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Pros and cons of operative vaginal delivery

Massachusetts mothers who are planning to have a natural birth should be aware of the options that are available if assistance is needed. Forceps and vacuum extraction are two of the most common tools obstetricians may use to expedite vaginal delivery, and there are risks associated with both.

Contemporary OB/GYN notes that there are several reasons doctors may choose to turn to operative vaginal delivery. For instance, existing medical factors, such as cardiovascular disease, may make unassisted delivery infeasible. Furthermore, if pushing during the second stage of labor is not effective or the mother is exhausted, assistance may become necessary.

Statistics from 2014--the most recent data available--suggest that operative vaginal delivery plays a role in 3.21% of live births; of these assisted deliveries, forceps are used only 20% of the time. Extraction by either vacuum or forceps is considered relatively safe, with mortality resulting from intracranial hemorrhage in only three or four of 10,000 births requiring operative assistance and neurological complications arising in only one out of 220 to 385 of these births. These numbers are favorable when compared with the figures related to cesarean sections.

According to Healthline, forceps present a higher risk of vaginal tears in the mother, whereas vacuum extraction tends to have a greater rate of failure than does forceps delivery. When a vacuum is used, failure may necessitate a C-section. Both forceps and vacuum extraction present some risk of cephalhematoma (that is, the buildup of blood between the skull and the tissue of the baby's head) and retinal hemorrhage. Forceps, in particular, may cause damage to the infant's facial nerves.

Ultimately, neither mothers nor doctors can know whether assistance will be needed until labor is underway. It is essential that expecting mothers be informed about the strategies their doctors may choose if operative vaginal delivery is necessary.


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