Labour
and Delivery
The
Second Stage
Pushing a baby into the world is one of the most terrifying and exhilarating
moments in a woman's (and a man's) life. There is a balance to be struck
between inappropriate early intervention (assisting with a forceps or
vacuum extractor/ventouse), or delaying until the mother is exhausted
or the condition of the baby deteriorates to a dangerous level.
Ventouse
or forceps assisted delivery
A ventouse or vacuum cup is often applied to the baby's head in the
second stage, to assist with the delivery of the baby. The ventouse
is now the first choice, as it causes less trauma to the mother's pelvic
floor. Occasionally a forceps is preferable to a ventouse, e.g. where
the mother is unable to push with contractions.
The
main reasons for using the Ventouse or forceps are;
Concern for the wellbeing of the baby,
Maternal exhaustion or lack of progress with pushing.
The available evidence suggests that prolonged pushing or pushing before
the cervix is fully dilated increases the risk of excessive damage to
the pelvic floor. This can lead to problems with incontinence
and prolapse of the pelvic floor, as well as problems with sexual
dysfunction. These risks must be weighed up against the mother's natural
wish to push her own baby out without the assistance of a ventouse or
forceps.