Assisted birth Heather Welford If you or your baby face problems during labour, intervention may be needed. We look at the options.

In this article

Expert help Ventouse or vacuum extraction

Forceps Your role

After-effects Avoiding forceps and ventouse

If you need help, your midwife or doctor may discuss ways to help your labour along.

There are three main ways in which the medical team can help:

• Forceps
• Ventouse, sometimes known as vacuum extraction
• Caesarean section

Using forceps or a ventouse is sometimes known as 'instrumental delivery'. They're an option in the second stage of labour, when the baby is part way down the birth canal (vagina) but for whatever reason can't get any further, is progressing too slowly, or needs to be born quickly.

Intervention with forceps/ventouse or by caesarean section may be necessary if:

• You're exhausted and unable to push any longer
• Your contractions have slowed or are no longer effective
• Your baby is showing signs of distress, which means he's not getting enough oxygen - signs include a slowing of his heart rate or if he passes meconium (his first bowel movement)
• Your baby's in a position that makes a quick exit difficult - he could be face-up, for instance
• Your baby is breech (feet or bottom first)
• You have a small or differently shaped pelvis that can't open wide enough
• Your baby is premature, ill or very small, which could mean he needs to be born quickly and given special or intensive care

A silicone cup fixed to a suction pump goes over the baby's head and stays in place with suction. The mother pushes with each contraction, while the doctor pulls the ventouse. This can cause swelling of the baby's head, but this will disappear in the first few days.

These are two spoon-like instruments that fit together and are placed on each side of the baby's head. Again, the mother and doctor coordinate to help the baby come out. The baby may have a mark on either side of his head, or even bruising, where the forceps have been. This will fade in a short time.

You'll be asked to lie flat on your back and your legs will be raised and supported at the ankles in stirrups. You'll be given a local anaesthetic (unless you already have an epidural in place) and probably an episiotomy (a cut made to enlarge the opening of your vagina) too, so there's room to insert the instrument. This will be stitched up after the birth.

You and your baby may feel a bit bruised and sore afterwards. Recovery from an assisted birth can take longer than an unassisted birth. There's some evidence that ventouse is less damaging for you than forceps, but forceps may be less distressing to your baby.

Most mothers and babies make a full recovery from forceps or ventouse deliveries.

Try changing your position in labour - an all-fours position, or supported squatting, can help move things along better.

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