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Home :: Intervention :: Instrumental

The best way to avoid the use of forceps or vacuum extraction is NOT to have an epidural.

Being able to move about freely and change positions greatly assists you to give birth without the need for the violence of forceps or vacuum extractions.

The main reason for using forceps and vacuum extractions is if there is a delay in labour in the second stage or the foetal monitoring indicates the baby is in foetal distress.

In 2006, more than 10% of Australian women who gave birth had vacuum extraction or forceps used.


Babies delivered with forceps may have some bruising or marking to their heads that usually fades in the weeks following birth

This may be caused by the use of analgesia, especially epidurals as they relax the pelvic floor preventing these muscles from guiding the baby’s head into the best position. Women who also choose to have an epidural cannot feel their contractions which means they have no feedback from their body about their baby’s progress.

After an epidural, women are often  required to sit on their coccyx bones, this also increases their chance of needing either forceps or vacuum.

Latest studies show that women who have epidural anaesthesia over 45% will go on to have an operative birth (instrumental assisted vaginal birth by forceps or vacuum extraction plus caesarean delivery.) If you have an instrumental assisted birth you may require an episiotomy.

Finding a  care provider that knows how to help you to get into the best positions and create an environment where you feel comfortable to fully open and let yourself birth your baby naturally is very important.

When interviewing care providers it is always good to ask for their forceps and vacuum extraction rate,  this will tell you a lot about the support they offer.

Research has shown that vacuum extraction is preferable to forceps as it causes fewer traumas to mother and baby.

The research also shows that the decision of your care provider to choose forceps or vacuum will mainly depend on their preference and experience.


14.67% Private Hospital (NSW)

9.14% Public Hospital (NSW)

(Source: NSW Mothers & Babies Report 2009)

Check your local hospital c-section rates here in our Birth Services Revealed.


Illustration of a breech delivery with obstetric forceps painted by American medical artist Catherine Sinclair Holt (1914 - 1990)



  • When allowing the women to continue pushing is detrimental to the mother due to a condition such; severe pre-eclampsia, high blood pressure or heart condition
  • When foetal distress is present, forceps may prevent a baby from becoming hypoxic (oxygen-starved) which if severe, can lead to brain damage or death


  • There is need for analgesia, which stops the mother from feeling the baby being born
  • Episiotomy is usually routinely performed with forceps
  • Damage to internal tissues
  • Additional strain on the pelvic floor muscles
  • Mother may feel disappointed about her birth experience
  • Drugs and discomfort can alter a mothers relationship with her newborn
  • Analgesics cross the placenta and may effect the baby
  • The baby’s face may be bruised or marked and great pressure it put on their skull and spine

Forceps have their place in museums. The last time I used forceps was in February 1965. Obstetrician Dr Michel Odent


Illustration showing forceps and ventuouse © 2008 Nucleus Medical Art, Inc

Vacuum extraction (Ventouse)

Advantages over Forceps

  • Can be used before the cervix is fully dilated if rapid delivery is necessary
  • Episiotomy is not usually required
  • Little internal bruising
  • Mother can still feel the birth due to not having to have analgesic so she can still feel her contractions and assist with pushing
  • There are fewer makes on the babies head


  • Not always available due to care-gives experience or preference
  • Suction cup may not stay in place and forceps or caesarean then may be necessary
  • The suction lump on the babies head may take time to disappear
  • The baby could be distressed from having the vacuumed attached and from the force applied to it head and spin when being pulled out.

heartTips to avoid an instrumental birth

storiesBirth Stories

Dr B said he would need to use clamps and that the more I pushed the less he would have to pull. So we coordinated our efforts and while I pushed, he cut me (DP heard the snip), stuck the salad tongs in and grabbed Bub’s head. I pushed, screamed and hollered, and he pulled (turning Bub at the same time) and shortly thereafter Bub’s head emerged. Read more.


Check your local hospital instrumental birth rates here in our Birth Services Revealed database to see the forceps or vacuum extraction rate at your local hospitals.



Norwest Private 18.5%

(Source: NSW Mothers & Babies Report 2009)

Check your local hospital forceps and vacuum extraction rates here in our Birth Services Revealed.

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