assisted birth
Statistics tell us that in about one in eight births a baby will need help from forceps or ventouse to be born. But what exactly do these instruments do?
When natureneeds a hand T
here are many reasons why your midwife or doctor will recommend an assisted birth for you.
Your baby may have become distressed
during labour, for example, or you may have had a long labour and have become too tired to push any more. (Or you may have a medical reason - such as heart disease - which makes it impossible for you to push for long.) Once an assisted birth - also known as an
instrumental or operative vaginal birth - is suggested for you, the healthcare professionals looking aſter you will then make the choice between using forceps or ventouse. Until recently, most hospitals used forceps far more frequently than ventouse, but the balance between the two methods is now shiſting and, if you have a preference for one over the other, you may actually be able to choose!
Forceps Sometimes described as 'stainless steel salad servers' or 'large sugar tongs', forceps come in two intersecting parts, and have curved ends to cradle your baby's head. Before forceps can be put round the baby's head, the doctor needs to enlarge the opening from the vagina by cutting through the back wall into
16MODERNMUM
the perineum (the tissue between the back of the vagina and the rectum). If you have an epidural in place, you won't feel the cut. If you haven't, your midwife or doctor will inject some local anaesthetic into the perineum before making the cut. Te forceps come in two sections and the doctor places the first blade around the side of your baby's head, and then the second blade around the other side. A mechanism fixes the forceps in place once they have been correctly positioned, and this ensures that they don't slip. You will then be asked to push with your next contraction and the doctor pulls. Basically, you deliver the baby together. Forceps have a higher success rate than ventouse, but you're more likely to sustain some damage to your pelvic floor or perineum during a forceps delivery than in a ventouse delivery.
Ventouse Te ventouse - or vacuum extractor - has a cup attached to a small vacuum pump and a handle for pulling on. Te cup fits on top of and towards the back of your baby's head. Tere are several types of ventouse cups: soſt, plastic, semi-rigid plastic and metal. Te type of cup used may depend on your baby's position and on how difficult your doctor thinks the delivery is going to be.
Te doctor or specially-trained midwife
places the ventouse cup on your baby's head inside the vagina and then sucks the air out of the cup using a foot-controlled vacuum pump or hand-help pump. Once the cup is securely fixed, the doctor will ask you to push with your next contraction, and he or she will then pull on the cup to help your baby out. If your baby is not moving down with
each pull, or is not born following three contractions, then the use of the ventouse may be stopped. An experienced doctor may try using forceps before opting for a Caesarean, although using different instruments one aſter the other can increase the risk of injury to your baby.
Aſterwards If you have to have an assisted birth, it's a good idea to find out the reasons why it happened, as this will make you better prepared for future pregnancies. Once you've recovered from the delivery, talk to the doctor or midwife who performed the assisted birth and get as much information as you can. But don't worry needlessly about future births. Te good news is that eight out of ten women who have had an assisted birth have a normal birth next time round.„
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