What Is Vacuum Assisted Delivery? Its Procedure & Alternatives

Image: iStock

There are times during natural childbirth or vaginal deliveries when certain situations or complications may require a doctor’s intervention to assist the delivery. Vacuum-assisted delivery is one such method to assist complicated natural deliveries where a baby is pulled out from the birth canal with the help of a vacuum pump.

Read along to know more about vacuum-assisted delivery, its types, procedure, prerequisites, risks, and when to avoid this procedure.

What Is Vacuum-Assisted Delivery?

When the mother is unable to push anymore while delivering the baby, doctors take the help of instrumental delivery, such as a vacuum-assisted vaginal delivery. In this case, a vacuum cup is used to pull out the baby from the birth canal. The vacuum cup, also called the ventouse cup, is a medical equipment made of plastic and attaches to the baby’s head, pulling it out with the help of a vacuum (1).

Why Is Vacuum-Assisted Vaginal Delivery Done?

There may be several reasons why a doctor can suggest assisted mode of delivery with the help of a vacuum cup (2).

• Second stage of labor is progressing slower than expected,
• The mother is unable to push further because she is exhausted or cannot push hard due to some medical conditions.

Danielle LaSusa, a mother and philosophical coach, shares the challenging experience of delivering her baby through vacuum-assisted birth while she was exhausted and battling a fever. She says, “Now, twenty-nine hours after my labor began, it was time for the morning shift change at the hospital. Another OB and nurse came in, and after assessing the situation, she determined that a vacuum assist was needed… The new OB warned me: you only get a few tugs with the vacuum, three or four contractions worth, and if the baby is not out by then, we’d have to go to the OR for a c-section.” Eventually, LaSusa pushed as per the doctors’ guidance and her baby girl was born vaginally (i).

• There are concerns about the neonatal health and safety of the baby, necessitating prompt delivery.

Prior to conducting an assisted delivery, the obstetrician-gynecologist. will take into account several factors, including: (3).

Image: Shutterstock

• Whether the fetus is in the birth canal
• The dilation of the cervix
• The weight of the fetus

What Are The Indicators For A Vacuum-Assisted Delivery?

There are several possible situations under which the doctors recommend going forward with a vacuum-assisted delivery. Some of the common maternal and fetal indicators for this include (4) (5):

Maternal indicators:

• The mother is exhausted, or there is a lack of cooperation
• Insufficient maternal expulsive efforts
• The mother has cardiac or cerebrovascular issues that require her to avoid expulsive efforts

Fetal indicators:

• Non-reassuring heart rate of the fetus
• Failure to progress to the second stage of labor
• The second stage of labor is prolonged

How Is Vacuum-Assisted Delivery Done?

Image: Shutterstock

The procedure for vacuum-assisted delivery is described as follows (6).

• You will be given a local anesthetic injection or an epidural (injection in the back) to block pain during the procedure.
• The vacuum cup is gently placed in a balanced way across the fetus’ scalp.
• Once the cup is successfully placed, the cup’s circumference is checked to avoid the tissues of the vaginal or cervical area from getting confined in between.
• After checking the circumference and the attachment, suction is applied. The pressure of the vacuum extractors is gradually increased. increased from 100 to 150 mm Hg to maintain the cup’s correct position.
• Once the appropriate pressure is reached, pressure is applied along the pelvic curve with the help of two hands to help the process of traction.
• The traction is discontinued when the mother stops pushing at the end of a contraction.

Point to consider

The general recommendation states that vacuum-assisted deliveries should be done with a maximum of three sets of pulls and two to three cup detachments. The vacuum application time should not be more than 20 to 30 minutes (6).

What Are The Complications Of A Vacuum-Assisted Delivery?

Fetal morbidity is a notable complication of vacuum-assisted delivery. In addition, it increases the chances of injuries, such as scalp lacerations, intracranial hemorrhageⁱXBleeding into the skull and brain tissue , retinal hemorrhage, and cephalohematomaⁱXCollection of blood under the baby’s scalp due to a birth injury , by 5% more common with the metal cup, and less in silicon or plastic cup (6).

Maternal complications of the procedure can include the following.

• PerinealⁱXArea between the genitals and anus pain during delivery
• Heavy blood loss after delivery
• Stool and urinary incontinenceⁱXA condition characterized by the loss of bladder control
• Hematomas (accumulation of blood outside the blood vessels)
• Vaginal tears or perineal lacerations
• Maternal morbidity

Things to know

Soft bell-shaped cups cause fewer scalp injuries in neonates and have a reduced risk of maternal perineal injury compared to rigid cups (6).

When Is Vacuum-Assisted Delivery Not Recommended?

Vacuum-assisted delivery may not be recommended in the following scenarios.

• The cervix is not fully dilated.
• Cephalopelvic disproportionⁱXA childbirth complication where there is a mismatch between the size of the baby’s head and the mother’s pelvis suspected. .
• The baby’s head is not low enough into the birth canal.
• There is an increased chance of the baby bleeding in the womb.
• The fetus has low bone density.

In such cases, the doctor may soon perform a cesarean delivery to prevent injuries in the mother and the baby.

Image: Shutterstock

Are There Alternatives To Vacuum-Assisted Birth Procedure?

Maternal health and the stage and duration of labor, as well as the health conditions of the baby, determine the potential alternatives to assisted delivery. The other techniques that are usually considered are:

• Expectant management or watchful waiting of the symptoms
• Stimulating the intensity and frequency of uterine contraction with the help of oxytocinⁱXA hormone secreted by the pituitary gland to stimulate contractions during childbirth and lactation
• Emergency cesarean section

Infographic: Notable Complications Of Vacuum-Assisted Delivery

Vacuum-assisted delivery, a prevalent medical intervention during childbirth, presents potential risks and complications. This infographic delivers a concise summary of the possible complications associated with the procedure. It equips expectant parents with essential knowledge for informed decision-making and effective management.

Illustration: Momjunction Design Team

Was this article helpful?

The following two tabs change content below.

• Reviewer
• Author
• Editor
• Fact-checker

Dr. Evert PangkahilaM. Biomed, SpOG(K), Subspes- KFM

Dr. Evert Pangkahila is an obstetrician & gynecologist, and a maternal and fetal medicine consultant in Indonesia with eight years of experience. He is a lecturer at Udayana University and runs a private hospital in Bali. Dr. Pangkahila obtained his medical degree in 2008 from the Udayana University, and a master’s degree in Biomedical Science. After doing a specialty in...more

Sanjana BhattacharjeeMSc

Sanjana did her post graduation in Applied Microbiology from Vellore Institute of Technology, India. Her interest in science and health, combined with her passion to write made her convert from a scientist to a writer. She believes her role at MomJunction combines the best of both worlds as she writes health-based content based on scientific evidence. Sanjana is trained in classical...more

Rebecca MalachiBSc

Rebecca is a pregnancy writer and editor with a passion for delivering research-based and engaging content in areas of fertility, pregnancy, birth, and post-pregnancy. She did her graduation in Biotechnology and Genetics from Loyola Academy, Osmania University and obtained a certification in ‘Nutrition and Lifestyle in Pregnancy’ from Ludwig Maximilian University of Munich (LMU). She has been into health and...more

Reshmi DasMSc

Reshmi Das has over four years of experience as a clinical coordinator, medical content writer and medical conference coordinator. Her continuous interest in medical journals and writing makes her write well-researched articles for MomJunction. She writes health and wellness articles for children and pregnant and lactating women. Reshmi has completed her post graduation in Biotechnology from MITS School of Biotechnology,...more