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Forceps or vacuum assisted birth might be necessary if your baby is low in your pelvis and:
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Most people labour and birth without any assistance. However, for some specific reasons your healthcare provider may recommend assistance to help you push your baby out once your cervix is fully dilated. If it's needed, your healthcare provider can assist you by using either vacuum or forceps. It is important for you to learn about the benefits, risks, and alternatives of using these procedures and their potential impact on breastfeeding, and to have a discussion with your healthcare provider to answer any questions before going into labour. This helps you to make an informed decision about your care.
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Forceps or vacuum assisted birth might be necessary if your baby is low in your pelvis and:
The following are population level benefits and risks. It's important to speak with your healthcare provider to discuss how these may apply to your individual situation to make an informed decision for your care.
The method chosen to assist with birth depends on the individual situation. There are risks associated with both methods. The choice of intervention needs to be individualized and the benefits of the chosen method should outweigh its risks.
Prior to an assisted vaginal birth, it must be confirmed that:
A vacuum extractor is a plastic cup-like instrument that is placed on your baby’s head and gentle suction is applied.1 4 Your healthcare provider gently pulls while you push during your contractions.1 4 The vacuum extractor is removed once your baby crowns.
Forceps are a pair of tong-like instruments that are placed around your baby’s head to guide your baby through the birth canal and to assist your pushing efforts.1 4 They are placed one at a time and locked in place to prevent squeezing your baby’s head.4 Your healthcare provider gently pulls or turns the baby's head while you push during your contractions.1 4 The forceps are removed once your baby crowns. With forceps, you will usually have some anesthetic, either an epidural, or a local injection.1 4 An episiotomy may be needed.1 4
Episiotomy is a surgical incision (cut) in your perineum (the area between your vagina and anus)10 to make the vaginal opening larger for your baby to pass through.10 Your healthcare provider will repair the cut using dissolvable stitches after the birth of your baby.10 Routine episiotomy is not recommended.9 10
Current best practice is to support the perineum and allow it to tear naturally rather than to perform an episiotomy.10 Tears are often smaller, are repaired more easily or not at all, heal more quickly, and are less painful than an episiotomy. An episiotomy will be considered if birth needs to occur quickly because the baby's heart rate is abnormal.9 10 An episiotomy is a surgical procedure that requires informed consent, so it's important to have a conversation with your healthcare provider to learn about the benefits, risks and alternatives before labour begins.
Ottawa Family Decision Guide
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