An operative vaginal delivery is one which uses a vacuum extractor (or forceps) to assist a woman in accomplishing a vaginal delivery. These are used in certain situations where the patient is unlikely to deliver vaginally without assistance, and where a cesarean section will be needed if they are not used. The incidence of operative vaginal delivery in the United States is estimated to be 10-15%.
Benefits include shortening the time a woman has to push (especially when she is too exhausted to push effectively), expediting deliveries when a fetus shows signs of compromise and needs to be delivered, and avoiding a cesarean section which is a major abdominal surgery associated with higher risks of infection, bleeding, and prolonged recuperation.
As with any procedure, there are potential complications associated with operative vaginal deliveries. These include, but are not limited to:
- Pelvic floor injury to the mother
- Fetal scalp lacerations
- Intracranial hemorrhage, cephalohematomas
- Retinal hemorrhage
These same complications can also occur with normal spontaneous deliveries. Fetal injuries can also happen inside the uterus long before the time of delivery. Overall, the incidence of serious complications with vacuum extraction is approximately 5%.
The lowest risk of fetal injury has been found in infants delivered spontaneously. An intermediate risk was observed for those infants delivered by forceps or vacuum alone or by cesarean delivery during labor. There appears to be NO difference in fetal outcomes between vacuum and forceps deliveries versus cesarean deliveries during labor. The doctor can only make recommendations. Our patients always have the final decision. If this option is presented to you during labor, you will decide to either: attempt an operative vaginal delivery and avoid a cesarean section, or refuse an operative delivery and proceed with cesarean section.
Dr. Shakespeare and Dr. Walker have been safely delivering infants since 1986 and have extensive experience with operative vaginal deliveries. Some of their own children were born with the assistance of forceps and vacuum extractors.
You will be given instructions during your pregnancy to read the information contained on our website pertaining to obstetrics. We expect that you will inform us if there is anything that you don’t understand and tell us if you need any further information. If operative vaginal delivery is offered to you as an option for delivery, you should already have made the decision to consent to this procedure or not based on the information on this page. We will obtain your final consent immediately prior to your delivery.