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Vacuum extractors have replaced forceps for many situations in which assistance is required to achieve vaginal delivery. Compared with metal-cup vacuum extractors, soft-cup devices are easier to use and cause fewer neonatal scalp injuries; however, they detach more frequently. Source: American Family Physician
Medical information intended to reassure parents with statistics like “rare” and “fewer injuries than…” are of little comfort to parents whose baby suffered a birth injury.
The following information explains vacuum-assisted delivery, potential complications for the mother and birth injuries to her baby, and when vacuum extraction should never be performed.
What is a vacuum extraction delivery?
Also referred to as “vacuum assisted delivery,” a vacuum extraction delivery is a type of assisted vaginal delivery. This type of assisted delivery may also be referred to as an “operative vaginal delivery” (forceps delivery is another type of assisted or operational vaginal deliver.) This simply means that a vacuum extractor was used to help deliver the baby.
What is a vacuum extractor and how is it used during the birth process?
A vacuum extractor is a medical device sometimes used to assist vaginal deliveries. 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 contractions.
Vacuum extraction is done (if necessary) during the second stage of labor (when you are actively pushing.)
If vacuum extraction fails, a cesarean delivery (C-section) might be needed.
When might a doctor use VE to help deliver a baby?
In certain situations, a baby may need help being delivered and a doctor may offer the mother in labor the option of a caesarean birth, forceps delivery, or vacuum extraction. However, in certain situations, your doctor may simply recommend or decide that you need a VE delivery and not offer you an option given the urgency and nature of your particular situation.
Vacuum extraction may be necessary:
- If your baby’s heart rate or rhythm is abnormal (a nonreassuring heart tracing on the fetal monitor.)
- If your baby is in fetal distress and needs to be delivered quickly.
- If there is a prolonged or stalled second stage of labor.
- The mother is exhausted and can no longer push, or has received medications that inhibit her ability to push.
- The mother’s health is in jeopardy (i.e., she has a medical condition such as high blood pressure, aneurysm, or a heart condition that would make pushing too hard or dangerous.)
What are the risks associated with a VE delivery?
As with any medical procedure, the use of a vacuum extractor to aid in delivering a baby has the risk of complications, however, the benefits of correct use of VEs may outweigh the risks of delaying birth, or those of a cesarean delivery for certain women who may have their own health risks.
A VE delivery carries the same risks for both the mother and her baby as a non-assisted vaginal delivery, however, there are additional risks associated with any assisted vaginal delivery, and there are more likely to be complications in a VE delivery than in an unassisted vaginal delivery. Some studies indicate risks of a VE delivery may still be preferable to those of a forceps delivery, but each birth situation requires a doctor to properly assess and advise the best course of action in the moment.
After a vacuum extractor delivery, there may be some mild abrasions, bruising or swelling on the baby’s scalp.
Additional Health Risks and Birth Complications for the Mother
Possible risks to the mother include:
- Difficulty Urinating or Emptying Your Bladder
- Short- or long-Term Urinary or Bowel Incontinence (involuntary urination or defecation)
- Secondary Anemia Due to Blood Loss
- Third Degree Tear (if you have an episiotomy ,there is also a risk of postpartum bleeding and infection.)
- Injuries to the Bladder and/or Urethra
- Uterine Rupture — when the uterine wall is torn, which could allow the baby or placenta to be pushed into the mother’s abdominal cavity
- Pelvic Organ Prolapse (Tearing, or weakening of the muscles and ligaments supporting pelvic organs, causing pelvic organs to drop lower in the pelvis.)
Possible risks to your baby include:
- Brachial Plexus Injuries
- Cerebral Palsy
- Developmental Delays
- Intercranial Hemorrhage
- Scalp Lacerations and Bruising (see photo, above)
- Shoulder Dystocia
- Subgaleal Hemorrhage (bleeding between the scalp and the skull)
When Should Vacuum Extraction Not Be Done
Although your birth story is unique, and your doctor’s decisions factor in more than we can in an article, in general, the following are situations in which the Mayo Clinic has stated that vacuum extraction is considered by most medical experts to be unsafe to attempt:
- You’re less than 34 weeks pregnant;
- Your baby has previously had blood taken from his or her scalp (fetal scalp sampling);
- Your baby has a condition that affects the strength of his or her bones, such as osteogenesis imperfecta, or a bleeding disorder, such as hemophilia;
- Your baby’s head hasn’t yet moved past the midpoint of the birth canal;
- The position of your baby’s head isn’t known;
- Your baby’s shoulders, arms, buttocks or feet are leading the way through the birth canal; and/or
- Your baby might not be able to fit through your pelvis due to his or her size or the size of your pelvis.
Did your baby suffer a birth injury as the result of a vacuum assisted vaginal delivery?
If you, or your baby suffered a severe injury as the result of an assisted vaginal delivery or medical neglect or malpractice you may be entitled to compensation. If you have questions about what happened and why your baby was injured, don’t trust an insurance company or doctor to provide you with all the information you need, call our lawyers today and take your first step in protecting you and your baby’s rights.
We offer a free legal consultation so you can tell us about your unique situation. We will be able to tell you if you have a case, the value of your case, and discuss your various legal options. We encourage you to at least talk to us and learn what your rights are so that you will have knowledge to help you make the best decision for your family about how to protect those rights for your child.
The Los Angeles area law firm of Donahue & Horrow, L.L.P., handles birth injury cases throughout California. The initial consultation will be at no cost. All cases are billed on a contingency fee basis — there will be no cost to you unless or until we recover compensation in the form of an insurance settlement or trial award.
Contact us today and you will have taken your first step towards ensuring your child’s future needs will be met.