Forceps and ventouse: what an assisted birth involves

About 1 in 8 births is assisted with forceps or ventouse. Here is why it might be offered and what to expect.

Why it might be needed

The NHS says an assisted birth may be offered if:

you’ve been advised not to push because of a health condition, such as very high blood pressure
there are concerns about your baby’s heart rate
your baby is in an awkward position
your baby is tiring or in distress
your baby is premature (forceps can help protect their head)
you’ve had an epidural (see epidural in labour)

The NHS says an assisted delivery is used in about 1 in 8 births, and is less common if you’ve had a spontaneous vaginal birth before.

Ventouse and forceps

A ventouse is a cup attached to your baby’s head by suction. Forceps are smooth metal instruments that look like large spoons or tongs, placed around your baby’s head. For births before 36 weeks, the NHS says forceps may be recommended over ventouse because the baby’s head is softer.

What happens

Your obstetrician or midwife should explain why, which instrument and how. You’ll usually have a local anaesthetic if you don’t already have an epidural, and a children’s doctor (paediatrician) is usually present to check your baby afterwards. The NHS says it is likely a cut (episiotomy) will be needed. If there are concerns, you may be moved to theatre in case you need a caesarean. Your consent is needed before it goes ahead.

Risks for you

Tears: a higher chance of a third or fourth degree tear. See tears and episiotomy in childbirth.
Blood clots: the risk is higher, so move around as much as you can. You may be offered stockings or injections.
Bladder and bowel: urinary incontinence is more common. Physiotherapy and pelvic floor advice should be offered.

Risks for your baby

The NHS lists marks from the cup or forceps, which usually fade within 48 hours. It also lists a head bruise (usually nothing to worry about), small cuts on the face or scalp in about 1 in 10 babies, which heal quickly, and jaundice, which should pass in a few days.

Afterwards

You may have a catheter for up to 24 hours, especially after an epidural. Take your time to recover, and tell your midwife if you’re struggling.

Questions people ask

Will it hurt?

You’ll usually have a local anaesthetic if you don’t have an epidural, but tell your team if you’re in pain.

Is ventouse safer than forceps?

The NHS says forceps are linked to a higher chance of a third or fourth degree tear (8 to 12 in 100) than ventouse (4 in 100). The right choice depends on your situation.

Will my baby be marked?

The NHS says marks usually disappear within 48 hours.

Can I say no?

Yes. The NHS says your consent is needed before the procedure. Ask your team about the alternatives.