Tanuja is excited but a little edgy. She is in the last weeks of her pregnancy. She has just read an article in the paper that says that assisted delivery rates are on the rise. The article has left her confused. What are assisted deliveries? Are they to be avoided?  If she has one, will it harm her baby? Are caesarean sections a better option?

What is an assisted delivery?

Assisted deliveries, also known as instrumental deliveries, are done to cut short the labour process and help ease the baby out. When done properly and at the right time, they reduce the need for a caesarean section.

The obstetrician may use a forceps or vacuum cup to help the mother deliver the baby. These instruments are attached to the baby's head so that it can be gently eased out with the least trauma to the mother and baby.

Instrumental delivery might be required when

• the woman is having a difficult time pushing the baby out through her birth canal
• the woman may have become too tired and exhausted to continue pushing
• the woman has had an epidural and may not have the urge to push
• the woman should not push too long because of a medical condition ( e.g. heart disease)
• the baby may need to be delivered quickly because it is showing signs of being in distress
• the second twin might require assistance in delivery

What are forceps?

Forceps are stainless steel instruments that are placed gently on either side of the baby’s head and are used to cradle the head. Holding the baby with the instrument, the obstetrician will apply traction and lift the baby out of the birth canal.

What is a vacuum-assisted birth?

The vacuum cup is attached by a flexible rubber tube to a small vacuum pump. The cup, which fits on top of the baby's head, may be made of metal or silicone plastic. The soft cups are less likely to cause damage to your baby's head, and are more commonly used nowadays. The obstetrician applies gentle traction on the tube attached to the cup, and lifts the baby out of the birth canal.

After your baby is born

Even after a normal vaginal delivery, the baby’s head may be a little elongated and conical. This happens because the baby has to mould itself to the shape of the birth canal. In babies born with the help of a forceps or a vacuum extractor, the head may be a little more conical or there may be a prominent bulge where the vacuum cup was applied. This will usually subside in a few days.