Maternal and Child Birth Injury Rates Higher With Forceps, Vacuum Delivery: Study

Use of forceps or vacuum extraction during delivery are more dangerous to the newborn than cesarean delivery, according to the findings of a new study. 

Babies are 80% more likely to suffer severe complications when forceps or vacuum extraction are used, researchers warn in a study published this month in the Canadian Medical Association Journal. The mother is also three to five times more likely to suffer trauma from the birth if those devices are used instead of a cesarean section.

Researchers looked at data on 187,234 deliveries in Canada between 2003 and 2013 that involved midpelvic operative vaginal or cesarean delivery. Of those, 76,755 involved women suffering poor uterine contractions and 110,497 involved fetal distress.

The study found that midpelvic vaginal delivery using forceps or vacuum extraction was linked with an 80% higher rate of severe injury or death of the infant. They also discovered that about 19% of women who delivered their baby with the use of forceps suffered severe obstetric tearing, compared to 12% who delivered by vacuum extraction, and 20% who delivered through a combination of both methods.

Vacuum extraction involves the use of suction on the child’s head to speed up delivery and help remove the infant from the birth canal. The process is primarily used when the baby is in distress.

Vaginal delivery using a vacuum extractor has slowly replaced the use of forceps in many situations, as they are generally considered safer and reduce the risk of facial nerve damage from forceps. However, severe and potentially life threatening birth injury can still occur with the use of vacuum extraction, most commonly involving bleeding in the area between the skull and the scalp or bleeding inside the child’s skull. This can result in brain damage, developmental problems or cerebral palsy.

“Our study showed that attempted midpelvic operative vaginal delivery is associated with substantially higher rates of severe birth trauma and obstetric trauma,” the researchers concluded. “Encouraging higher rates of operative vaginal delivery as a strategy to reduce the rate of cesarean delivery could result in increases in severe perinatal and maternal morbidity and mortality, especially birth trauma, severe postpartum hemorrhage and obstetric trauma.