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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 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
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.1
Before a forceps delivery, the vaginal area is usually numbed by
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.
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
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.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
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.
Cunningham FG, et al. (2010). Forceps delivery and
vacuum extraction. In Williams Obstetrics, 23rd ed., pp.
511–526. New York: McGraw-Hill.
November 13, 2013
Kathleen Romito, MD - Family Medicine & Kirtly Jones, MD - Obstetrics and Gynecology
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