Vacuum extraction is one of the procedures to help the normal delivery process. Delivery with the help of vacuum extraction is done with a device called a vacuum extractor. Generally, this action is only done when the normal delivery process is hampered.
A vacuum extractor is a medical instrument that is used as an aid to pull the baby out of the vagina during labor. Doctors will usually help delivery with vacuum extraction if the baby is difficult to be born normally without the aids.
The vacuum extractor device has a bowl-like shape and is made of plastic (soft cup). However, there are also vacuums made of metal materials (metal cup). This tool is equipped with a vacuum pump that is used to pull the baby.
Use of Vacuum Extractors in Labor
The extractor vacuum consists of 2 types, namely a vacuum that uses human power and a vacuum that uses machine power. However, how to use it is more or less the same. This tool is used by pasting cup vacuum the extractor to the surface of the baby's head when it starts to appear out of the vagina.
If necessary, the doctor may perform an episiotomy to widen the birth canal, so that the baby can be removed easily. When the vacuum is in the baby's head, the doctor will ask the mother to push when she feels the contractions.
If the mother gets an epidural injection and doesn't feel any contractions, the doctor will give the signal. Next, the doctor will use a vacuum pump and pull the bottom of the vacuum, so that the baby's head will be pulled out.
If within 3 attempts to withdraw the baby by vacuum extraction the baby cannot be removed, the doctor may consider using other tools, such as forceps or starting a cesarean section.
Labor Conditions Requiring Vacuum Extraction
Delivery aids are often a solution when the labor process takes too long or feels tiring for the mother. Assisted labour, including a vacuum, is usually performed when the second phase of labor is considered too long.
For first-time mothers, the normal duration of the second phase of labor is about 3 hours naturally or 4 hours with an epidural injection.
Meanwhile, for mothers who gave birth for the second time or so, the second phase which is considered too long is about 1 hour naturally and 2 hours with an epidural injection.
In addition, there are several obstacles in labor that require doctors to use birthing aids such as vacuums, including:
- Baby has fetal distress when mother pushes
- Mother is already feeling very tired and the baby is not coming
- Mother has certain medical conditions that prevent her from pushing too long, such as heart disease or retinal disorders
However, there are several conditions during childbirth that cause the use of vacuum equipment is prohibited, namely in premature birth or when the gestational age is less than 34 weeks, the baby is in a breech position, and the baby's face is facing the vagina or the birth canal.
Stages of the Vacuum Delivery Procedure and Process
The following are the stages of the process of giving birth using a vacuum:
Before the vacuum extraction procedure
Before the vacuum extraction procedure is performed, the doctor will take several steps to help the labor process take place quickly and smoothly, for example by induction of labor using drugs or by an episiotomy procedure.
If all these efforts have been made but the baby is still difficult to deliver, the doctor will try to perform a vacuum extraction. Before doing so, the doctor will explain the benefits and risks of the procedure and seek the consent of the mother and family.
During the vacuum extraction procedure
After getting the mother's consent, the doctor will start the vacuum extraction procedure. As with normal delivery, the mother will be asked to lie down with her legs wide apart.
To be stronger and more powerful during contractions, the mother can hold both sides of the bed or another place that feels more comfortable.
After the baby's head is visible in the birth canal, the doctor will insert a vacuum extractor into the vagina and attach it to the baby's head. Next, the vacuum pump is activated so that withdrawal can be made and the baby can be expelled through the vagina immediately.
After the baby's head is successfully removed, the doctor will then remove the vacuum extractor from the baby's head and pull the baby's body out of the vagina.
If vacuum extraction doesn't work to get the baby out, the doctor may consider using other tools, namely forceps, or delivering the baby by caesarean section.
After use of vacuum
After the mother has given birth, the doctor and the midwife or nurse will examine the possibility of injury to the mother and baby due to the use of a vacuum.
If the doctor previously performed an episiotomy procedure by making an incision in the vagina to facilitate the delivery process, this section will be stitched after delivery.
In addition, the doctor will also carry out a follow-up examination to determine any signs of complications due to vacuum extraction in the baby, such as an injury to the baby's head.
Risks of Vacuum Assisted Childbirth
The following are some of the risks that can occur due to the process of giving birth with the help of vacuum extraction:
Risk for mother
Mothers who give birth with delivery aids are at risk of developing clots or clots in the veins of the legs or pelvis.
To prevent this, the mother can try to remain immobile after delivery (if the doctor allows it), use special stockings, or get a heparin injection from the doctor.
Sometimes, mothers who give birth with the help of vacuum extraction and have a severe perineal tear, have a higher risk of experiencing urinary or fecal incontinence, which is a condition where it is difficult to hold urine or defecate.
Risk for baby
Babies born with the help of vacuum extraction are at high risk of injury or bruising to their head. However, this condition will generally improve within a few days.
Sometimes, babies born with the help of vacuum extraction may experience more serious injuries, such as brain bruising or brain hemorrhage. This condition needs to be treated by a pediatrician immediately.
In certain cases, being born with the help of vacuum extraction can also increase the baby's risk of jaundice and bleeding in the retina of the eye.
Delivery with the help of vacuum extraction is generally done when the delivery process is experiencing problems. Although it is important to do to help the delivery process, this technique also has some risks that have been mentioned above.
Therefore, ask your obstetrician further about the benefits and risks of using the birth aid.