Vacuum Extraction During Delivery

No, it’s nothing like a Hoover. A vacuum extraction, also known as a vacuum-assisted delivery, is used to help move the baby through the birth canal when labor has stalled.

While somewhat rare — only about 5 in every 200 babies are born with the help of a vacuum extraction — you should know that the procedure is safe for both mother and baby.

What is a vacuum extraction?

A vacuum extraction is a type of assisted delivery. During a vaginal delivery that has stalled — for example, the baby simply hasn’t moved during the past few hours — a doctor will place a suction cup with a handle on the baby's head to help guide her through the birth canal and into the world.

When and why is a vacuum extraction done?

A vacuum extraction is done during the second stage of labor — i.e. the pushing phase — when your baby is very close to being delivered. (If your baby’s head is too high in the birth canal, then your doctor will likely opt for a C-section.)

A vacuum-assisted delivery may be necessary if your labor is prolonged and needs to be sped up — particularly if you or your baby are at risk for health complications during the delivery.

Specifically, your doctor may do a vacuum extraction if:

• Your baby is stuck in the birth canal — for example, you’re pushing, but labor is no longer progressing.
• You're too tired to push.
• You have a medical problem like a heart condition or very high blood pressure, both of which can make it risky to keep pushing.
• Your baby is experiencing fetal distress or her heart rate indicates there's a problem.

How is a vacuum extraction done?

Before a vacuum extraction is done, you’ll usually be given an epidural (if you haven’t had it already) or numbing medication to block the pain.

There’s also a chance that your doctor may perform an episiotomy — an incision of the tissue between the vagina and the anus — to enlarge the vaginal opening for the placement of the vacuum.

Then, the doctor will perform the following steps:

• Between contractions, a doctor will place the vacuum extraction's cup onto your baby's head.
• During contractions, the doctor will use the vacuum pump to create suction, which will help guide the baby through the birth canal and prevent the baby's head from moving back up the birth canal in between contractions.
• After the baby's head is delivered, your doctor will remove the cup and you can push the rest of your baby's body out.

Are there any side effects or risks to the baby with a vacuum extraction?

Luckily, it’s rare for a baby to sustain a serious injury during a vacuum extraction. Possible risks, however, include:

• Swelling on the scalp, which goes away within a few days
• Jaundice, or skin taking on a yellowish hue, which may need to be treated with light therapy 
• Shoulder dystocia, which occurs when the shoulder gets stuck after the head has been delivered
• Skull fracture or bleeding within the skull, which is rare

Keep in mind, too, that there's no evidence a successful vacuum-assisted delivery will have any effect on your child's development.

Are there any side effects or risks to the mother with a vacuum extraction?

If your doctor opts to use a vacuum extraction, there are a few possible risks to the mother, though most of these side effects can occur during an unassisted vaginal delivery as well. These include:

• Pain in the perineum
• Tears in the vagina or the perineum
• Short-term difficulty urinating
• Short- or long-term incontinence
• An episiotomy to enlarge the vaginal opening to place the vacuum on your baby’s head

If the vacuum extraction isn’t successful, the doctor may have to perform a C-section next.

How often is a vacuum extraction done to deliver a baby?

Vacuum extractions aren’t used very often during delivery. According to the Centers for Disease Control and Prevention (CDC), vacuum extraction is used in just 2.5 percent of live births in the United States. (A forceps delivery is used in just 0.5 percent of live births.)

Even if your labor has stalled, it’s unlikely that your doctor will use a vacuum extraction during your delivery. It's more likely that you’ll undergo a C-section if you’re having trouble pushing. But if your baby is struggling to make her grand entrance into the world, a vacuum extraction is one option for delivering her safely into your arms.