Overview

An assisted delivery is when we use a ventouse suction cup or forceps to help deliver your baby.

A ventouse uses suction to attach a plastic cup onto your baby’s head.

Forceps are 2 metal spoon-shaped instruments that are carefully positioned around your baby’s head.

The doctor waits until a contraction and then asks you to push while gently pulling to help deliver your baby. More than 1 pull is often needed.

You might have had an assisted delivery because:

• we had concerns about your baby’s heart rate or overall condition
• you needed help in the final stages to deliver your baby because you were tired or your contractions became less strong

Your recovery after an assisted delivery

The length of your stay in hospital after an assisted birth depends on the needs of you and your baby. Your midwife or doctor will talk to you about when you can return home and the aftercare involved.

During an assisted delivery, as the baby is being born, an episiotomy (cut) is needed to make the vaginal opening bigger. This can reduce the chance of uncontrolled tearing and make delivering your baby easier. Any tear or cut is repaired with dissolvable stitches which do not need removing. You might be seen by the physiotherapy team before leaving hospital.

After any birth, including an assisted delivery, you may feel bruised and sore. The stitches and swelling may make it painful when you go to the toilet. Any stitches will heal within a few weeks. You will be offered pain relief which should be taken regularly for the first few days.

The catheter tube in your bladder will be removed once you are able to move around. The midwives will monitor how you pass urine (pee) to make sure your bladder is recovering.

Pelvic health

Urinary incontinence (leaking of urine) is common after childbirth, especially after an assisted delivery. It can happen because of bruising of the neck of the bladder during labour and delivery. Problems peeing normally improve as the bruising goes down, and pelvic floor exercises help regain bladder control.

The NHS website has information about urinary incontinence.

Sex

You can begin to have sex again when you and your partner both feel that it’s the right time for you, physically and emotionally. Usually it takes a few weeks for any stitches to heal. The first few times may be uncomfortable, and you might need to use lubricant.

The NHS website has information about sex and contraception after birth.

Emotions

You might want to talk about the emotional impact of your experience of birth. It's normal to feel upset that things didn't go as you planned or that you feel you were not in control of the situation. It's important that you understand the decisions that were made around the time of your baby’s birth and why you needed an assisted delivery.

Before you leave hospital, if you would like to talk to someone about your birth experience, your doctor or midwife should be able to help. You can also talk to your GP, who can refer you back to your obstetrician.

If you have concerns about your baby

If your baby is in any discomfort or irritable because they have a sore head this may lead to problems settling or feeding. Your doctor or midwife may offer pain relief (analgesic) to help with any discomfort.

If you have any concerns about your baby or caring for them at home, then you should talk to your midwife or neonatal team before leaving hospital.

How ventouse might affect your baby

The ventouse suction cup can leave a temporary swelling on your baby's head, called a chignon (pronounced sheen-yon). This is different to the temporary change in shape of your baby’s head after travelling through the birth canal. Both conditions will disappear over the next few days. There is no need to massage the swelling.

The cup may also leave a bruise on your baby's head, called a cephalhaematoma, which will disappear with time (up to 6 to 8 weeks). This bruising can lead to jaundice (yellow colouration of the skin and whites of the eyes).

Yellowing of the skin can be more difficult to see in brown or black skin. It might be easier to see on the palms of the hands or the soles of the feet.

Other symptoms of newborn jaundice can include:

• dark, yellow urine (a newborn baby's urine should be colourless)
• pale-coloured poo (it should be yellow or orange)

Jaundice may require ultraviolet light treatment (phototherapy).

Rarely, bleeding can develop underneath the white surface of your baby’s eye which will disappear with time. Your baby’s vision is not affected.

How forceps might affect your baby

The forceps can leave small marks and bruises on your baby's face but these will usually heal or disappear within a week by themselves.

Rarely, forceps may compress your baby’s facial nerve, causing one side of their mouth to droop (palsy). This is usually only temporary. Your baby will be seen by the neonatology doctor before discharge.

Future births

Having an assisted vaginal birth does not necessarily mean you will have one in your next pregnancy. Most women who have an assisted vaginal birth deliver spontaneously next time. Even if your assisted vaginal birth was performed in theatre, you have an 8 out of 10 (80%) chance of having a spontaneous birth next time.