What is an assisted delivery?

Vaginal delivery is the most common type of birth. When necessary, assisted delivery methods are needed. While labor can be a straightforward, uncomplicated process, it might require the assistance of the medical staff. This assistance can vary from use of medicines to emergency delivery procedures.

What are some assisted delivery procedures that might take place during my labor?

The procedure your doctor might use will depend on the conditions that might arise while you are in labor. These assisted delivery procedures can include the following:

Episiotomy

An episiotomy is a surgical incision made in the perineum (the area of skin between the vagina and the anus). The incision enlarges the vaginal opening to allow the baby’s head to pass through more easily and to prevent tearing of the mother’s skin. Most women will not need one. This is reserved for special circumstances.

There are two types of incisions: the midline, made directly back toward the anus, and the medio-lateral, which slants away from the anus. A local anesthetic might be used in mothers who do not opt for an epidural during labor.

Amniotomy (“Breaking the Bag of Water”)

An amniotomy is the artificial rupture of the amniotic membranes, or sac, which contains the fluid surrounding the baby. The amniotomy can be done either before or during labor. An amniotomy is usually done to:

• Induce or augment labor
• Place an internal monitor to assess the uterine contraction pattern
• Place an internal monitor on the baby’s scalp to assess the infant’s well-being
• Check for meconium (a greenish-brown substance, which is the baby’s first stool)

Your healthcare provider will use an amniohook, which looks like a crochet hook, to rupture the sac. Once the procedure is completed, delivery should take place within 24 hours to prevent infection.

Induced labor

Induction of labor usually means that labor needs to be started for a number of reasons. It is most often used for pregnancies with medical problems or other complications. Labor is usually induced with Pitocin®, a synthetic form of the drug oxytocin given intravenously.

Medical reasons for inducing labor might include:

• Diabetes
• High blood pressure
• Ruptured membranes
• Small baby
• Past-due pregnancy

Fetal monitoring

Fetal monitoring is the process of watching the baby’s heart rate. This can be external or internal.

• In external fetal monitoring, an ultrasound device is placed on your abdomen to record information about your baby’s heart rate, and the frequency and duration of your contractions. This can be used either continuously or intermittently.
• Internal monitoring involves the use of a small electrode to record the baby’s heart rate. While the membranes must be ruptured before the electrodes can be attached to the baby’s scalp, this is the most accurate way of obtaining this information. A pressure sensor can also be placed near the baby to measure the strength of contractions.

Forceps delivery

Forceps look like two large spoons that the doctor inserts into the vagina and around the baby’s head during a forceps delivery. The forceps are put into place and, the doctor uses them to gently deliver the baby’s head through the vagina. The rest of the baby is delivered normally.

Vacuum extraction

A vacuum extractor looks like a small suction cup that is placed on the baby’s head to help deliver the baby. A vacuum is created using a pump, and the baby is pulled down the birth canal with the instrument and with the help of the mother’s contractions. The pump can often leave a bruise on the baby’s head, which typically resolves over the first 48 hours.