Forceps & Vacuum Assisted Delivery
The second stage of labor is unpredictable, and sometimes assisted delivery is required when maternal efforts fail and fetal heart rate changes. Vacuum assisted delivery is the predominant instrument used in delivery rooms, but forceps are also still occasionally needed.
Use of these assistive methods has decreased significantly in the last decade, due to the unnecessary risks they place on both mother and child. For instance, vacuum extraction accounted for about 4.4% of all lives births, according to the most recent available CDC statistics from 2010. Forceps assisted delivery accounted for just 1% of vaginal births in 2010.
If your delivery required the use of extraction tools, you may be feeling uneasy – particularly if your baby has suffered a birth injury. Enlisting the help of the birth injury team at Eisbrouch Marsh can help reveal whether use of these instruments amounted to excessive force during delivery. If, upon careful review, our experts believe that the injuries inflicted on your baby were avoidable, we will file a medical malpractice lawsuit to recover damages.
What is assisted vaginal delivery?
Deliveries don’t always go as planned. Possible assisted delivery interventions may include:
- Episiotomy – a surgical incision made to the skin between the vagina and anus that allows the baby’s head to pass through more easily and prevent tearing of the mother’s skin.
- Amniotomy – the artificial rupture of the amniotic sac done to induce labor.
- Induced labor – drugs given to prompt a woman to begin proceeding through the stages of labor.
- Fetal monitoring – the process of watching the baby’s heart rate through an ultrasound device or small internal electrode.
- Forceps delivery – the use of two large spoon-like tools to pull the baby’s head through the vagina.
- Vacuum extraction (ventouse) – the use of a suction cup and pump to pull the baby’s head down the birth canal.
- Caesarean section – a surgical incision made into the abdomen and the uterus to physically remove the baby when a vaginal birth is not possible.
Benefits of vacuum extraction & forceps assisted delivery
Assisted delivery may be necessary if:
- The maternal temperature is higher than 99.5 degrees.
- The baby’s birth weight is relatively high.
- The labor has been long and the mother is too exhausted to push.
Risks associated with forceps assisted delivery
The use of forceps yields a higher rate of vaginal tears, pain and incontinence, according to a 2000 review published in the American Journal of Epidemiology. Women are also more likely to require general anesthesia and undergo a Caesarean section.
Facial nerve injury is the most disconcerting forceps delivery risk. Birth trauma may cause the baby to suffer from weakness, muscle paralysis, altered taste, excessive tearing or salivation. Sometimes these injuries resolve themselves within a few weeks, but on rare occasions, the trauma may be permanent. Other risks include bumps, bruises, cone-shaped heads, droopy facial muscles and bleeding. These injuries may be alarming, but are rarely permanent.
Risks associated with vacuum assisted delivery
A systematic review of 10 trials compared forceps and vacuum assisted delivery in more than 50,000 cases. Researchers found that there was less maternal soft tissue trauma and less need for anesthetic with vacuum deliveries. However, vacuum extraction was also more likely to fail.
The greatest maternal risks associated with vacuum delivery failure is third and fourth degree laceration leading to hemorrhaging. The review found the laceration rate to be 1.7% for spontaneous vaginal delivery, but as high as 9.3% for vacuum extraction and 19.2% for forceps delivery.
Risks of vacuum assisted delivery were much greater for the infants, including:
- Cephalohematoma (blood collection beneath the skull bone) – 3.37% risk, compared to 1.68% with forceps
- Retinal hemorrhage (eye bleeding) – 2.96% risk, compared to 1.35% with forceps
- Shoulder dystocia (birth obstructed by pelvic bone) – 2.48%, compared to 1.62% with forceps
Retinal hemorrhaging tends to clear up within four weeks of birth, but cephalohematoma can lead to hyperbilirubinemia – jaundice associated with liver abnormalities, increased risk of infection, metabolic disorder and hemolytic disease. Vacuum use is the biggest risk factor for shoulder dystocia, which can lead to damage to the upper brachial plexus nerves and leave children with disabilities like Erb’s Palsy and Klumpke Paralysis – or, worse yet, cause fetal hypoxia and even death.
What is “excessive traction,” and how does it cause birth injuries?
Excessive traction during delivery is the main cause of brachial plexus injuries involving the nerves running from the spine through the neck, shoulder and arm. This type of injury causes a loss of feeling and function in the arm, which may resolve within a few weeks or result in permanent disability. It’s not uncommon to see birth injury verdicts ranging from $1.5 to $4 million for families that can prove excessive traction was the main culprit behind a brachial plexus injury.
Impact of birth injuries from assisted delivery techniques
Birth injuries are devastating and emotionally draining, no matter which type occurs. Lifelong disabilities are the cases that are most likely to win sympathy from judges and juries because the medical bills and cost to society are high.
Birth injury victims and their families may be entitled to receive compensation for:
- Past and future medical expenses
- The cost of ongoing therapy and assistive technology
- Home modifications to accommodate a wheelchair / disability
- Emotional pain and suffering
- Loss of future earning potential
Finding a birth injury attorney
Eisbrouch Marsh specializes in all manner of birth injuries including those caused by forceps assisted delivery, vacuum extraction and excessive traction during delivery. If you suspect the use of assisted delivery techniques may be the reason for your family’s pain and suffering, our experienced legal team would be happy to take a closer look at your case.
Birth injury attorneys have the research capability, access to records and financial means to build a strong case against entrenched hospitals or medical doctors in these complex cases. Plaintiffs do not pay a single cent unless they successfully win a settlement or jury award, so there is no risk or obligation in seeking legal counsel.
- CDC - National Vital Statistics Report 2010, http://www.cdc.gov/nchs/data/nvsr/nvsr61/nvsr61_01.pdf
- AAFP – Hyperbilirubinemia In The Term Newborn, http://www.aafp.org/afp/2002/0215/p599.html
- AAFP – Vacuum Assisted Vaginal Delivery, http://www.aafp.org/afp/2008/1015/p953.html
- American Journal of Epidemiology – Comparison of Maternal and Fetal Outcomes Between Vacuum Extraction and Forceps Delivery, http://aje.oxfordjournals.org/content/153/2/103.full
- Cleveland Clinic – Assisted Delivery Methods, http://my.clevelandclinic.org/healthy_living/pregnancy/hic_assisted_delivery_methods.aspx
- ASSH – Brachial Plexus Injury, http://www.assh.org/Public/HandConditions/Pages/BrachialPlexus.aspx