What are assisted delivery births and why are they used? Assisted delivery births are performed during the last stages of labour (when the woman is fully dilated). The reason for these types of births is to provide both the mother and the child with help during the final moments of the birthing process. An ADB (Assisted Delivery Birth) may be performed for a number of reasons, the most common being if the baby is in distress and not moving out of the birthing canal or if the mother is unable to or has been instructed not to push during the birth.
The reason for the assisted delivery birth is to copy spontaneous birthing and the risks to baby and mom are regarded as being minimal. There is specialized equipment that is used during assisted births and includes forceps and a vacuum extractor. Although the names of the equipment makes the process sound a little daunting and a bit scary – as many as 12% of women who opt for natural birth will need to rely on the assistance of the specialized assisted delivery equipment and trained medical staff.
How safe are Assisted Delivery Births?
When a soon-to-be first-time mum hears the words forceps and vacuum extractors – she will probably be more than a little nervous. However, the fact is that when birthing mothers are in experienced hands, an assisted delivery is considered safe as long as the baby’s head is positioned low enough in the birth canal and no additional problems exist that may make a vaginal delivery difficult or dangerous. If the obstetrician tries to deliver the baby using the necessary equipment and is unsuccessful in getting the baby out safely and quickly, the next option would be to perform a c-section.
What takes place during an Assisted Delivery?
Remember that a caregiver will only use assisted delivery methods if the woman is completely dilated (this mean the cervix has dilated to 10 centimetres). The medical staff will insert a catheter to drain the bladder and if the woman has not been given an epidural during the first stages of labour, a local anaesthetic or Pudendal block will be administered. The anaesthetic will be injected into the vaginal wall and the entire area will be numbed. It may also be necessary for the woman to have an episiotomy which is very common if forceps are to be used during the delivery. In most cases a paediatrician will be notified before the assisted delivery takes place so that he or she can monitor the baby directly after the assisted delivery birth.
Vacuum Extraction Delivery
The vacuum extractor is a flexible, rounded cup that is placed over the baby’s head while the baby is in the birth canal. The flexible cup is linked to an electric suction pump, or some vacuum extractors have a small handheld pump. The pump creates a vacuum pressure and this pressure holds the cup securely on the head of baby. While the doctor is using the vacuum extractor, the expectant mom will be advised to push and the doctor will gently pull on the handle that is attached to the cup and this will assist the baby to move down and eventually out of the birth canal.
With this type of assisted delivery, complications for the infant are uncommon. A baby may have a raised bruise on the top of the head (that is caused by the pressure of the vacuuming) but the bruise tends to fade soon after birth. A baby who is delivered by a vacuum-assisted birth is, however, more likely to develop jaundice as the red blood cells in the bruise break up and they release bilirubin. Both the bruising and jaundice are not considered to be serious complications. Babies who are delivered in this manner may also suffer from retinal haemorrhaging (which is otherwise known as bleeding in the eyes). Although the condition sounds serious, it’s temporary and there are no long-term side effects. Interestingly this can also occur in babies who have not been delivered with assistance.
Women who have vacuum-assisted delivery increase the risk of tears in the vagina, perineum, and the anal sphincter but the tearing risk is increased with a forceps delivery.
Delivery with forceps
Forceps look like a pair of surgical tongs. The forceps are inserted into the vagina and applied to the sides of the baby’s head. When a woman experiences contractions, the doctor will grab the handles of the forceps and gently pull the baby down the birth canal while the mother is pushing. A baby may be bruised slightly by the forceps and it takes a few days for the bruises to fade. In some cases, blisters may start to form on the baby’s head in the areas where the forceps clamped the head. The blisters will heal after a few weeks. Another risk with the forceps-assisted delivery is facial nerve injury; any damage that is caused is generally temporary. When compared to the vacuum-extraction method, the forceps are considered as being slightly more risky as the birthing mother risks tears to her cervix, vagina and perineum.
Recovery after an Assisted Delivery Birth
Even if a tiny tear results from the birth, the woman will need to have stitches and stitches will take a few weeks to heal properly. It may happen that the tissue around an episiotomy will tear and could cause a laceration that goes into or through the anal sphincter and this may lead to problems with gas or incontinence (the woman may experience trouble controlling her bowel movements). Even though tearing can happen during normal vaginal birth, it’s more common with assisted deliveries.
When a woman has endured a long and exhausting delivery that has demanded the use of forceps or a vacuum, the new mother may find recovery is difficult. They may experience urine leaks because of the temporary changes in the pelvic and perineal nerves and muscles. It is also not uncommon to experience pain from the recent episiotomy or vaginal and other tears and because of the pain, the new mom may be nervous to empty her bowels and this causes constipation.