Your doctor chose vacuum extraction over forceps or cesarean delivery of your baby, and you’re now wondering if the postpartum health problems you or your baby experienced resulted from that choice, or improper execution of vacuum extractor delivery. Are vacuum extractions the safest delivery method? You may want to learn more about the practices and pitfalls of instrument-assisted delivery, and what you can do if you or your child suffered injuries from vacuum birth negligence. While using vacuum extractors in the labor and delivery process may be the most beneficial method under certain circumstances, it may also lead to direct and serious injury for the mother or baby when contraindicated or used improperly.
If you suspect that your doctor caused injuries due to negligent use of vacuum extractor during birth, it is important to know and understand your legal options to pursue compensation. An experienced birth injury attorney on our seasoned team is available immediately to discuss your case free of charge. Whether you suffered physical trauma or your child was subsequently diagnosed with brain damage, cerebral palsy, or another condition that may have been caused by negligence at birth, contact us today at 866-708-8617 for a free consultation. Our lawyers are dedicated to aiding birth injury victims and families like yours in New Jersey and beyond.
How is Vacuum Delivery is Done
A vacuum extraction-assisted delivery is one option to assist a mother with delivering her child vaginally. A vacuum extractor is a vacuum pump with a handle and a cup, made of plastic, polyethylene, or silicone, either a funnel or bell-shaped (soft) or mushroom-shaped (rigid), each cup with its own advantages and disadvantages. During a vaginal birth, a healthcare provider places the vacuum cup on the baby’s head, making sure vaginal tissue isn’t trapped between the cap and the baby’s head. The correct placement is critical to the success of the extraction and to the health of the baby. Knowing how much suction and when to apply it is also important to keep the procedure within the statistically 1 to 3 pull safety range. After applying the cup, the vacuum operator increases the suction to grip the baby’s head and help steer the baby out of the birth canal, while the mother pushes through a contraction. Only when the head is delivered, the suction is decreased or shut off.
Why Doctors Choose Vacuum Extraction during Birth
Operative vaginal delivery means a delivery in which the fetus is extracted by forceps, a vacuum, or other device with or without the mother’s help. When a physician decides on an instrument-assisted birth, they must consider the impact on mother and baby, pre- and post-delivery, and weigh that against delivery by c-section. About 3 percent of all deliveries in the U.S. are done via operative vaginal, and 2.6 of those by vacuum extraction. In recent years, vacuum extraction has been favored over forceps delivery. Choosing vacuum suction over other methods depends on the birthing situation, the comfort level and experience of the instrument operator, the degree of maternal anesthetization, and the risks and benefits of each instrument option.
After obtaining consent and explaining the procedure, risks and alternatives to the mother, a healthcare provider might choose vacuum extraction if the mother’s cervix is fully dilated, her membranes have ruptured, she has no history of placenta previa (placenta covers the cervix), her bladder is empty, and the baby is headfirst into the birth canal (the head is in the pelvis), but the mother is too exhausted or otherwise unable to push the baby out. The operator absolutely must have the requisite skill in operating the tool. Vacuum extraction should be used in a hospital or birthing center where the baby can be constantly monitored, and, if the extraction fails, a cesarean section can be performed.
A vacuum extraction is an option if pushing is not progressing labor after a long time (three hours with anesthesia, two without), the baby’s heartbeat pattern signals danger to the baby, and the mother has a medical condition that makes it dangerous to push for too long (heart condition or neuromuscular disorder).
When Suction Should not be used for Delivery
Use of vacuum extractors is not appropriate for pregnancies under 34 weeks, nor if certain factors are present, including if:
- The baby has a bone or bleeding disorder, such as osteogenesis imperfecta or hemophilia;
- Has not descended further than half way down the birth canal;
- Does not have an ascertainable head position;
- I not heading down the canal head first; or
- Is too big for the mother’s pelvis.
Vacuum extractions fail because the mother is not a good candidate, for example, her pelvis is too small for the size of the baby’s head, or application and technique errors. Though vacuums are more likely to fail than forceps, cesarean deliveries are lower with vacuum use over forceps, probably because a failed vacuum attempt is followed by a forceps attempt, while a failed forceps attempt is followed by a c-section. Vacuum extraction can also be used in c-sections when the baby’s head is not engaged. Delivery by c-section, a surgical procedure, is least favored by most women.
Before opting for a vacuum extraction, the delivering healthcare professional may try other ways to move labor along, such as changing the mother’s position; giving her more emotional support; reducing her anesthesia to create more productive pushing; introducing medication such as Pitocin to induce stronger contractions; laboring down (delayed pushing); or performing an episiotomy to help delivery of the baby.
Injuries and Risks of Vacuum Extraction
The vacuum extractor is a means to speed up delivery when labor is stalled or progressing too slowly during the pushing stage or if the baby is in danger and immediate delivery is necessary. However, this method comes with risks to both mother and baby. Risks for vacuum extraction to the baby include:
- Shoulder dystocia (shoulder is stuck after delivery of the head)
- Skull fracture
- Facial nerve palsies
- Subgaleal hematomas (blood pooling outside of the skull),
- Scalp wounds
- Brachial plexus injury (nerves that run from the spinal cord to the arms, shoulders and hands)
- Erb’s palsy (paralysis due to brachial plexus injury)
- Retinal bleeding
- Cerebral palsy
- Bleeding inside of the skull, some of which may appear hours after birth.
Risks for the mother when a vacuum birth is performed are similarly vast and varied. If the doctor chooses the vacuum extraction method for delivery, the mother may experience any of the following serious injuries and complications:
- Perineum (tissue between the vagina and anus) pain
- Genital tract tears
- Difficulty urinating
- Difficulty emptying the bladder
- Urinary or fecal incontinence (involuntary urination or defecations that may show up later and last for years)
- Episiotomy-related pain (cutting the tissue between the vagina and anus in order to insert the vacuum)
Which is safer vacuum extraction or forceps?
Data suggests that forceps cause more maternal injury, such as perineal injury, postpartum pain, and increased need for anesthesia. On the other hand, vacuum extractor delivery causes more neonatal injury, including scalp injury and cephalohematoma or blood pooling under the skull.
Contact a New Jersey Vacuum Extractor Injury Lawyer Today
If your injury or your child’s injury is a result of improper or wrongful use of the vacuum extractor, your healthcare provider may be liable for negligently causing damages. Specifically, your doctor’s negligence may give rise to a medical malpractice action for breach of the standard of care expected of a similarly situated medical practitioner. Medical malpractice awards in New Jersey include compensation for medical bills due to injury, as well as pain and suffering and future medical and therapeutic needs. However, you have a limited time in which to file a lawsuit on behalf of yourself or your minor child. Be sure to discuss your case with a qualified birth malpractice attorney experienced in vacuum extraction methods and practices. Our team of birth injury lawyers is here to provide dedicated legal guidance and representation when seeking the compensation you and your child need and deserve. Contact us today at 866-708-8617 for a free case evaluation.
- Vacuum extraction, MayoClinic
- Vacuum-Assisted Vaginal Delivery, Reviews in Obstetrics & Gynecology
- Assisted Vaginal Delivery, The American College of Obstetricians and Gynecologists