Birth

Cases in which an instrumental delivery is necessary


The current trend is for childbirth to be respected to the maximum, that it proceeds normally and with minimal external intervention. However, there are certain circumstances where the gynecologist or obstetrician must actively intervene, such as instrumental deliveries. In which cases is it necessary to perform an instrumental delivery?

The moment of delivery is one of the most important moments in a woman's reproductive life and, in turn, one that generates more uncertainty. In the case of first-time pregnant women, more if possible. Possibly you have heard a story, with some negative nuance (the good thing we do not usually tell) of how bad it was the delivery of that known or relative with whom they used the vacuum or suction cup, or about the mark that was left on the scalp when using forceps for quite some time.

I hope with these lines I can help you understand a little more what this type of procedure consists of and when they are used, hoping that, if you find yourself in one of these situations, you will fully trust the medical team that assists you and be clear that it does not have why should there be any kind of sequel neither in the mother nor in the baby. And it is that the vast majority of deliveries occur in a controlled natural way, but approximately 15% require the use of instruments.

A childbirth goes from natural and becomes instrumental when help is required, due to maternal or fetal circumstances. There are a series of tools to ensure that the baby is born properly and the mother is still not affected, trying to ensure that everything goes well.

In order to decide when an instrumental delivery is needed, given circumstances in which both the mother and / or the baby require rapid action as help in the last phase of labor, a series of circumstances must arise: ruptured membranes, cephalic presentation of the baby very lowered (embedded), child in the correct plane (level in the birth canal), position and orientation of the baby or state of the mother's dilation.

Under these premises (and some more specialized ones) this type of delivery is indicated when:

- The expulsive period is exaggeratedly prolonged or when this phase of so much effort should not be lengthened due to some health problem in the mother (you can imagine why: heart, lung, retina, etc ...).

- There is fetal distress, there are problems in the baby's descent position, etc.

During this type of delivery, three types of instruments are used, which I will explain to you below:

Empty
It is a piece of metal or plastic, shaped like a suction cup. It is applied on the baby's head, generating (manually or automatically) a vacuum, which helps to pull the baby down, without causing any damage, and without touching the birth canal.

Forceps
It is a tool that at first glance is much rougher and more striking than the previous one. It consists of two sheets, usually made of metal, articulated, which in certain situations of urgency is very useful to lower the baby when circumstances require and allow it. Unlike the vacuum, the forceps is applied on the head of the child, but also passes through the birth canal, so it is possible to perform the rotational movement of the child as well as its extraction.

Spatulas
They are similar to the previous ones, but without the joint. Its action is by push (impulse) instead of traction. They help to widen the birth canal and to deliver the baby, in its last phase of exit.

As might be expected, in natural childbirth the possible risks are lower than in instruments, and therefore, the best choice under normal conditions. The rate of complications in instrumental deliveries it is greater, but always acceptable if they are well executed and, of course, in the correct indications.

Throughout history its use has been progressively more restrictive (under the conditions indicated), so that a few decades ago its use was much more frequent than it is today. Its application, I emphasize, is always under the premises indicated above and helps us to solve and reverse the problems that may have occurred or could be triggered by childbirth.

Ultimately, its purpose is to end the delivery quickly, totally optimal for both mother and baby, safeguarding the health status of both to the maximum.

You can read more articles similar to Cases in which an instrumental delivery is necessary, in the On-Site Delivery category.

Video: Forceps Delivery - Obstetrics (September 2020).