What is an assisted delivery?

An assisted birth, also known as an instrumental birth, means that your doctor or midwife ‘assists’ or helps your baby out of your vagina during birth. Your doctor or midwife may use instruments such as a vacuum cup or forceps to assist at your baby’s birth.

Why might I need one?

Your baby is unwell and needs to be born quickly
Your baby is in a position that makes it difficult for them to be born
Your baby is bigger you are unable to push effectively, or you have a medical problem that means you shouldn’t push during labour

How is an assisted delivery done?

An assisted birth is usually done by an obstetrician, but other medical staff, including midwives, will be there to assist. A paediatrician may also be in the room to make sure your baby is healthy after the birth. An assisted birth can only happen if your cervix is fully dilated (to 10cm) and if you baby is low enough in your pelvis. In some cases, your doctor may choose to do the assisted birth in an operating theatre. This is especially true if they think there is a chance you may need to have a caesarean, for example if your babies head is still quite high in your pelvis. Your doctor generally offer pain relief. This may include an epidural anaesthetic, or a local anaesthetic injected around the birth canal. Your doctor or midwife will insert a catheter in your bladder to make sure it is empty before the birth, so your baby has enough room to move through the birth canal.

TYPES OF ASSISTED DELIVERIES

VACUUM/VENTOSE

A ventouse is an instrument that assists the baby’s delivery using a very gentle vacuum extractor. A small plastic or metal cup is attached your baby’s head, which is connected by a tube to a suction device. This may leave a small suction mark on your baby’s head, although it generally goes away quickly. A ventouse is more gentle to mothers than using forceps, and is less likely to cause vaginal tearing

FORCEPS

Forceps are smooth hand-held metal instruments, similar to tongs, which are used to pull your baby during delivery. They are curved so that they fit around your baby’s head. During each contraction, your doctor will tell you to push while they use the forceps to ease your baby through the birth canal.

INSTRUMENTAL BIRTH RISKS TO YOU

Almost 100 percent chance of an episiotomy 3rd or 4th degree vaginal tear
Higher risk of blood clots
Urinary incontinence
Anal incontinence
There's a higher chance of having a vaginal tear that involves the muscle or wall of the anus or rectum, known as a 3rd- or 4th-degree tear. Stats show 4 in every 100 women having a ventouse delivery will have this tear and 8 to 12 in every 100 women having a forceps delivery have this tear.
After an assisted birth, there's a higher chance of blood clots forming in the veins in your legs or pelvis. You can help prevent this by moving around as much as you can after the birth.
Urinary incontinence (leaking pee) is not unusual after childbirth. It's more common after a ventouse or forceps delivery. You should be offered physiotherapy to help prevent this happening, including advice on pelvic floor exercise

INSTRUMENTAL BIRTH RISKS TO BABY

A mark on your baby's head being made by the ventouse cup – this usually disappears within 48 hours
A bruise on your baby's head – this happens to around 1 to 12 of all 100 babies marks from forceps on your baby's face – typically usually disappear within 48 hours
Small cuts on your baby's face or scalp – these affect 1 in 10 babies born using assisted delivery
Yellowing of your baby's skin and eyes – this is known as jaundice, and should pass in a few days