An assisted delivery, or a delivery that occurs with the help of medical tools like forceps or vacuum-extractors, are an alternative to a C-section when the baby cannot naturally pass through the birth canal.
Assisted deliveries are not planned. A doctor may recommend an assisted delivery only if the baby is engaged in the birth canal and is not able to progress normally or enters fetal distress, or if the mother is physically unable to complete the birthing process on her own. Especially if the baby is in fetal distress, meaning its heart rate significantly drops or spikes, or the baby experiences a lack of oxygen or blood flow, doctors may decide to take action to help birth the baby as quickly as possible.
The use of devices like forceps or vacuum-extractors to aid in delivery comes with risks. Babies have soft and malleable bones for the first few months after birth, and these devices can damage or bruise their bones, or cause serious internal injuries if used improperly or with too much force. These devices can also cause maternal harm including increased pain, internal tears, and many other injuries.
Forceps or Vacuum-Extractor Tool
Medical studies demonstrate that about 5% of newborns in the US are born with an assisted delivery. That comes out to about 1 in 20 babies. The U.S. Center for Disease Control reported that of those 5%, about 4% are delivered by vacuum-extractor and 1% were delivered with forceps.
Most health and medical organizations, including the FDA, encourage the use of vacuum-extractor tools over forceps for safety reasons. The use of forceps brings increased risk to the mother and child. Mothers who had an assisted delivery with forceps were also more likely to have deliveries that ended in emergency C-sections than mothers who had assisted deliveries with vacuum-extractor tools.
Medical studies on both tools show that serious injury is rare during assisted delivery. Neither tool should be dangerous if used correctly by your doctor. Assisted deliveries are a viable option to emergency C-sections that put the mother and child at an even greater risk of injury, though there is speculation that failed vacuum-extractor assisted births result in attempts with forceps, whereas failed forceps assisted births result in emergency C-sections.
Risks Associated with Forceps
Forceps are instruments that look like a long pair of tongs which will cradle the baby's head and help pull the baby out during delivery. Though vacuum-extractors are generally considered to be safer tools for assisted delivery, in certain situations forceps show increased advantage over vacuum-extractors.
Forceps are more successful in completing deliveries than are vacuum-extractor tools, though vacuum-extractor tools still show less risk of emergency C-sections for mothers. Vacuum-extractors show a lower overall incidence of injuries to the baby during assisted delivery, but forceps show a reduced risk of scalp and cephalohematoma, or hemorrhaging under the scalp. Forceps, unlike vacuum-extractor tools, can also be used to turn or move the baby's head to correct its position.
One tool may not have a full advantage over the other, and both pose risks to the baby and mother. Possible injuries from the use of forceps includes:
For the mother:
- Internal tears and injuries
- Increased pain in the perineum and vagina
- Uterine rupture, or tearing of the mother's uterus
- Bladder and urethra injuries
- Weakening of muscles around pelvic organs
- Increased bleeding
For the baby:
- Skull fracture or other bone fracture
- Bleeding under the skull
- Erb's palsy or facial palsy, reduction of movement and sensation in the arms or face
- Other minor facial injuries from the forceps
Risks Associated with Vacuum-Extractor Tools
Studies have shown that vacuum-extractor tools employ almost 40% less force on the baby's head than forceps exert. This helps contribute to the growing insistence in the medical field that vacuum-extractor tools are safer for the mother and child than forceps.
Vacuum-extractor tools are made of a soft cup attached to some sort of pump. The soft cup is placed on the baby's head, and the doctor engages the pump to create a kind of seal. The doctor will then help pull and guide the baby out of the birth canal.
To use forceps the baby's head has to be in a specific position, if it is turned at all the forceps could strain the baby's head and neck. Vacuum-extractors are more adaptable and the soft cups on top are be bent and moved into position.
Forceps also pose greater internal risk to the mother, and can damage the sides of the birth canal. Vacuum-extractor tools are only attached to the top of the baby's head, and pose a reduced threat of injury to the mother.
Still vacuum-extractor tools come with risk. Possible injuries from a vacuum-extractor assisted birth include:
For the mother:
- Increased pain
- Lower genital wounds and tears
- Injuries to urinary tract
For the baby:
- Subgaleal hemorrhage, or bleeding between the scalp and the skull. Mortality rates for subgaleal hemorrhages are as high as 20%.
- Hypoxia, or a reduced oxygen flow to the baby which can result in cerebral palsy among other brain injuries
- Shoulder dystocia, when the baby's shoulder gets stuck on the mother's pelvic bone
- Bleeding under the skull
- Scalp wounds
When an assisted delivery causes harm
There are specific indicators that doctors should turn to an assisted delivery. These include:
- Maternal exhaustion
- Other physical conditions with the mother, like heart problems
- Fetal distress
- Prolonged or unproductive labor
If doctors fail to act quickly when these problems arise, or if they use assisted delivery tools negligently or incorrectly, you and your baby could face serious harm.
The attorneys at Gilman & Bedigian are experienced in medical malpractice and are dedicated to helping your family through the difficult times after a birth injury. If you believe you or you child has been seriously injured from negligence surrounding an assisted delivery, call our offices today for a free consultation.