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Operative Vaginal Delivery


Julie S. Moldenhauer

, MD, Children's Hospital of Philadelphia

Last full review/revision Jan 2020| Content last modified Jan 2020
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Operative vaginal delivery is delivery using a vacuum extractor or forceps.

A vacuum extractor consists of a small cup made of a rubberlike material that is connected to a vacuum. It is inserted into the vagina and uses suction to attach to the fetus’s head. If vacuum extraction delivery is tried and is unsuccessful, cesarean delivery is done. Rarely, a vacuum extractor bruises the baby’s scalp or causes bleeding in the baby’s eyes (retinal hemorrhage). Vacuum extraction also increases the risk of shoulder dystocia (especially if the baby is large) and jaundice.

Forceps are metal surgical instruments with rounded edges that fit around the fetus’s head. Rarely, using forceps bruises the baby or tears the area between the opening of the woman’s vagina and anus (called the perineum).

Vacuum extraction or forceps delivery may be required in the following situations:

  • When the fetus is in distress

  • When the woman becomes too tired to push effectively

  • When labor is prolonged

  • When the woman has a disorder (such as some brain or heart disorders) that make vigorous pushing inadvisable

Using Forceps or a Vacuum Extractor

Forceps or a vacuum extractor may be used to help with delivery. Forceps are placed around the baby’s head. A vacuum extractor uses suction to adhere to the baby’s head. With either device, the baby is gently pulled out as the woman pushes.

Using Forceps or a Vacuum Extractor
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