Vacuum Extraction Complications Explained
Vacuum extraction (also known as ventouse) is a procedure used to assist a complicated or prolonged delivery. Delivery assistance with either vacuum extraction or forceps is used in about 5% of births.
Though the majority of vacuum extractions are successful and cause few complications, the procedure does pose a risk of birth injury. The vacuum can cause scalp wounds, skull fractures and internal bleeding. Additionally, vacuum extraction increases the likelihood that the baby’s shoulders will get stuck in the birth canal.
More severe vacuum extraction complications can result in permanent health conditions for the child or mother. Serious injuries are rare, but they can occur when doctors perform vacuum extractions improperly or when they are not needed. Improper use of vacuums can be considered medical negligence.
Doctors typically prefer vacuum extraction since it has a lower chance of injuring the mother compared to forceps. However, vacuum extraction also presents a higher risk of harming the baby.
What Is a Vacuum Extraction?
A vacuum extraction is a procedure performed to speed up a delivery that is taking too long or that threatens the safety of the baby or mother. Vacuum extractions are only recommended during the second stage of labor. During this stage, the cervix is fully dilated and the baby has descended headfirst into the birth canal.
Doctors may use vacuum extraction in a variety of circumstances, including:
- The mother is pushing, but labor is not progressing
- The mother is getting too tired to continue pushing
- The baby’s heart rate is abnormal, indicating a problem
- The mother has a health condition that prevents her from pushing for too long
The vacuum extraction device includes a cup placed against the baby’s head and a vacuum pump for creating suction. The cup is firmly attached to the baby’s head and the doctor uses it to guide the baby through the birth canal gently. Typically, the doctor will pull during the mother’s contractions, as she pushes. The doctor removes the cup once the baby’s head is delivered.
When done properly, a vacuum extraction removes the baby from the birth canal quickly, reducing the risk of harm to the baby or mother. This eliminates the need for invasive C-section surgery. However, if the doctor cannot safely deliver the baby with the vacuum extraction, a C-section is recommended.
An improperly performed vacuum extraction can endanger both the baby and the mother.
What Leads to Vacuum Extraction Complications?
Vacuum extraction complications occur in many situations. Since there is a higher risk to the baby and mother during a vacuum extraction than with a natural birth, the procedure should only be done if required.
Medical professionals do not recommend vacuum extractions in the following circumstances:
- The mother is less than 34 weeks pregnant
- The baby’s head is too high up in the birth canal
- The doctor cannot determine the position of the baby’s head
- The baby is not positioned head-down in the birth canal
- The baby is too large to fit through the mother’s pelvis
- The baby has a medical condition that causes weakened bones or a bleeding disorder
One of the most serious complications to the baby is bleeding under the scalp or inside the skull. The bleeding is caused by damage to veins as the suction cup pulls at the tissues in the baby’s head. This can cause hematomas and brain damage, and it can be life-threatening. Excess pressure placed on the baby’s head can also lead to skull fractures.
During vacuum extraction, babies can suffer stretching or tearing of the nerves in the neck, risking spinal cord injury. This often occurs when the neck is twisted or pulled harshly during a vacuum extraction.
The mother is also at risk of complications when increased stretching is required to get the baby through the birth canal. Vaginal tears affect about 4% of women who go through a vacuum extraction. During a vacuum extraction, the mother is also at risk of blood loss and hematomas.
If vacuum extraction complications are not appropriately treated, the baby or mother may experience long-term health conditions.
Effects of Vacuum Extraction Complications
The complications of a vacuum extraction can be either acute and immediate or long-term and chronic. Whether the baby will recover fully or develop an ongoing medical condition depends on the severity of the damage and how quickly doctors intervene.
Short-Term Effects for the Mother and Baby
Most vacuum-related injuries are visible within 10 hours after birth. Bruising and swelling of the baby’s head are common after a vacuum extraction and will disappear over time. More severe complications, like bleeding under the scalp or bleeding in the brain, can be immediately life-threatening.
Following delivery, mothers may experience pain or tears that require stitching. Tearing puts her at risk of infection as the wound heals.
The mother may also develop anemia as a result of blood loss during delivery. Blood clots are another immediate threat to mothers. However, they can be prevented by moving around and following doctor’s advice for anti-clot stockings or injections.
Long-Term Effects for the Mother and Baby
If the baby’s head was bruised from vacuum extraction, doctors should monitor the baby closely for signs of jaundice during the next 2 to 3 days. Bruising increases the risk of severe jaundice, which can result in kernictrus, cerebral palsy, hearing loss and other serious cognitive problems when left untreated.
Stretching or tears to the nerves in the neck during delivery can cause Erb’s palsy—long-term or permanent issues with sensation and movement in the arms.
Bleeding inside the skull due to vacuum extraction complications can cause long-term damage to a baby’s brain. Damage may lead to problems with speech, memory, learning or movement depending on the area of the brain affected.
Severe tears to the mother during a vacuum extraction can cause long-term problems with the pelvic floor such as incontinence, pelvic pain and sexual problems. Mothers may also experience long-term difficulties with urination or defecation.
Vacuum Extractions and Medical Negligence
Most severe vacuum extraction injuries are preventable. Patients rely on their doctor’s professional experience to decide the best way to assist with delivery. Sometimes vacuum extractions fail. When a doctor determines that a vacuum extraction is the best option, they should be ready to abandon the procedure if it does not work and opt for a C-section instead.
In some cases, medical malpractice occurs alongside vacuum extraction complications—either caused by misuse of the procedure during delivery or a failure to provide prompt and appropriate treatment afterward. After a vacuum extraction, doctors should monitor the mother and her newborn for any signs of complications.
Prompt treatment of jaundice, skull fractures, bleeding in the brain and nerve damage can prevent a baby from developing long-term complications from a vacuum extraction. Likewise, doctors should take precautions to prevent maternal tears from becoming infected.
Financial Compensation for Vacuum Extraction Complications
If your baby suffered a birth injury as a result of an improper vacuum extraction or untreated complications from the procedure, you may be entitled to financial compensation. Vacuum extraction complications are preventable when doctors follow procedures correctly and administer prompt treatment for complications.
Work with an attorney experienced in birth injury cases for a better understanding of your legal options. Contact the Birth Injury Justice Center today at 800-914-1562 to get a free medical case review.