Vacuum Delivery Complications

In an ideal world, the birthing process is smooth. It progresses through each stage of labour without delay and with minimal pain and complications. Unfortunately, issues may arise during birth that may necessitate prompt medical intervention.

If a baby is having trouble moving through the birth canal and labour is stalled, then the medical team may choose to intervene with an obstetric tool such as a vacuum extractor. This device is placed on the baby’s head and used to assist in a difficult delivery. It does present a risk of injury to both mother and baby, including serious birth injuries like brain damage and even death.

When a baby suffers a preventable birth injury, a lawsuit may be the best way to hold the responsible medical professionals responsible and to get the money that you need to move forward with your life. The Birth Injury Lawyers Alliance (BILA) works with families throughout Canada to help them get justice for preventable birth injuries. If you or your baby have been hurt during the delivery process, reach out to schedule a consultation with a member of our legal team.

When Is Vacuum Assisted Delivery Used?

Vacuum extraction is a type of assisted delivery that uses a machine and suction to assist in labour. It is used when labour is not progressing and when the health of the mother and/or baby is in danger. Like forceps delivery, it can be used as a way of avoiding a surgical delivery through a cesarean section (c-section).

There are three stages of labour: early and active labour, birth, and delivery of the placenta. When labour is stalled at this second stage – when the mother is pushing – the delivery team should be actively monitoring the heart rate and blood pressure of both the mother and baby. If the mother has certain medical conditions and if the baby is showing signs of fetal distress, it may be necessary to assist in the labour through the use of a tool like a vacuum.

Vacuum extraction, or ventouse, is one of two options that healthcare providers may use to assist in a vaginal delivery. Along with forceps delivery, it is considered a last resort to avoid surgery. In the United States, approximately 2.5% of all vaginal births involve the use of vacuum-assisted delivery.

Vacuum extraction is not appropriate for all situations. It may be indicated if labour is stalled in the second stage, and either the baby’s heart rate is “non-reassuring” or the mother cannot push anymore because of a health condition or exhaustion. A baby’s heart rate is considered “non-reassuring” if it is unusually high or low, has a pattern of abrupt decreases, or takes too long to return to baseline after a contraction. This type of abnormal heart rate might be a sign that a baby is not getting enough oxygen during labour and delivery.

The process involves placing the cup of the vacuum or ventouse on the baby’s head. It may also be necessary to perform an episiotomy, break the mother’s water, and/or drain her bladder before starting. Once the cup has been placed, the medical team will apply traction with the mechanical or electric pump of the vacuum. The vacuum will add to the force of the contraction, pulling on the baby’s head when the mother pushes and pausing during breaks in contractions. At the same time, the doctor will grasp the cup and try to guide the baby’s head through the birth canal.

Getting the right amount of suction can be a delicate balance. With too little suction, the cup will detach from the baby’s head. Too much suction can injure the infant’s scalp. 

If there are any issues with using the vacuum extractor, then the delivery team will stop using it and proceed to the next steps, which may involve a cesarean delivery. Vacuum delivery should not be continued if there is any sign of trauma to the baby’s scalp after it has been attempted for 20 minutes, and/or if the suction cup has detached from the baby’s head multiple times. 

Once the baby has been delivered, the medical team will check both mother and baby for any signs of tears, bruising, or wounds from the vacuum. They should also continue to monitor the baby for any signs of complications.

Vacuum extraction is not the best option for every delivery that has stalled. It is contraindicated for cases where:

• The baby is premature;
• The infant has not progressed low enough in the birth canal;
• The baby might not fit through the birth canal;
• The instant is not positioned headfirst (breech baby);
• The baby needs to be rotated; or
• The baby has a bleeding disorder.

If any of these situations are present, then a vacuum delivery is not appropriate or safe. Forceps delivery may be possible, or it may be necessary to perform a surgical delivery instead of a vaginal birth. Choosing to use a vacuum extractor when contraindicated may be a form of medical negligence.

Potential Injuries from Vacuum-Assisted Delivery

While vacuum deliveries can be safe, there are risks to both the mother and baby. For the mother, potential complications of this type of assisted delivery include:

• Vaginal tears
• Postpartum bleeding
• Incontinence
• Pelvic pain
• Blood clots
• Anemia due to blood loss

For babies, improper placement or excessive suction can cause both temporary injuries like bruising and swelling as well as more serious brain damage and nerve damage. Some minor injuries associated with vacuum-assisted deliveries include:

• Caput succedaneum, or scalp edema. This is the swelling of the scalp that can result in a cone-head appearance. It typically goes away within a few days.
• Bruising and jaundice. The vacuum can bruise the scalp, which increases the likelihood of developing neonatal jaundice. Both bruising and jaundice usually resolve within a few weeks.
• Cephalohematoma is a collection of blood between the baby’s scalp and skull that is caused by damaged blood vessels. It typically resolves on its own within one to two weeks.

In addition to these relatively minor injuries, serious complications may occur. This may include birth injuries such as:

• Skull fractures may cause brain bleeding and may require surgery to correct.
• Intracranial hemorrhage, or bleeding in or around the brain. These brain bleeds can be serious and may cause apnea, seizures, and/or brain damage.
• Subgaleal hemorrhage occurs when the emissary veins in the baby’s head rupture and blood accumulates in the connective tissue between the skull and scalp. If left untreated, it can cause hemorrhagic shock and death.
• Brachial plexus injuries, or nerve damage can cause Erb’s palsy when a baby’s arm, head, neck, or shoulder is pulled while the baby is stuck in the birth canal.  It is often associated with shoulder dystocia.
• Blindness due to a retinal hemorrhage
• Cerebral palsy can be caused by brain damage and result in permanent disability.
• Facial palsy
• Hearing loss
• Kernicterus
• Stroke

It is important to remember that a vaginal birth is not always possible – or safe.  If you are in the second stage of labour and are struggling, then a vacuum device may be used to help you have a vaginal birth. However, depending on your risk factors, the best and safest option may be to proceed directly to a cesarean delivery.

What Are Some Causes of Vacuum Delivery Birth Injuries?

Birth injuries that occur during vacuum deliveries are usually due to one of several causes:

1. Using vacuum delivery when contraindicated;
2. Incorrect placement of the suction cup on the baby’s head;
3. Choosing the wrong vacuum cup size for the baby’s head;
4. Twisting the neck and head too much;
5. Using excessive force when pulling or pulling in the wrong direction; and
6. Attempting a vacuum-assisted delivery for too long before opting for an emergency c-section.

If you or your baby suffered a birth injury after a vacuum delivery and one or more of these factors were present, it may be a sign of medical negligence. Reach out to BILA today to schedule a free consultation with a birth injury lawyer in your province.

Are Vacuum Extraction Injuries Treatable?

Many birth injuries related to vacuum extraction injuries can be treated. In fact, some – like intracranial and subgaleal hemorrhages – must be treated promptly to avoid further injury and/or death. However, some birth injuries can cause permanent damage, such as cerebral palsy.

If your child suffered a birth injury linked to a vacuum-assisted birth, BILA is here for you. We will listen to your story, help you understand your legal rights, and fight for your right to full compensation. Give our law offices a call today to schedule a free initial consultation with a birth injury lawyer in your province.

How BILA Can Help

The risk of complications in an instrumental delivery is higher than in a natural vaginal birth. While a vacuum-assisted vaginal delivery is quicker than an operative delivery, there is still a potential for birth injuries to both the baby and the mother. If a medical professional does not carefully evaluate the patient’s risk factors before deciding to undertake a vacuum delivery or does not use the vacuum device appropriately, it may be considered a form of medical negligence.

A birth injury lawsuit may be possible if you or your child have suffered a preventable birth injury from a vacuum delivery, forceps delivery, or another type of assisted delivery. We can help you sort through your options and make an informed delivery about whether to pursue legal action. To talk to a birth injury lawyer in your province, call BILA today at 1-800-300-2452 or fill out our online contact form.