In some situations, an unplanned Caesarean section, forceps or ventouse (vacuum) extraction are used to assist your baby’s birth. These can happen for various reasons:
- Your baby is short of oxygen – called fetal distress. This is diagnosed when the baby’s heart rate slows in response to contractions, and doesn’t speed up again as it should. A further sign is if the baby’s bowels pass meconium (the contents of the bowels). This will stain the amniotic fluid a green or brown colour. A small blood sample may be taken from the baby’s scalp to be measured for oxygen.
- Your baby’s exit is blocked or hampered – the position may be difficult, such as face-up (occipito-posterior), or your pelvis may not be able to open wide enough, sometimes due to your position.
- Contractions have weakened.
- Your baby is preterm, which means the head needs more protection.
- You are too tired to push because of a long labour.
- You have a condition such as a heart disorder, and should not push for too long.
If you need help with forceps or ventouse
Forceps and ventouse are both instruments that are attached to your baby’s head so she can be pulled out. You will be given an anaesthetic, most likely an epidural or a spinal, or a local anaesthetic called a pudendal block. Your bladder may be emptied with a catheter which is a thin tube inserted into your bladder. You will probably need an episiotomy to allow room for the forceps to be inserted.
You will probably be helped to lie down on your back, and your legs will be raised in stirrups. After the forceps have been inserted, as you feel each contraction coming, you push, just as you were doing before, as the doctor pulls. After the birth your baby may show bruising on each side of her head where the forceps have been.
Ventouse extraction can turn your baby for delivery. It uses a tube with a cup which attaches to the baby’s head by suction. You push with each contraction and the doctor pulls. Ventouse extraction can cause swelling (sometimes called a ‘chignon’) on your baby’s head. This is not permanent, and will disappear over the next few days.
How you may be feeling
Sometimes women feel disappointed if they’ve had a Caesarean birth. You may feel you have missed out on something or be feeling guilty because you didn’t manage to give birth without assistance.
Understanding why you needed a Caesarean section can help you put the experience in perspective. There is no need to feel guilty. Talk about your feelings with your midwife and other mothers who have had Caesarean births. The important thing is that you and your baby are safe and well.