Vacuum extraction is one kind of assisted delivery procedure that can help get your baby through the birth canal when labor is stalled in the second stage. The vacuum extractor applies suction and traction to the baby’s head to help pull it out while you push. Vacuum extraction is only recommended under certain conditions.
During the second stage of labor, when you’re actively trying to push your baby out, sometimes the process of childbirth seems to stall. You’re trying, but the baby isn’t coming. This can go on for hours. While you’re in labor, your healthcare team will monitor your vital signs and your baby’s heart rate to stay alert to any signs of fetal distress. If you or your baby’s health is in danger from prolonged labor, and labor isn’t progressing, your healthcare team will look for ways to assist you in delivering your baby.
Vacuum extraction is one way they can assist. If certain conditions are met — your baby’s head is low enough in the birth canal and they’re in an appropriate position — a vacuum extractor may be able to help guide them out. The vacuum extractor consists of a suction cup attached to a mechanical or electric pump. The cup is applied to your baby’s head and the pump provides traction to pull while you push. It's not always the solution you need, but sometimes it does the trick.
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Vacuum extraction, or “ventouse,” is one method healthcare providers use to help get your baby out when they aren’t coming out on their own. There are other methods, including forceps delivery and c-section. Usually, surgery is considered a last resort. Vacuum extraction and forceps delivery offer additional ways for healthcare providers to assist laboring mothers before resorting to c-section delivery.
Vacuum extraction and forceps delivery are similar in their advantages and disadvantages, and often the choice between them comes down to the training and experience of your healthcare provider. Both methods carry some risk, but healthcare providers recommend them when the risks of not helping appear to be greater. This might be because either you or your baby are suffering from prolonged labor.
In the US, vacuum extraction accounts for about 2.5% of vaginal births. Overall, rates of both vacuum extraction and forceps delivery have been falling while cesarean rates have been climbing. Assisted vaginal delivery is only indicated under specific conditions. If those conditions aren’t met, your provider might recommend a cesarean instead.
Vacuum extraction might be indicated if:
Healthcare providers see an abnormal fetal heart rate as a sign that the baby isn’t getting enough oxygen during labor. It’s normal for oxygen to be restricted temporarily during labor, but if it goes on for too long, it’s dangerous to the health of the baby.
Your baby’s heart rate might be considered non-reassuring if:
If your baby’s heart rate indicates possible distress, your healthcare team might first try to compensate by:
If these interventions don’t improve your baby’s heart rate or advance labor, your healthcare team may recommend an operational procedure such as vacuum extraction.
Sometimes you might need assistance, but vacuum extraction isn’t the right choice. This might be true if your baby:
Before the procedure, you’ll be informed of the risks and benefits of vacuum assistance and asked for your consent. You’ll be offered pain relief if you haven’t had it already. In some cases, your delivery assistant may need to perform an episiotomy — an incision between the birth canal and the anus — in order to widen the opening of the birth canal. They may also break your water and drain your bladder.
Your delivery assistant will carefully position the cup of the vacuum (ventouse) in just the right spot on your baby’s head, making sure not to trap any vaginal tissues under it. On your next contraction, they will apply traction with the mechanical or electric pump. The idea is to add the force of the vacuum to the force of your contraction, pulling when you push, and pausing when you pause.
The delivery assistant is trained in how to apply just the right amount of suction to the vacuum. Too much suction can cause scalp injury to the baby, but too little can cause the cup to detach from the baby’s scalp. While applying suction with one hand, they will grasp the cup with the other hand to try and guide the baby’s head through the birth canal.
If the cup detaches repeatedly from the baby’s head, or if there is any sign of bruising to the baby’s scalp, your delivery assistant will abandon the vacuum extractor. If the vacuum is successful, your delivery assistant will detach it as soon as your baby’s head is safely out. Now they can use their hands to help deliver the rest of the baby.
Once your baby has been completely delivered, your healthcare team will check you and your baby out for any signs of wounding from the procedure. If you had a tear or an episiotomy, they’ll repair it for you. They’ll continue to monitor your baby for any signs of complications that might arise. Some complications may take several hours to present. If no complications arise within 10 hours, you and your baby can go home and recover normally.
If vacuum extraction is unsuccessful, your healthcare team may recommend a c-section next.
When conditions are favorable, vacuum extraction can help deliver your baby from an oxygen-deprived environment without putting you through surgery. It's also faster than surgery, which is sometimes very important.
Risks to the mother from vacuum-assisted delivery are comparable to the risks of childbirth in general. They include:
Short-term side effects of vacuum extraction for the baby can include:
Serious complications for the baby are rare. They can include:
If there are no serious complications, you’ll recover normally over the next six weeks. You might need to wear a pad for normal vaginal bleeding. You can manage your pain with over-the-counter medications while you heal. If there are any stitches, they will dissolve on their own.
If your baby has any of the common short-term side effects of vacuum delivery, such as bruising, jaundice or scalp swelling, these will resolve over the next few weeks. Take extra care to protect your baby’s head while it heals and make sure to bring them in for follow-up checkups.
A note from Cleveland Clinic
Many mothers hope and plan for a simple vaginal birth, but the course of childbirth can have its twists and turns. When difficulties arise, it's good to know the options available to you. Vacuum extraction is one strategic tool that you and your healthcare provider might choose to help deliver your baby under certain conditions. As you plan for your childbirth, you can discuss interventions like vacuum extraction with your healthcare provider in advance. They’ll help you understand the risks and benefits and make a plan for how to proceed if you need help delivering your baby.
Last reviewed by a Cleveland Clinic medical professional on 01/28/2022.
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