Instrumental birth

An instrumental birth refers to the use of either forceps or ventouse (suction cup). An instrumental birth happens for 1 in every 8 births.  

Forceps are metal instruments which fit together around your baby’s head to speed up the process of baby being born during the pushing phase.  The doctor will pull the forceps as you also push down during a contraction.

Ventouse is a suction cup which is placed on baby’s head firmly and also pulled by the doctor while you push.  

The choice of instrument will depend on the situation, how many weeks pregnant you are and how low the baby has already descended into the pelvis.  This should be discussed with you fully and will only be carried out with your consent.

An assisted birth will be suggested if there are concerns about your baby’s heart rate, your wellbeing or if pushing has gone on over a long time with not much progress.

If you don’t have an epidural in place, then some local anaesthetic can be given called a pudendal block.  An episiotomy (a cut to the vaginal opening in order to make more space) may be needed. The doctor will repair this after the delivery of the placenta using dissolvable stitches.

What are the risks of an instrumental birth to me?

• 3^rd or 4^th degree tear - this is when you have a tear leading down from your perineum (the skin and muscles between your vagina and anus), which affects the anal sphincter and will need to be repaired in theatre.  It can lead to issues with urine and faecal retention.
• Extended episiotomy - this is when the cut that is made extends further when baby’s head is born.
• Postpartum haemorrhage (excessive blood loss after birth).
• Higher chance of a blood clot.
• Urinary incontinence.
• What are the risks of an instrumental birth to baby?
• Baby may be left with a bruise from where the ventouse cup has been placed, but this will resolve in a couple of days.
• Baby may be left with marks from the forceps on their head or face, or partial facial palsy, and this will resolve in a couple of days.
• Baby is more likely to be jaundiced due to any bruising caused by instruments.

Here is an NHS video about instrumental birth: Forceps or vacuum delivery - NHS (www.nhs.uk)