Most vaginal deliveries are completed without any assistance beyond the support of the obstetric and midwifery team. But in some situations, the second stage of labour reaches a point where the baby needs help moving the final distance through the birth canal. Instrumental delivery provides that help safely and skilfully, completing a vaginal birth that would otherwise require a caesarean section.
At KIMS Cuddles at KIMS Hospitals, Electronic City, instrumental delivery is performed by experienced obstetricians with the training and clinical judgement to use these techniques safely and appropriately for women across Electronic City, Hosur Road, Neeladri Road, and South Bengaluru.
What Instrumental Delivery Is
Instrumental delivery uses either forceps or a ventouse cup to assist the baby through the final part of the birth canal during the pushing stage. These instruments help the obstetrician guide and assist the baby’s descent and rotation as the mother continues to push. The baby can be delivered without the need for a surgical incision.
Forceps are curved metal instruments that cradle the baby's head, and they are used for guided traction. A ventouse, also known as a vacuum extractor, uses a suction cap applied to the baby’s head to create a gentle pulling force with each contraction. The choice of instruments depends on the medical situation, the position of the baby and the operator’s experience.
The choice between them depends on the specific clinical situation, the position of the baby's head, and the operator's training and experience.
When Instrumental Delivery Is Used
The decision to use instrumental delivery is made by the obstetrician when the clinical assessment indicates that the second stage is not progressing to safe completion without assistance. Situations where instrumental delivery may be recommended are listed below.
Prolonged second stage where progress has stalled despite effective pushing
Foetal heart rate changes suggest the baby needs delivery more quickly than a spontaneous delivery allows
Maternal exhaustion, where the mother cannot sustain effective pushing
Specific maternal medical conditions where prolonged pushing is contraindicated, including certain cardiac conditions and severe hypertension
The baby's head is in a position that requires rotation before delivery can safely occur
The decision is made after checking the position of the baby’s head, confirming that vaginal delivery is safe. Doctors also explain the recommendation clearly to the mother before proceeding.
Informed Consent
Instrumental delivery is never performed without the mother's understanding and agreement. Our team explains clearly what is being recommended, why, what the procedure involves, and what the alternative is if instrumental delivery is not successful or not appropriate. This conversation happens at the bedside in the context of active labour, and our team communicates calmly and clearly, however urgent the situation may be.
The Procedure
Instrumental delivery is performed in the delivery room or, where appropriate preparation for possible escalation to caesarean is needed, in the operating theatre. Adequate pain relief is confirmed before the procedure begins. If an epidural is in place, it is used. If not, a pudendal block or additional perineal anaesthesia is provided.
The obstetrician uses the instrument of their choice, working with the mother’s pushing and the natural forces of uterine contraction to deliver the baby. An episiotomy can be done to provide more space if needed, and it also reduces the risk of severe tearing of the perineum.
Once delivered, the baby is assessed immediately. The paediatric team is present at all instrumental deliveries to provide immediate assessment and any support the baby needs.
After an Instrumental Delivery
The perineum and vaginal walls are examined carefully after instrumental delivery to identify and repair any tears or the episiotomy. Appropriate anaesthesia is used for this. The repair is performed meticulously, as the quality of the repair significantly influences postnatal recovery and long-term pelvic floor health.
Women who have had an instrumental delivery are counselled on what to expect during recovery, which may involve more perineal soreness than a straightforward vaginal delivery, and on pelvic floor physiotherapy referral where appropriate. At the six-week postnatal check, recovery is specifically assessed alongside any concerns the mother has.
Why Choose KIMS Cuddles at KIMS Hospitals, Electronic City
Instrumental delivery requires specific training and clinical experience to perform safely. The decision to use it, the choice of instrument, and the technique of application all require obstetric expertise that comes from a substantial volume of practice. At KIMS Cuddles at KIMS Hospitals, Electronic City, our obstetric team performs instrumental delivery within a fully equipped maternity unit with immediate access to the theatre if escalation to a caesarean is needed.
Book an Appointment
To discuss your birth preferences and the range of delivery options available at KIMS Cuddles at KIMS Hospitals, Electronic City, book an antenatal consultation online or by phone.
