Assisted delivery: procedures, indications and complications

Assisted delivery is recommended when the baby has descended the birth canal and you have been pushing for a long time with no progress accompanied with a low baby’s heart rhythm. As it might seem frightening, the assisted delivery is considered safe as long as the baby’s head is low and there are no other complications.

What kinds of procedures are used during an assisted delivery?

The procedures used depend on the conditions of your labor. These procedures can include:

- Episiotomy: A median lateral incision is done between the vaginal opening and the anus. This cut is needed to enlarge the space and be able to insert the instrument. A local anesthesia is injected if you do not have an epidural.

- Fetal heart monitoring: The doctor will monitor the baby’s heart throughout the procedure. A fetal monitoring device is placed on your tummy to record the baby’s heart rate and your contractions.

- Vacuum extraction: The doctor will apply a rounded cup on the baby’s scalp. He will connect it to an electrical suction pump. This would create a vacuum pressure on the baby’s head. He will ask you to push while gently pulling the cup and directing the baby to move outside the birth canal. It is a safe technique at least after 34 weeks of pregnancy. It does not need an episiotomy and would not cause vaginal and perineum damage. Most likely the baby’s head will have raised bruise which goes couple of weeks after birth. In some cases, retinal hemorrhage is likely to happen which does not have long-term consequences.

- Forceps:  It is a pair of spoon shaped surgical tongs inserted on the sides of the baby’s head. While pushing during a contraction, the doctor pulls the baby down with the forceps handle and guides him out of the birth canal. This technique is more harmful to the mother than the baby. You might experience tears in your cervix, perineum and anal sphincter. It also might cause bruises on the baby’s head which heals weeks after birth. In rare cases, facial nerve injury might happen, however the consequences are temporary.

Assisted delivery is not an easy method to understand and accept. Your doctor will explain the procedures as well as the cons and pros of it. It is a useful method when the baby is in distress and you are exhausted. Some doctors may apply local anesthesia to the vagina wall to reduce the discomfort feeling. After an assisted delivery, stitches might be done which take few weeks to heal causing discomfort especially when you go to the bathroom.

In most of the assisted delivery cases, mother and child are safe with no complications. Always seek for advice and discuss all techniques with your doctor.