Forceps and ventouse are both types of assisted (or instrumental) delivery, in which instruments are used to assist with the birth of your baby. They can only be used during stage 2 of labour, so if your baby needs to be born quickly before this stage, she would be delivered by emergency caesarean section. An obstetrician will perform both types of delivery.
Reasons for assisted delivery
This type of delivery is commonly used if you have been pushing for a long time and your baby is making slow progress down the birth canal, particularly if she is showing signs of distress. This is more likely if progress has already been slowing during stage 1, perhaps indicating that you have a large baby or that the head is not in an occiput anterior (OA) position.
The obstetrician will carry out a vaginal examination in order to decide on the most appropriate instrument to help deliver your baby. This will depend upon the position of your baby and how far down the birth canal she is. If there is a significant chance that the instruments may still fail to deliver your baby then you will be advised to have the procedure attempted in the operating theatre. The obstetrician can then proceed to a caesarean section quite quickly. This is called a trial of ventouse/forceps. Your bladder will be emptied prior to the procedure, using a catheter, and your legs will be placed with your feet higher than your hips. Your midwife will stay with you throughout.
A ventouse uses suction to help guide your baby out, and a metal or plastic cup is placed on your baby's head.The cup gets its suction either from a separate machine via a tube or from a hand-held device. While you push with each contraction, the obstetrician will gently pull the cup, guiding your baby out. It is not always necessary to have an episiotomy with this procedure.
Forceps are a pair of metal instruments that look rather like two large salad servers. They link together and are placed inside the vagina. The forceps cradle the baby's head and guide her out, although you still need to push with the contractions. Forceps known as Kielland's are used to help turn your baby if she is facing the wrong way. Neville Barnes'or Wrigley's forceps are used to guide and lift your baby out. As with ventouse, episiotomy is not always necessary, but is performed in many cases to help the baby's delivery.
Effects on your baby
The delivery can cause distress or trauma to your baby, so it is usual to have a paediatrician in the room, with a resuscitaire. in any case, you may have had an assisted delivery because your baby was already showing signs of stress, so it is a wise precaution to have a paediatrician and eguipmentto hand.
Babies who have had a ventouse delivery commonly have a bump on the back of their heads. This is usually reddish purple in colour and can be quite prominent. Forceps can sometimes leave two red marks on the side of your baby's head, but any bruises or bumps should go down within the first week.
Because of the bruising, these babies are more likely to develop jaundice. Occasionally, a baby appears irritable after an instrumental delivery, so it may be best not to let too many different people handle her for the time being.