Helping your baby be born

Sometimes an unplanned caesarean section, forceps or ventouse (vacuum) extraction is used to help your baby be born.

It's very common to need an assisted delivery. These can be life-saving measures and are used to keep you and your baby safe.

Why your baby might need help to be born

There are a number of reasons for the delivery team to intervene and assist in your baby's delivery. Some are concerns about you and some are concerns for your baby.

For you

The delivery team will intervene if:

• your contractions have weakened
• you’re too tired to push because of a long labour
• you have a medical condition such as a heart disorder and should not push for too long.

For your baby

The delivery team will intervene if:

• your baby is potentially short of oxygen (fetal distress) - this is diagnosed when a baby's heart rate slows in response to contractions and doesn't speed up again as it should
• your baby passes meconium (the contents of the bowels) - this will stain the amniotic fluid a green or brown colour and a small blood sample may be taken from your baby's scalp during labour to be measured for oxygen
• your labour is not progressing as well as it should - either due to the position your baby is lying in, such as face-up (occipito-posterior) or how your baby fits in your pelvis

More about how your baby lies in the womb

Methods of assisted delivery

There are 3 main ways your baby can be born with assistance:

1. Forceps delivery – about 1 in 9 births are forceps deliveries
2. Ventouse delivery – about 3 in 100 births are ventouse deliveries
3. Caesarean section – about 1 in 3 births are caesarean deliveries

Forceps and ventouse

Forceps and ventouse are instruments used to:

• deliver your baby if your baby's head is facing the correct way for delivery (called occipito anterior)
• turn your baby's head round to face the correct way for delivery

If you need a forceps or ventouse delivery:

• you'll be given an anaesthetic, most likely an epidural or spinal, or a local anaesthetic called a pudendal block
• your bladder may be emptied with a catheter, a thin tube inserted into your bladder
• you may need an episiotomy to prevent trauma to the vaginal tissues, such as tears

Your obstetrician will recommend one or another and explain why.

Delivery with forceps

During a forceps delivery:

• you'll probably be helped to lie down on your back, and your legs will be raised in stirrups
• forceps are inserted to cup your baby's head
• as you feel each contraction coming you push as the doctor pulls - just as you were doing before

After the birth your baby may sometimes have some bruising on each side of their head where the forceps have been. This will disappear over the next few days.

Delivery with a ventouse

During a ventouse delivery:

• you'll probably be helped to lie down on your back, and your legs will be raised in stirrups
• a tube with a cup is inserted - this attaches to your baby's head by suction
• as you feel each contraction coming you push as the doctor pulls - just as you were doing before

Ventouse extraction can cause swelling (sometimes called a chignon) on your baby's head. This isn't permanent and will disappear over the next few days.

While ventouse is less likely to cause a tear in your vagina than forceps, it's less safe for your baby.

Caesarean section (C-section)

In a caesarean section your baby will be born during an operation. Your obstetrician will make a cut in your abdomen and womb to deliver your baby.

Having a caesarean section in one pregnancy doesn’t mean you have to have one again in future pregnancies. For most women a vaginal delivery would be an option in any later pregnancies.

Understanding why you needed a caesarean section can help you put the experience in perspective. Talk about your feelings with your midwife and other mothers who have had caesarean births.

More about having a caesarean section

Choices and decisions

It's a good idea to make a birth plan while you're pregnant, which sets out your choices and what you would like to happen during the birth.

Your birth plans can include choices you may be asked to make if your baby needs help or urgent help to be born.

More about making a birth plan

How you may be feeling

Sometimes women feel disappointed if they’ve had an assisted delivery. You may feel you've missed out on something or be feeling guilty because you didn’t manage to give birth without assistance. There's no need to feel guilty. The important thing is you and your baby are safe and well.

Translations and alternative formats of this information are available from Public Health Scotland.