A vacuum extractor is a small cup connected to a suction pump that may be used to help with your baby’s birth. The cup is placed on your baby’s head. When you push, your caregiver will use the suction to help your baby move through the birth canal. Vacuum extraction may be used to:
- Speed up delivery if your baby is in distress
- Speed up delivery if you are exhausted and unable to push
- Turn baby’s head to a better position
Disadvantages:
- The extractor temporarily molds (shapes) or bruises your baby’s head. This bruising disappears within a few days
- Large amounts of bruising may increase the jaundice risk for your baby
Forceps
Forceps are metal devices that may be gently applied to your baby’s head to help with the birth. When you push, your caregiver uses them to help your baby move through the birth canal.
Forceps may be used to:
- Speed up delivery if your baby is in distress
- Speed up delivery if you are exhausted and unable to push
- Change your baby’s position
- Protect the head of a premature baby during delivery
- Avoid a cesarean birth when vagainal delivery can be done safely
- Help you deliver your baby’s head during a vaginal breech birth
Disadvantages:
- An episiotomy may be necessary for a forceps delivery
- There may be an increased risk of bruising or a tear to your cervix and vagina
- Forceps can cause bruising, or red marks on your baby’s head. These usually fade within a few days
Episiotomy
An episiotomy is a cut made through the perineum, the area between the vaginal opening and the anus, done to enlarge the vaginal opening. It may be performed at the end of the second stage (pushing) of labour if there is a need for the baby to be born quickly, or if you need assistance with forceps.
There are 2 main types of episiotomy that may be performed:
Midline: Straight down from the vaginal opening towards the anus
Advantage:
- A smaller cut
Disadvantages:
- If it continues on it could tear into the anal area
Medio-lateral: Slightly downward and out to the side towards the leg
Advantages:
- A larger opening for baby
- If it continues on the tear will be away from the anal area
Disadvantages:
- Larger area to heal, and could be more painful
The episiotomy will be closed using dissolvable sutures.
Episiotomy is not a routine procedure and is not necessary in most normal labour and birth situations. There are some things that may reduce the need for an episiotomy:
- Maintain a good healthy diet to the end of your pregnancy
- Practice perineal massage in the last month of your pregnancy
- Daily “Kegel” or pelvic floor exercises during pregnancy (and for life)
- Discuss your preference of avoiding an episiotomy with your caregiver before going into labour
- Using upright positions for pushing and delivery
- Having your caregiver use perineal massage and warm compresses during pushing
- Listening to your healthcare provider when the baby’s head is crowning so that it is eased over your perineum in a controlled manner