Imagine that you are in the labor room to deliver your baby. You feel like the baby is still not coming out even after pushing hard for hours. Sometimes mothers have to face such experiences during childbirth. At such times, there are various ways for the doctors to help you, thinking about the safety of you and your baby. One such method is `Vacuum Extraction`. You may feel a little scared when you hear this name, but after reading this article, you will get answers to many of your questions about this.
Simply put, what is Vacuum Extraction Delivery?
This is actually a device that helps doctors get the baby out. To be precise, it's a small `suction cup`, which is like a rubber cup, connected to a pump via a small tube. The doctor carefully places this `cup` on the baby's head and uses `suction` (a vacuum) to make it stick to the head. Then, as you push the baby out, the doctor pulls back with the `cup`.
Imagine trying to get a cap stuck in a bottle. It's easier to pull it out with a small tool than by hand, isn't it? That's what this little help does. It makes it easier for the baby to get out.
In countries like America, about 3% of normal births occur through this method. In Sri Lanka too, this is a successful method used when necessary.
Why do doctors decide to use this method?
A doctor makes this decision with a lot of thought for your and your baby's safety. There are usually a few main reasons for using this method. Let's take a look at what they are.
| Reason | Simply explained |
|---|---|
| The baby doesn't come out even though you've been pushing for a long time. | Sometimes, even after pushing for two or three hours, it can be very difficult for the baby to come out. This is called 'prolonged labor.' At times like these, it's not good to wait any longer, so we offer a little help. |
| Fetal distress | Doctors and nurses regularly check the baby's heart rate. Normally, the baby's heart rate should be between 110 and 160 beats per minute. If the rate suddenly drops or increases too much, it means that the baby is in distress, perhaps not getting enough oxygen. In that case, the baby should be removed as soon as possible. |
| Mother is overworked or has other health problems | Pushing for hours in pain can be very tiring for a mother. Sometimes she is too weak to push. Or if the mother has a condition like heart disease, pushing for too long is not good for her health. This method is also used in such cases. |
Do you try anything else before vacuuming?
Yes, absolutely. Doctors don't use this kind of device right away. Before that, they try a few simple things that can speed up labor a little.
- Helping you change your position. Perhaps turning on your side or changing to a different position may make it easier for the baby to descend.
- An oxygen mask will be given. This will ensure that you and your baby get enough oxygen, which can help your baby's heart rate return to normal.
- Fluids are given through a saline (IV) line. This will help restore your body if it is dehydrated and give you new energy.
If there is no improvement after doing these things, then the doctor will talk to you about `Vacuum Extraction` or another method, `Forceps Delivery`.
Are there any cases where this method cannot be used?
Yes, this method is not suitable in all cases. Sometimes, even if a mother needs help, there are several reasons not to use the `Vacuum`.
- If the baby is born prematurely: A baby born before 34 months has a very soft head, so using this device can be risky.
- If the baby is in a transverse or breech position: This method can only be used if the baby is head down and fully inserted into the birth canal.
- If the baby is not far enough down the birth canal: The baby's head must be at a certain level down the birth canal to apply the vacuum.
- If the baby is too big: If the doctor thinks the baby's head is too big for your pelvis, this method should not be attempted. If that happens, the baby could get stuck.
- If the baby has a bleeding disorder: If it is known in advance that the baby has a disorder like `hemophilia`, this method is not used because even a small wound can cause a lot of bleeding.
In such a situation, the doctor will often decide to perform a cesarean section (C-section) .
How exactly does this process happen?
Before starting this process, the doctor will explain the pros, cons, and possible side effects to you and ask for your consent. Only then will these steps be followed.
1. Giving painkillers: If you have not already been given painkillers, you will be given medication to reduce pain before this procedure.
2. Episiotomy (if necessary): Sometimes a small cut may need to be made in the area between the vagina and the anus. This is called an ``Episiotomy''. This is done to make the opening for the baby to come out a little larger and easier. This is not done for everyone, but only if necessary.
3. Inserting the Suction Cup: The doctor carefully inserts the suction cup into the correct position on the baby's head.
4. Pushing and pulling: Next, you will be told to push hard when you feel the pain (contraction). As you push, the doctor will gently pull with the `vacuum`. When both of these happen together, the baby will slowly descend.
5. Baby's birth: Once the baby's head is fully out, the suction cup is removed. The doctor then holds the baby's hand and helps to pull the rest of the baby out.
Are there any instances where this method is stopped halfway?
Yes. Doctors always try to deliver the baby safely without causing any harm to the baby. Therefore, they stop using the vacuum in the following cases:
- If the baby doesn't come down after trying for a while.
- If the `Cup` falls off the baby's head three times.
- If you see any signs of damage to the baby's scalp.
In a situation like this, the next step is most likely to be a cesarean section.
What effects can this have on the mother and baby?
Like any medical procedure, it has both benefits and risks. The biggest advantage is that you can get the baby out quickly, without having to go through major surgery like a cesarean section. Sometimes, that speed is very important.
Let's now look at the possible risks separately.
| Risks for the Mother | |
|---|---|
| Vaginal tears | This can happen even during a normal delivery. The risk is slightly higher when using a `Vacuum`. But the doctor will sew up the wounds right there and then and repair them. |
| Postpartum Bleeding | This is something that can be seen even during normal childbirth. The medical team is attentive to this and provides the necessary treatment. |
| Difficulty urinating | Temporary difficulty urinating or incontinence may occur. These usually resolve over time. |
| Effects on the Baby | |
|---|---|
| Short-term and Minor Effects | |
| Substitute Head | What happens in this case is that a fluid like water collects under the skin where the `cup` was on the baby's head and swells up a little. As a result, the head takes on a cone-like shape. Don't be alarmed if you see this. This will disappear completely in a few days. |
| Bruising & Jaundice | The vacuum may cause small bruises on the baby's scalp. As these bruises heal, bilirubin levels in the blood increase, slightly increasing the baby's risk of developing jaundice. This also usually resolves within a few weeks. |
| Cephalohematoma | This is when a small blood clot forms on top of the baby's skull, but under the skin. This does not affect the baby's brain in any way. This too will heal on its own within a week or two. |
| Serious but Very Rare Complications | |
| Small cracks in the skull (Skull Fracture) | A newborn baby's skull is very soft. Very rarely, a small crack may occur. These usually heal on their own and do not cause long-term damage. |
| Intracranial Hemorrhage | This is bleeding in or around the brain. This is very, very rare, but if it happens, it can be serious. |
| Subgaleal Hemorrhage | This is a rare, serious condition where blood collects in the connective tissue between the skull and the scalp. |
Don't be alarmed by these serious complications. Doctors use this method very carefully and in a way that minimizes these risks. The likelihood of these occurring is very low.
How long does it take to heal?
For the mother: Unless there are major complications, you will need the same amount of time to recover as you would after a normal delivery. That's about six weeks . If you had an episiotomy or any injuries, you may experience some discomfort until those injuries heal.
For babies: Swelling and bruising on a baby's head will heal completely within a few weeks . During that time, take extra care of your baby's head. It's also a good idea to see a pediatrician for a checkup.
Most mothers hope to have a normal, problem-free birth. But sometimes things can happen that we don't expect. Knowing that these options are available can be a great help in times like these.
Take-Home Message
- Vacuum Extraction is a safe medical procedure used to help both mother and baby during childbirth. It can help avoid a cesarean section in an emergency.
- This method is used for specific reasons, such as if labor is prolonged, the baby is having difficulty, or the mother is having difficulty pushing.
- As with all medical procedures, there are some minor risks. It is common to see some swelling and bruising on the baby's head, but these will heal completely in a few days.
- If you're expecting a baby, talking to your doctor about these things in advance and asking any questions you have can help you prepare mentally.
- Remember, the most important thing is your and your baby's safety. Doctors always try to ensure that safety.
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