An assisted or instrumental delivery is when the birth of a baby is aided by forceps or ventouse extraction.
Forceps are like large metal tongs designed to fit around the baby’s head.
The tongs will be gently placed around the head while a medical practitioner will hold on to the handles. During a contraction, the patient will be asked to push and the clinician will pull the forceps, delivering the baby’s head. More than one pull may be required.
An episiotomy may also be needed in order to make enough room for the forceps to be applied.
Sometimes forceps will be used in order to turn the baby into the correct position. There are different types of forceps that are employed for this purpose.
A ventouse can also be known as a ventouse suction cup or vacuum extraction.
A metal or plastic cup is attached to the top of the baby’s head. The cup is attached to a tube, which is attached to a suction device. During a contraction, the patient will be asked to push and the clinician will pull on the tube. The cup will remain suctioned to the baby’s head which will help deliver the baby.
Forceps or ventouse?
A forceps delivery has a higher rate of success than a ventouse delivery. However, forceps are more likely to cause a perineal tear.
The mode of instrumental delivery will be decided upon by the obstetric team. It will come down to clinician preference and the urgency of the situation. Sometimes it is essential that the baby is delivered as quickly as possible. For example, because of:
- Maternal exhaustion
- Concerns over the baby’s heart rate
- Concerns over the mother’s condition
- Shoulder dystocia
Instrumental delivery in theatre
Where there is a sense of urgency, doctors may decide to move a patient to theatre before attempting an instrumental delivery. If the assisted delivery does not work, doctors can proceed immediately to an emergency Caesarean section.
Risks of assisted delivery
There are certain risks associated with an instrumental delivery. A ventouse can leave a bruise on the baby’s head. Furthermore it is not appropriate for premature babies as their heads will still be too soft. Forceps can leave small cuts on the baby’s face.
As mentioned above, an instrumental delivery also increases the chance of a severe perineal tear. This in turn can result in ongoing anal incontinence. Around 4% of women will have a 3rd/4th degree tear after a ventouse extraction. Around 8-12% of women will have a 3rd/4th degree tear after a forceps delivery.
Nevertheless, an instrumental delivery is intended to avoid more serious complications, so it is generally considered to be better to continue with an assisted delivery if needed. The main reason why it might be deemed negligent is if the 3rd or 4th degree tear is not diagnosed and repaired.
If your tear was not diagnosed and treated, you need to talk to a solicitor today.