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Assisted Vaginal BirthWhat is assisted vaginal birth? How can having an assisted vaginal birth affect my pelvic floor? What are other ways of helping a baby come through the birth canal? When might an assisted vaginal birth be recommended? What are some important considerations if my caregiver offers an assisted vaginal birth? If I have an assisted vaginal birth, does it matter whether I have vacuum extraction or a forceps delivery? What is assisted vaginal birth?In an assisted vaginal birth, the caregiver uses vacuum extraction or forceps to help bring the baby out. The vacuum extraction device uses suction to hold a cap onto the baby's head. The cap is attached to a handle. The caregiver then pulls while the mother pushes. In a forceps delivery, the doctor inserts curved blades on either side of the baby's head, locks them together, and pulls.How can having an assisted vaginal birth affect my pelvic floor?Assisted vaginal birth increases the likelihood of having a tear into or through the anal muscle, especially when used in combination with a midline episiotomy (cutting the back of the vaginal opening straight back to enlarge it for birth). Anal muscle tears can lead to leaking gas - and more rarely, feces - or a sense of urgency about elimination (bowel incontinence) as well as increased likelihood of pain during sexual intercourse.What are other ways of helping a baby come through the birth canal?Time and trying various pushing positions - especially upright positions that allow gravity to assist the process - will work in most cases.When might an assisted vaginal birth be recommended?A vacuum extraction or forceps delivery may be recommended when progress in bringing the baby down during the pushing phase of labor has come to a halt, and the pushing phase of giving birth has gone on for a very long time. (Most first-time mothers take about 2 hours to birth the baby once they begin pushing, and women who have had a vaginal birth before take about an hour. When an epidural is in place, the time may be much longer than these norms.) Sometimes assisted vaginal birth is recommended when the baby is close to being born and an urgent problem develops or when the head needs to be shifted into a better position for birth.What are some important considerations if my caregiver offers an assisted vaginal birth?If you will be having an assisted delivery, speak with your caregiver about avoiding an episiotomy with this procedure. If no episiotomy is performed, tears into the anal muscle rarely occur.When a difficult assisted vaginal birth is anticipated, you are at greater risk for pelvic floor injury. In this case, you may wish to weigh the respective pros and cons of assisted delivery and having a c-section. If I have an assisted vaginal birth, does it matter whether I have vacuum extraction or a forceps delivery?Vacuum extraction is much less likely to result in deep tears and other tissue injuries compared with forceps delivery. For this reason, most assisted vaginal births are with vacuum extraction in the U.S. at this time.Most recent page update: 2/21/2006
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Listening to MothersSM III: New Mothers Speak Out (June 2013) reports on new national surveys about issues women face in the postpartum period and their views about maternity care.
Access the full report and supplementary materials  Listening to MothersSM III (May 2013) is the third national survey exploring women's experiences in pregnancy and childbirth. Commissioned by Childbirth Connection, conducted by Harris Interactive, and funded by the W.K. Kellogg Foundation, the survey polled 2,400 women who gave birth in U.S. hospitals from 2011 to 2012. Results show that medically intensive experiences are typical, and evidence-based practices are underutilized. Childbearing women need better support and knowledge to navigate their maternity care. Access the full report and supplementary materials New Report: Maternity Care and Liability Go to report and supporting materials New Report: The Cost of Having a Baby in the United States Go to report and supporting materials New Cesarean Resources: Go to Best Evidence Report Go to web pages and booklet for women 
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