Policy & Procedure for Vacuum Assisted Delivery
In their article, "Vacuum-Assisted Vaginal Delivery," Doctors Unzila A. Ali and Errol R. Norwitz point out the decrease in the use of forceps in the last twenty years. In operative vaginal deliveries, many more doctors and patients opt for vacuum extraction. Doctors need to be aware of the risks to their patients as well as their babies and pass this information on to their patients to ensure the safety of all involved.
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Instructions
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Policy
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Your doctor needs to properly assess your situation. In 2000, the American College of Obstetricians and Gynecologists passed guidelines of appropriate reasons to perform a vacuum-assisted vaginal delivery.
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The first indication for a vacuum-assisted delivery is prolonged second stage of labor. If this is your first baby, your second stage of labor is considered prolonged if there is a lack of progress for 3 hours using regional anesthesia or lack of progress for 2 hours without it.
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Other reasons for electing to have vacuum-assisted delivery include suspicion of fetal compromise such as decreased fetal heart rate. Mothers who have cardiovascular disease may elect to shorten their second stage of labor with vacuum extraction. Although subjective, vacuum assisted delivery may be performed due to maternal exhaustion.
Procedure
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Before your doctor attempts vacuum-assisted delivery, your membranes should have ruptured and you must be fully dilated. Your baby's head must be properly engaged in the pelvis. You and your baby will continue to be monitored. Your doctor will obtain your verbal or written permission before beginning the procedure. All risks and procedures will be explained to you before beginning.
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You must empty your bladder prior to the procedure. The vacuum cup must be correctly placed on the scalp. The suction pull should coincide with your contractions to expedite delivery. Between contractions, vacuum pressure may be sustained or reduced.
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When your baby's head begins to crown, the suction cup should be released and removed. You will proceed with delivery in the normal fashion.
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Tips & Warnings
As the patient, make sure your doctor has thoroughly explained the procedure as well as the risks.
As with any surgery, there are risks to the mother and her unborn baby.
Maternal exhaustion should not be the only factor in deciding to perform vacuum extraction.
Be prepared to have an emergency c-section should the vacuum-assisted delivery fail.
References
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