake or supervise a vacuum extraction. If the baby’s head is not delivered easily then the procedure should be stopped, and forceps used, or c-section performed.

How Can I Avoid A Vacuum Assisted Birth?

Most women can push their baby out without any help. The best way to avoid an assisted birth is to be proactive during pregnancy and birth to ensure your labour progresses normally.

Some things you can do:

Stay fit and healthy during pregnancy.
Optimise fetal positioning during pregnancy (check out our article on OFP).
During pre and early labour, avoid trying to get things moving by over exerting yourself; conserve energy for when you need it.
During labour, stay upright and active; avoid lying on your back or being restricted by interventions from moving.
Keep your fluids up and eat if you want to; this can reduce your chances of maternal exhaustion so that you have energy to push later.
Research open, active positions for the pushing stage, such as kneeling, squatting and lunging.
Avoid having an epidural or, if one is needed, wait an hour after full dilation or until you have a pushing urge before trying to push.

Some women will need an assisted birth, despite doing all the right things to avoid it. If, in the end, you need a vacuum assisted birth, it’s important to remember this: the reason it happened might not occur again, and your next birth is likely to be a normal vaginal experience. The benefits of a vacuum birth can help women avoid a c-section, which could limit her future birth choices.

As with all interventions, ensure you are informed of the risks and benefits of a vacuum birth, and make sure your care provider is experienced in the procedure.