Instruments Can Assist Birth, But With Risks To Mother, Child

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Forceps might be a better instrument than a vacuum cup for assisting a successful birth, but new mothers might experience more trauma and complications after a forceps delivery ...

If the choice of instrument is the vacuum device - also known as a ventouse - metal cups are more successful than soft cups in delivering a baby ...

This procedure comes with its own risks, however: Newborns are more liable to have scalp lacerations with the metal cup than the soft cup vacuum ...

"In general, these results show tradeoffs between the different instruments, with both advantages and disadvantages in most comparisons," ... "What is important is to be aware of the specific advantages and disadvantages of each instrument."

Forceps and vacuum-assisted births are relatively rare in the United States ... less than one percent of births involved forceps, and less than 4 percent involved vacuum assistance.

The decline in forceps use might be due in part to a lack of training ... "... [forceps] [are] substantially more effective at executing delivery," ...

In forceps-assisted births, the Cochrane reviewers found, women were more apt to suffer vaginal tears and trauma and experience some kind of incontinence after the birth than those who had vacuum-assisted births. They were also more likely to need general anesthesia, and to undergo a Caesarean section.

"This may be because forceps were more often used following a failed vacuum birth," O'Mahony said, "whereas the vacuum was less often used following failed forceps."

Although vacuum cups appeared to be less risky for the mother's health, they come with their own set of concerns, the researchers said.

"The risk of scalp injury with the metal vacuum cup is a particular cause for concern," ...

... some expectant mothers might not want to consider an instrument-assisted birth, but ... they should know that these instruments could help them avoid a Caesarean section, which carries its own risks. Her approach, she said, is to discuss all the options with a woman before birth, "so we can negotiate between the risks to get everyone to be safe and have a healthy mom and healthy baby."

My experience has been that forceps are more likely than a vacuum to result in a vaginal birth. Often times, if the vacuum is unsuccessful, the woman is advised to have a caesarean. In this instance, forceps might have been a better option. Forceps can be used after an unsuccessful attempt at a vacuum birth, however this does increase the risk of trauma to mother and baby.

Melissa Maimann, Essential Birth Consulting 0400 418 448