Assisted Delivery

When labor doesn't progress smoothly, some assistance becomesnecessary. Popular procedures involve the use of instrumentssuch as forceps or a vacuum extractor. Common reasons forassisted delivery are -

• Fetal distress - heart beat slows down in response tocontractions
• Maternal distress - the mother is too tired to push;has heart, muscular or respiratory complications
• Prolonged labor or prolonged second-stage labor
• Baby's head is facing the wrong direction or if baby'shead is too large for the pelvis

Prerequisites before the Procedures

• Cervix needs to be fully dilated and effaced and themembranes ruptured; the fetal head has to be engaged
• Prep time takes about 30-45 minutes; the birth is overwithin 2-3 contractions
• An experienced physician should handle the procedure.Choice of instrument used will depend after a vaginal examinationto determine which is more appropriate
• An epidural or a local anesthetic will be given to numbthe perineal area
• A thin catheter will be inserted in the bladder to emptyit
• An episiotomy may be performed to enlarge the vaginalopening
• All necessary preps for a C-section should be made incase instrumental delivery fails

Forceps-assisted Birth

• The instrument is shaped like a pair of scissors whichwhen hooked together look like salad tongs. It may lookscary but it is preferred if your doctor deems it necessaryor to avoid a C-section.
• Forceps are used to help turn the baby's head if he isfacing the wrong way
• One spoon goes in one at a time into the vagina to cradlearound the temples of the baby's head. With the uterinecontractions and the mother pushing, your doctor gentlypulls on the forceps to help the baby through the canal.
• Forceps delivery will only be used if the baby's headis properly engaged in the mother's pelvis. A cesareanwill be performed otherwise.
• Episiotomy may always be necessary but it is performedin most instances to help with the delivery

Vacuum-assisted Birth

• Also known as venthouse birth, it is an alternative toforceps. A venthouse or vacuum extractor uses suction toguide the baby out.
• A rubber or plastic cup is pressed against the baby'shead; the cup gets its suction through a tube from a vacuumbottle attached to a small pump.
• With each push the obstetrician will gently pull thecup and guide the baby out.
• Again, episiotomy may not always be necessary with thisprocedure

Instrumental birth and the Baby

• Baby is able to feel the blades of the forceps or thevacuum cup as well as the force which is applied duringthe contractions
• Pressure will only be exerted when the mother is activelypushing
• Venthouse delivery mostly leave a prominent reddish purplecolored bump on the back of baby's head
• Forceps can sometimes leave two red marks on baby's temples.Both bruises and bumps take about a week to subside
• Sometimes bruising cause babies to become irritable andeven develop jaundice
• Immediate special care services are usually arrangedfor babies who were already in distress prior to the useof the instruments. The delivery style has nothing to dowith the need for special care.

Instrumental birth and the Mother

• The mother is likely to feel sore and bruised. In caseof stitches special care needs to be taken to help in thehealing.
• Some women may feel a sense of disappointment but don'tforget baby's safety necessitated the use of instrumentsduring delivery.
• Once an assisted delivery doesn't mean always an assisteddelivery. Similar assistance may not be necessary withthe second delivery because fatigue experienced will beless this time round and fetal distress may not even bea possibility because of a shorter labor.