Imagining your baby being suctioned out of your vagina isn’t exactly a thrilling thought; however, it’s proven to be a safe and effective method used in many obstetric units for assisted deliveries.

In recent years, ventouse or vacuum extraction has become an increasingly popular instrument of choice for assisted delivery.

Your doctor or midwife may recommend an assisted delivery if your labour is unusually long, you’re exhausted, your baby is in distress, or if the baby’s head needs turning in the correct position.

How does vacuum extraction work?

Ventouse equipment includes a metal or soft plastic cup that has a handle or chain.

The cup is attached to a tube, connecting to the suction apparatus, or may be a handheld device called a ‘KIWI’ cup.
The cup is attached to the crown of the baby’s head and is held firmly in place against the scalp.
An electrical pump is used to secure the attachment.
The edges of the suction cup are checked to ensure no maternal tissues have been trapped.
During a contraction, with the help of the mother pushing, the baby is helped through the birth canal.
Once the head has been delivered, the vacuum is released, and the cup is removed. The delivery of the rest of the body proceeds as normal.

An episiotomy is currently advised when a ventouse delivery is performed.

What are the advantages and disadvantages of ventouse?

Advantages

The biggest advantage of vacuum extraction is that it can rotate the baby’s head into the correct position as it descends through the maternal pelvis.
Another great advantage is that the equipment takes up less space in the vagina than forceps. As a result, there is less risk of damage to the vagina and perineum, and there is therefore less need for pain relief.

Disadvantages

Delivery tends to be slower because of the time it takes to set up the equipment and place the cup correctly on top of the baby’s crown. However, an experienced obstetrician should be able to successfully apply the vacuum in about two minutes (approximately the length of time in between contractions during the second stage of labour).

What are the possible complications?

Maternal complications after ventouse are uncommon, but foetal complications, such as scalp injuries, bruising, and bleeding of the head, can happen even after a simple procedure. These injuries are more likely if the cup becomes dislodged or the delivery is prolonged.

Scalp swelling is normal after extraction but is more pronounced when a metal cup has been used. This usually subsides after a few days with no harmful effects.

About 12% of ventouse deliveries experience superficial scalp injuries; however, it is rare for these injuries to lead to long-term complications. About 6% of vacuum extractions develop cephalohematomas (a collection of blood beneath the top layer of the skull). This is usually resolved within two weeks, but if it is severe, the baby could develop jaundice.

Intracranial haemorrhage (bleeding into the head) happens in about 1 in 300–400 cases and is very serious. However, it is believed that this is more to do with an abnormal labour progression than the ventouse application itself.

What is a ventouse birth?

On Unii’s Giving Birth Journey, we explain ventouse birth (or vacuum extraction).