Operative Vaginal Delivery

By Julie S. Moldenhauer, MD, Associate Professor of Clinical Obstetrics and Gynecology in Surgery, The Garbose Family Special Delivery Unit;Attending Physician, The Center for Fetal Diagnosis and Treatment, Children's Hospital of Philadelphia;The University of Pennsylvania Perelman School of Medicine

NOTE: This is the Consumer Version. DOCTORS: Click here for the Professional Version

Complications of Labor and Delivery
Introduction to Complications of Labor and Delivery
Abnormal Position and Presentation of the Fetus
Amniotic Fluid Embolism
Excessive Uterine Bleeding at Delivery
Fetal Distress
Inverted Uterus
Labor That Progresses Too Slowly
Multiple Births
Nuchal Cord
Placenta Accreta
Postterm Pregnancy and Postmaturity
Premature Rupture of the Membranes (PROM)
Preterm Labor
Prolapsed Umbilical Cord
Shoulder Dystocia
Uterine Rupture
Augmentation or Slowing of Labor
Cesarean Delivery
Induction of Labor
Operative Vaginal Delivery

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). The risk of shoulder dystocia and jaundice is also increased.

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 is having difficulty pushing
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.