Vacuum extraction, also called vacuum-assisted delivery, carries risks depending on factors such as the position of the baby in the womb, type of instrument used, and the doctor’s experience.
For example, an episiotomy may be needed to seal the vacuum cup. An episiotomy is an incision made around the perineum (area surrounding the vagina) and is used in other delivery methods as well. Episiotomies can cause infections, pain, and blood loss.
However, vacuum extraction may be a life-saving procedure for both mother and baby, and the risks of serious injury are typically low. Furthermore, most of the risks of vacuum extraction occur with nonoperative vaginal delivery.
What are the risks of vacuum extraction?
Risks to the mother
- Perineal pain and injuries
- Blood loss
- Lower genital tract injuries
- Hematoma (collection of blood in between the tissues)
- Urine retention or difficulty in passing urine
- Loss of bowel or bladder control (incontinence)
Risks to the baby
What is vacuum extraction?
Vacuum extraction is a type of assisted delivery in which the baby is delivered with the help of a vacuum pump that guides the baby out of the birth canal using a cup-like structure placed on the baby’s head. Over 80% of operative vaginal deliveries in the United States are done using vacuum extraction. During a vacuum extraction:
- The mother is given an epidural so that she does not feel pain and asked to lie on her back with her legs apart.
- The doctor or midwife places the vacuum extractor cup on the baby’s head.
- The mother is then asked to push during contractions while the doctor or midwife simultaneously pulls by creating suction between the baby’s head and vacuum cup.
- The baby’s head is typically the most difficult part to push out of the vagina. Once the head is delivered, the doctor removes the vacuum cup, and the rest of the baby is delivered by the mother’s pushing efforts.
After vacuum extraction is done, both mother and baby are examined for injuries and appropriate care is provided. If, however, the vacuum extraction fails to deliver the baby, the doctor may perform a cesarean delivery.
When is vacuum extraction recommended?
Vacuum extraction is typically done in the second stage of labor (period between full dilatation of the cervix and birth of the baby) when the baby is low enough to be delivered by this method.
Reasons for doing vacuum extraction include:
- Maternal exhaustion (the mother is too tired to push)
- Baby does not move despite mother’s pushing efforts
- Signs of fetal distress (such as changes in baby’s heartbeat)
- Certain maternal conditions that may make prolonged pushing efforts risky (such as heart diseases and lung conditions)
- Poor pushing efforts due to certain maternal diseases, such as spinal cord injury or neuromuscular diseases
Garrison A. Vacuum Extraction. Medscape. https://emedicine.medscape.com/article/271175-overview
Ali UA, Norwitz ER. Vacuum-assisted vaginal delivery. Rev Obstet Gynecol. 2009;2(1):5-17. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2672989/
Greenberg J. Procedure for vacuum-assisted vaginal delivery. UpToDate. https://www.uptodate.com/contents/procedure-for-vacuum-assisted-vaginal-delivery#H1753442051
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