Vacuum Extraction, Forceps Delivery, and Birth Trauma Risks

Vacuum Delivery Forceps Delivery Brain Damage Risks to Mother

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Last updated Oct. 18, 2017.

Sometimes the baby needs a little help getting through the birth canal. A difficult labor may be caused by an unusual birth position, high birth weight, the anatomy of the mother’s pelvis and birth canal, and other maternal and fetal health conditions.

Prolonged labor is painful and exhausting and can be dangerous to the baby. That means doctors want to get the baby delivered within a certain amount of time. They may use vacuum extraction or help delivery along with forceps. While those devices can speed up delivery, they also increase the risk of birth trauma.

Here’s what you need to know about vacuum extraction, forceps delivery, and their associated risks. If your baby has been injured by either method, you may be entitled to compensation.

Vacuum Extraction vs. Forceps Delivery

When would you need a vacuum extraction or forceps delivery? Your doctor may want to use vacuum extraction or forceps when your labor has “stalled.” That means you’re still in labor and you’re still pushing, but you’re not making progress toward actually delivering the baby. First, you may be running out of energy. Labor is also stressful for the baby and the physician may want to move the delivery along if your little one’s heart rate is indicating a high level of stress.

These techniques are typically performed in hospitals or in birth clinics where a C-section may be performed. If assisted vaginal delivery does not succeed in getting the baby out through the birth canal, you may need a C-section.

Delivery assistance is quite common; about 1 in 20 vaginal deliveries in the U.S. end up using some form of assistance. Vacuum extraction is becoming increasingly favored over forceps, but both techniques are still in use.

A vacuum extraction involves placing a small, flexible, round cup to your baby’s head in the birth canal. A small electrical or handheld pump is used to create suction so that the cup holds securely to the baby’s head. The doctor can then pull gently on the cup to guide the baby down the birth canal as you push. This technique can only be used if the baby is born headfirst and is at full term; it can be dangerous for premature babies.

Vacuum extraction is also called “ventouse,” from the French word for “suction cup.”

A forceps delivery is similar to a vacuum extraction. Instead of a suction cup, the doctor will insert a pair of forceps (spoon-shaped tongs) into the birth canal and gently grasp the sides of the baby’s head. She’ll use the tongs to gently pull the baby out as you push.

Forceps delivery may be used for babies in abnormal birth positions and for premature babies.

When does a forceps or vacuum delivery cause brain damage?

Both vacuum extraction and forceps delivery are generally safe for both mother and baby. Both techniques can cause bruising on the baby’s head; it may look scary but is generally harmless and will fade within a few days.

The bruise caused by ventouse is called a cephalohematoma and may increase your child’s risk for mild jaundice as the blood that makes up the bruise breaks up. The pressure of a vacuum extraction can also break minor blood vessels in the baby’s eyes. This is called retinal hemorrhage; it sounds scary but it’s not serious and will clear up in a few days or a week.

In addition to these relatively minor risks, vacuum extraction and forceps delivery can cause serious birth trauma. The suction can cause bleeding in the skull or even a skull fracture. Those injuries can cause permanent brain damage and put your child at risk for lifelong physical and intellectual disabilities.

Ventouse (vacuum extraction) increases the risk that the baby’s shoulders will get stuck after the head is delivered, which can cause broken collarbones and injuries to the brachial plexus nerves. Broken collarbones typically heal quickly and completely. Brachial plexus injuries may or may not heal, depending on the severity of the damage to the nerves.

Forceps delivery can also cause skull fractures, skull bleeding, and bruising on the face and head. It may also damage the cranial nerves, resulting in facial paralysis. This type of nerve damage is usually temporary, but serious damage is permanent.

In some cases, the use of forceps may damage the baby’s brain and cause seizures.

Forceps Delivery Risks to Mother

Delivery assistance devices aren’t just hard on the baby. They also pose certain risks to the mother. Most importantly, they can cause tears in the tissue between the vagina and the anus. This is painful and requires stitches to repair.

In some cases, your doctor may perform an episiotomy, a procedure in which that tissue is cut with a scalpel, before using a delivery assistance device. This ensures that the cut is clean and can easily be stitched back together.

This type of tearing can also happen in an unassisted vaginal delivery, but the risks are higher with a vacuum extraction and highest of all with a forceps delivery.

See also: Millions of Women Don’t Know They Have Birth Injuries — and They’re Suffering

What are my legal options if I’m injured?

Most injuries associated with delivery assistance devices are mild and will clear up on their own. Some are unavoidable and not the fault of the doctor or other medical care providers. Some injuries, however, are caused by the negligence of a medical care provider. A doctor who places the forceps improperly, pulls too hard, or twists your child’s neck during delivery may be acting negligently and putting your child at risk.

In the hands of an inexperienced or untrained physician, a delivery assistance device can cause you and your little one serious injuries. If you or your child were injured by a vacuum extraction or forceps delivery, you may be entitled to compensation for medical bills and other costs. This type of injury is one of the most common reasons for birth injury lawsuits.

If your child was injured by a delivery assistance device, please reach out to Safe Birth Project to learn more about your options.


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9 replies
  1. Laura
    Laura says:

    My daughter was delivered vaginally, after episiotomy and 3 suction attempts. She went into cardiac arrest 3 times before delivery, I assume because the the cord was around her chin.
    Her apgars were 9, 10, 10, then all 10’s.
    She had a raised suction bruise on her scalp and at about 1-2 weeks developed fairly severe jaundice.
    Her childhood was plagued by emotional outbursts and what seemed like a physical dyslexia and some learning difficulties although she has always been very intelligent.
    She is now 17. Has some emotional delays, diagnosed with adhd, which I don’t agree with. constant unusual, unexplained headaches and bloody noses—for her entire life. She also suffers from what might be IBS. Has tremors and occasional right body side dragging/refusal to continue walking with pain. Pediatricians have never solved this.
    She researched the web looking for answers, and sometimes comes up with possibly multiple sclerosis as a cause.
    In a couple of weeks I am taking her to a 2nd neurologist.
    Does any of this sound like it could have been caused by birth trauma?
    I only started considering that it could be a factor in the past year or so.

  2. Laura
    Laura says:

    Hi Laura. I went though almost the same experience. I had a super healthy and awesome pregnancy but my OBGYN decided to use a high dose of epidural then vaccum then forceps then episiotomy. My daughter is almost 15 now and her story sounds a lot like your daughter’s. She’s mostly emotionally and socially delayed. But she’s straight A student. She was also diagnosed with ADD but I was never convinced. She still has some occasional reaction mostly related to autism such as not wanting a hug o be touched and also some flipping with her hands,etc. She can be insensitive then starts crying and cant stop. Her psychologist then asked me for the delivery records, which I had no idea why she wanted them. To my bad she moved overseas by the time I finally got the records. Then since I don’t want any medication for her, I started my own research. This search has encouraged me to study anatomy and physiology and other related studies. I am convinced there is a relationship between the two. There are specific areas in the brain I am sure they are damaged during assisted deliveries.

  3. Ashley Morphis
    Ashley Morphis says:

    Both of your stories sounds like my Kamryn. He is my 5 year old son. My labor with him was hard but delivery was worse. He had gotten stuck in my birth canal and the nurse physically puther body weight on my stomach and pushed at the same time that i was pushing and thenthe dr used the vaccuum. (Tmi) i tore up and down. When he got my son out which was only a few short minutes after inserting the vaccuum he had this horrible dark bloody bruise on top of his head and his SOFT SPOT!! The vaccuum has also broken the skin. It took two weeks or netter for this bruise to heal and during the healing process i kept it covered with a hat because everyone would freak out about it. He also has a lot of emotional problems. He has outbursts, diagnosed with adhd that hes now on vyvanse for, delays in a lot of areas, etc. Hes in kindergarten but is struggling for his age. Can someone please help me with this? Because not too long ago (maybe a year and a half ago) the dr that delivered him actually got temporarily suspended for showing up intoxicated at the hospital for a delivery but this isnt the first time. He also had his license yanked away for a while back for writting prescriptions for himself so im a little worried here especially since i now realize im not alone.

    MICHELLE says:

    Hi Laura,

    Look up non verbal learning disorder. This happens when visual spacial IQ is significantly lower than verbal IQ. Is your daughter gifted verbally but struggles with non verbal things? It can be misdiagnosed as ADHD.

  5. Shelley Bastos
    Shelley Bastos says:

    I gave birth to my oldest son in March 2006. The pregnancy had no complications and I thought the delivery was going well. My son’s heart rate started to continually drop. Every time I would push and he would get further down the birth canal, his heart rate would drop. The doctor’s made the decision to vacuum suction. He came out blue, with the cord around his neck. After removing the cord and stimulating him to get blood flow going, he finally cried. It was very scary. Very early on there were things like, he wouldn’t suck. I had to squeeze his cheeks to have him suck his bottle. Then I had noticed no eye contact, he wasn’t very interactive. He was my first baby so I didn’t know much about what to expect. Before he was 2 years old I knew something wasn’t right. He didn’t speak; He would “sing-song vowel sounds”. He was diagnosed with Autism before age 3. He was perfect textbook for Autism with Sensory Issues. He toe-walked, flapped, had trouble eating certain foods, needed deep pressure sensation to calm down and de-sensitize. He was in a full-day ASD classroom at 3 years old. He continued ASD services until 2nd grade and was mainstreamed. Even when he couldn’t talk there were signs that he was very intelligent. He would program the tv to his shows. He started to memorize letter and recognize words at 3 and 4 years old. But the first 6 years of his life was the most difficult years of my life. I couldn’t work, I read everything I could about autism and got him all the help I could! Even after he was mainstreamed we had a long road of trying to get his social issues under control. He is 12 years old and still receiving services. I wasn’t able to go back to work until he was 6 years old.

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