Newborn BabyWhy did I need a ventouse (vacuum extraction) birth?

The ventouse is suction apparatus that is commonly used to assist you in giving birth. It involves placing a small suction cup (made of soft or hard plastic or metal) onto your baby’s head. There are two types of ventouse available: a silastic cup which is attached to a machine which creates a vacuum on baby’s head; similar to the action of a sink plunger. Or there is a kiwi which is a little hand-operated device that has the same effect.

The ventouse is often used to help turn the baby from a back-to-back, upward facing position (called occipito posterior – OP), to a position where the baby’s head is facing downwards (ie baby is looking down onto the bed) – this is called occipito anterior – OA). In the OA position, the baby’s head passes more easily down the birth canal. When your baby is lying in the OP position however, their head presents in a wider diameter. This tends to make labour and birth a longer and more painful process, and women can be pushing for up to two hours with little progress. When it is not possible to rotate the baby, it can be possible for the baby to be delivered in the OP position. This is also commonly referred to as a ‘face to pubis’ delivery.

Once the ventouse has been applied, the woman is asked to push with each contraction and at the same time the doctor/midwife applies a gentle steady traction (slight pull) which carefully guides the baby down the birth canal. Sometimes an episiotomy (a small cut into the perineum) needs to be performed to allow extra space and minimise tears.

The ventouse can also be used if the baby becomes distressed in labour. Fetal distress can be identified by the baby’s heart rate becoming very fast (above 160bpm) or very slow (below 110bpm). Where your baby’s heart rate dips down before, during, or after contractions (called fetal heart decelerations), or the baby’s heart rate takes a long time to recover from a deceleration, this can also indicate fetal distress. The decision to assist the birth is made when the baby needs to be born as quickly as possible.

Following the birth you may notice that your baby has a swelling on their head from where the ventouse cup was applied. This is called a chignon and usually disappears within 24 hours of the birth.

Loudon JAZ, Groom KM, Hinkson L et al (2010). Changing trends in operative delivery performed at full dilatation over a 10-year period. Journal of Obstetrics and Gynaecology 30(4):370-375.

O’Mahony F, Hofmeyr GJ, Menon V (2010). Choice of instruments for assisted vaginal delivery (Cochrane Review). (Review content assessed as up-to-date: 4 October 2010). The Cochrane Database of Systematic Reviews. Issue 11.

Royal College of Obstetricians and Gynaecologists (2012). An assisted vaginal birth (ventouse or forceps): information for you.London: RCOG.