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Vacuum Extraction Delivery: What Expecting Mothers Should Know

Written by Berkowitz

doctor and baby

Vacuum extraction is a process used during labor that applies a suction cup to the baby’s head and helps “suck” the baby out of the mother’s birth canal. Vacuum extraction helps expedite childbirth, but it can also cause injury. Injury due to negligent vacuum extraction can form the basis for a malpractice lawsuit.

Why Vacuum Extraction?

In some cases, the contractions of labor are insufficient to push the baby out of the mother’s body. Vacuum extraction is then used to pull the baby through the birth canal before oxygen deprivation sets in and causes lifelong disability or even death. Vacuum extraction is uncommon, but not rare – two to three percent of all babies are delivered this way.

Different Types of Vacuum Extractors

Three different types of vacuum extractors are commonly used in hospitals as described below:

  • Metal cup: An electrical suction device is attached to a metal cup that is then attached to a central chain, which is, in turn, attached to a handle This design is the most successful, although hardly the most comfortable to use.
  • Soft cup: A bell-shaped soft cup is attached to a manually operated vacuum pump. This type of vacuum extractor is more comfortable, but it is less effective than metal extractors
  • M-cup: The M-cup vacuum extractor offers a soft sidewall, and it combines the advantages of metal and soft cups while minimizing the disadvantages of both.

Informed Consent

Vacuum extraction is not the standard procedure for birthing a baby, and before it is used, doctors typically seek informed consent from the mother. In other words, she subjectively consents to the procedure while understanding its risks and consequences.

Informed consent is not required for all medical procedures, and there is some uncertainty as to whether it is required in the case of vacuum extraction. It is almost certain, however, that informed consent is not required in an emergency when the life of the baby is at stake. Under most circumstances, a doctor’s best policy is to seek informed consent from the mother before performing the procedure. A claim based on lack of informed consent may or may not succeed.

When Vacuum Extraction Should Be Considered

The following factors, if present, render a decision to use vacuum extraction more appropriate than it otherwise would be, although no single factor is dispositive:

  • You are having a vaginal birth (in other words, not a C-section);
  • Your cervix is fully dilated;
  • Your membranes have ruptured;
  • You are pushing, but your labor is not making progress after two hours;
  • Your baby’s heartbeat is abnormal and suggests the need for immediate delivery;
  • You have a medical condition, such as heart disease, that limits the amount of time you are able to push during labor;
  • You are exhausted and cannot push much longer, or you experience a sudden medical issue that prevents you from being able to push any longer;
  • Your baby is in a breech position (bottom first, which is a very dangerous condition); and/or
  • Your baby’s shoulders are too wide to fit through the birth canal.

Doctors sometimes suggest vacuum extraction as a last resort before proceeding with a C-section. Although a vacuum extraction is painful without anesthesia, doctors routinely supply epidural or local anesthesia, resulting in no pain and no loss of consciousness.

When You Should Not Have a Vacuum Extraction

There are certain circumstances in which you should not have a vacuum extraction (and your doctor is likely to have committed professional negligence by ordering one), including:

  • You are less than 34 weeks pregnant at the time;
  • Your baby is suffering from osteogenesis imperfecta (affecting bone strength) or hemophilia (a bleeding disorder);
  • Your baby’s head has not yet passed the midpoint of the birth canal;
  • The doctor does not yet know the exact position of your baby’s head;
  • The baby’s head is not the body part that is leading the way through the birth canal;
  • There is doubt as to whether your baby can fit through our pelvis (a situation that calls for a C-section, not a vacuum extraction); or
  • Other valid medical reasons or circumstances too numerous to mention here.

Medical Risks to the Mother

The medical risks of a vacuum extraction that are borne by you, rather than your baby, include:

  • Lacerations and tears around your urethra, vagina, or rectum;
  • Increased loss of blood;
  • Urinary incontinence;
  • Pelvic prolapse (“drooping” of the bladder, uterus, vagina, small bowel, and/or rectum due to weakness in the pelvic floor muscles);
  • Bowel incontinence;
  • Chronic postpartum pain; and
  • Anemia.

Risks to the Baby

Your baby is far more at risk than you during a vacuum extraction. The following are some of the most prominent risks:

  • Blood under the skin (hematoma);
  • Bleeding inside the skill (intracranial hemorrhage);
  • Jaundice due to blood vessel damage (which may or may not require treatment to correct);
  • Skull fractures;
  • Facial bruising (usually minor);
  • Temporary weakness in your baby’s facial muscles;
  • Minor scalp wounds;
  • Minor swelling of the scalp;
  • Bleeding behind the eyes (retinal hemorrhage);
  • Neurological conditions such as Erb’s palsy or cerebral palsy; and/or
  • Various forms of brain damage

Most of these risks are temporary, minor injuries. However, the most serious injuries, such as cerebral palsy, can result in lifelong disability.

How to Minimize Your Risk of a Vacuum Extraction

The best way to get through a vacuum extraction successfully, or avoid one entirely, is to start preparing for the possibility in advance by observing the following tips before and during labor:

  • Take care of your health during your pregnancy. Don’t smoke or drink, watch your diet, and exercise to the extent that your doctor says it’s safe to do so.
  • Pace yourself during labor so that you don’t get exhausted. Exhaustion is one of the main reasons for vacuum extraction.
  • Keep yourself properly hydrated (drink plenty of water) to avoid exhaustion.
  • Stay upright and active during labor – avoid lying on your back as much as possible.
  • During labor, avoid an epidural, or at least wait until an hour after you are fully dilated.

Even following these rules cannot guarantee that you won’t need a vacuum extraction or that a vacuum extraction will proceed smoothly. The foregoing tips can, however, maximize your odds of a desirable outcome.

Examples of Possible Professional Negligence during a Vacuum Extraction

Just as there are a thousand things that can go wrong during the delivery of a baby, there are a thousand ways that your doctor might commit professional negligence during a vacuum extraction (and a thousand reasons why a birth injury during vacuum extraction probably will not occur). The following are some examples of malpractice incident to vacuum extraction:

  • Vacuum extraction is attempted after forceps have already been used, especially if the doctor is attempting to use a vacuum extractor to rotate your baby’s head.
  • Vacuum extraction is used when the baby’s head is too high in the birth canal.
  • The doctor does not know the exact position of your baby’s body during vacuum extraction. Proceeding with a vacuum extraction under these circumstances is extremely risky.
  • The doctor pulls too long or too hard on your baby’s head or twists the head inappropriately.
  • The doctor uses a vacuum extractor and forceps at the same time.
  • The doctor uses lateral traction to pull your baby through the birth canal.
  • The doctor places the vacuum extractor incorrectly.

The mere fact that your baby was injured after a vacuum extraction does not, by itself, prove that malpractice was involved. If there were four or more attempts to remove your baby from the birth canal using vacuum extraction, however, it is a fairly good bet that any injury to your baby was the result of malpractice.

Filing a Birth Injury Claim in Connecticut

Filing a birth injury claim in Connecticut means you must:

  1. Investigate the claim and gather evidence.
  2. Locate a medical expert (we enjoy working relationships with several of them) to investigate your claim and sign a written statement confirming that, in the expert’s opinion, the harm you or your baby suffered was due to malpractice. This opinion letter can be used to create something called a “reasonable inquiry” certificate, which is a prerequisite to filing a malpractice lawsuit in Connecticut.
  3. Draft a formal lawsuit complaint. This document must be drafted with the utmost care, because every word has consequences.
  4. Submit the lawsuit complaint together with the reasonable inquiry certificate to a Connecticut court of appropriate jurisdiction.
  5. Initiate settlement negotiations after the defendant is notified of the lawsuit (through service of process).
  6. Demand evidence from the defendant and third parties through the lawsuit “discovery” process. This evidence can include physical evidence, such as medical records, and testimonial evidence, such as the questioning of witnesses under oath.
  7. Use the evidence gathered through the discovery process to attempt to settle your malpractice claim out of court.
  8. Go to court to litigate the claim if settlement negotiations fail.

Let Us Handle Your Claim for You

If you or your baby suffered an injury during vacuum extraction, an investigation can determine whether the injury was the result of professional negligence. If it was, then it is time you began preparing to file a claim. Of course, many injury lawyers boast of their ability to obtain quick settlements for their clients without ever going to court. The irony is that, without a strong record of winning in court, a lawyer lacks the bargaining power to extract a generous settlement.

At Berkowitz Hanna, however, winning multimillion-dollar lawsuits is a common occurrence, even though the vast majority of our clients’ claims are settled out of court. We’re so confident of winning that we will charge you nothing for our services unless we win your claim. Call us or contact us online to get the process started today!