Assisted Birth Methods

Learning Activity
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2016 Assessment Technologies Institute®, LLC
Assisted Birth Method Review

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Vacuum-Assisted Delivery

• Involves use of cuplike suction

device attached to fetal head.
• Traction is applied during
contractions to assist in descent
and birth of head.
• Vacuum cup is released and
removed preceding delivery of
fetal body.

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Conditions for Use of Vacuum-Assisted Birth

• Vertex presentation
• Absence of cephalopelvic disproportion
• Ruptured membranes

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Indications for Vacuum-Assisted Birth

• Maternal exhaustion
• Ineffective pushing efforts
• Fetal distress during second stage of labor
• Generally not used to assist birth prior to 34 weeks gestation

• Client Outcome: Labor will progress without complications.

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Risks associated with vacuum-assisted births

• Neonatal risks
• Scalp lacerations
• Subdural hematoma
• Cephalohematoma
• Maternal risks
• Lacerations to cervix, vagina, or
perineum

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Nursing Actions

• Provide teaching and support. • Assess and record FHR before

• Assist client into lithotomy and during vacuum assistance.
position to facilitate traction of • Assess for bladder distention.
vacuum cup when applied to fetal Catheterize if necessary.
head.

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Nursing Interventions

• Observe neonate for lacerations,

cephalohematomas, or subdural
hematomas after delivery.
• Check neonate for caput
succedaneum.

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Forceps-Assisted Delivery

• Using an instrument with two

curved, spoonlike blades to assist
in delivery of fetal head.
• Traction is applied during
contractions.

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Indications for Forceps-Assisted Birth

• Fetal distress during labor

• Abnormal presentations or
breech position requiring delivery
of head
• Prolonged second stage
• Maternal exhaustion
• Arrest of Rotation

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Nursing Actions
• Explain procedure to client and
support person.
• Assist client into lithotomy
position.
• Assess for empty bladder.
Catheterize if necessary.
• Assess that fetus is engaged
and membranes have ruptured.
• Be prepared for emergency
cesarean birth.
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Interventions
• Assess and record FHR
• Before, during, and after
forceps assistance.
• Cord compression between
fetal head and forceps
causes decrease in FHR.
• Observe neonate
• Bruising and abrasions
• Facial nerve palsy
• Facial bruising
• Check mother for possible
injuries after birth.
• Vaginal or cervical
lacerations
• Urine retention resulting from
bladder or urethral injuries
• Hematoma formation in
pelvic soft tissues from blood
vessel injury
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Amniotomy

• Artificial rupture of amniotic membranes (AROM)

• May be indicated for labor induction or augmentation
• May be indicated for cord compression or meconium-stained amniotic
fluid necessitating AROM

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Amniotomy: Nursing Indications

• Monitor FHR prior to and following AROM to assess for cord prolapse
evidenced by variable or late decelerations.
• Assess and document characteristics of amniotic fluid: color, odor, and
consistency.
• Document time of rupture.
• Limit maternal activity following AROM to reduce risk of infection or
malposition of fetus.
• Obtain temperature every 2 hr.

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Learning Activity Review Questions

1. Distinguish between the forceps-assisted and vacuum-assisted delivery

process.
2. Describe pertinent assessments that must be done postprocedure for the
mother and neonate.
3. What is the priority assessment after the amniotomy?

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