Vacuum Assisted Delivery

Updated on November 29, 2012
S.O. asks from Birmingham, AL
12 answers

I have a question regarding this type of delivery. My wife delivered our little girl on Monday and the doctor recommended a vacuum delivery. My wife asked what the problems associated with such a delivery are and the doctor indicated there were none. Believing in the doctor we proceeded with the vacuum instead of c-section. Right after delivery I noticed our baby had a large bump on her head where the vacuum was located, a cephalohematoma. While in the delivery room our baby had trouble breathing and was taken to NICU. She was also found to have increased levels of bilirubin, which is an indicator of jaundice. They told us that the increased levels were due to the incompatability between my wifes blood and my daugther. I am familiar with this type of jaundice which is cauled Rh factor mismatch, and feel that the doctors are covering their mistakes with the vacuum, because my wife is O+ and my daughter is A+ [both have same Rh factor]. The doctor indicated that my wife produced antibodies that were destorying my daughters red blood cells which is why she needs to be in NICU. I recently found out that when a newborn has a large bruise such as a cephalohematoma this too can cause jaundice.

Now my question is, do you believe that my daughter can now have mental defects in the long run due to our doctor improperly using the vacuum [as evident by her having difficulties breathing]? I say improperly, because it seems as if they are covering their tracks by blaming my wife's antibody production on my daughters increased bilirubin levels. Would a CAT scan be an option for my new baby?

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So What Happened?

Thank you everyone for your wonderful comments. I was unaware of the ABO issues in newborns.

I was absolutely frustrated with the delivery team because they hit so many bumps during the delivery, which caused me to lose my trust in the doctor. First the doctor was almost 45 minutes late after the nurse had called and spoke to her that the baby was not progressing through birth canal [wife had already been pushing for 1 hour]. I understand the doc can't be there immediately after the call, but 45 minutes in a troubled delivery? Next the doc told us there were absolutely no complications with vacuum, which I later found out there most definitely are. While the doc was assisting she pulled hard and the vacuum made a loud pop when it popped off, then she reapplied it and continued assisting. Next the neonatal team was late getting all their stuff ready for my baby...the neonatal doctor practically gave oxygen to my baby in her arms, because the machines weren't running. After they rolled her into NICU and stabilized her they took her measurements and weighed her incorrectly. They indicated her weight as 7lbs 5.6 oz, but later found out they made a mistake. her actual weight was 8lbs 4.8 oz.

I will update everyone soon after my baby comes home. Thank you all very much, you made it easier on me just reading your comments.

Featured Answers

M.B.

answers from Tampa on

My daughter was born via scheduled c section and she was over 10 pounds. Just the force of them pushing to get her out caused her to have a huge bruise. It happens, a lot of babies are born with jaundice. Their little bodies are new at this whole life thing. Lots of babies are born using a vaccume, it's not like its a new thing.

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J.B.

answers from Boston on

My oldest son was a vacuum-assisted delivery and was fine. He does have ADHD and learning disabilities that were diagnosed in elementary school, but those run in both sides of our family so he comes by those honestly. I don't think there's any relationship between the vacuum delivery and his later learning issues.

As Malia B mentioned, jaundice can be caused by ABO incompatibility and is more common in a case like yours, where the mother is type O and the baby is A or B. What the doctors explained to you is consistent with ABO incompatibility.

Trouble breathing is very common, especially in stressful deliveries like your baby's. They don't just bust out the vacuum for no reason - they do it because the baby is showing signs of distress and is not handling the delivery well. Usually, the baby is "stuck" and there are concerns about heart rate and respiratory distress and this is the last step before going to a c-section. Yes there will be a bruise on the head, but it goes away in a few days.

I know that as a new parent of course you're concerned, but try to have a bit more faith in your wife and baby's medical team. From what you describe, it does not sound as if the use of the vacuum was unwarranted or a mistake or that they're "covering" for anything. You had a complicated delivery, your baby has some routine and fairly minor issues that are being treated appropriately. Just be there for your wife and baby. I would not push for a CT scan on an infant - that kind of radiation (and possibly sedation) does not seem worth it for what are routine issues following a tough delivery.

Congrats on your new baby!

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B.C.

answers from Norfolk on

Lot's of babies have increased levels of bilirubin the first few days.
They are born with a large blood volume (from the need to circulate around through the placenta) and as the excess blood cells break down, the babies liver is not quite online yet to process it - and the babies get a little jaundiced for a few days.
All of us (myself, husband and son) are A+ blood type and the first week or so we went for daily bilirubin tests (but he didn't need any light treatments to get it under control - some babies do need it, but it's common and normal and fine).
Honestly, newborns often look like little space aliens.
They come with stork bite bruises back of neck and around eyes, and cone heads.
It's not easy squeezing any size baby through 10 centimeters (go measure it out - it's a TINY space.
And yet - there are 7 billion people on the planet and the vast majority got here that way.
You are a worried new father, but your daughter is fine.
Please get "What to Expect the First Year" (it's a great book) and read it.
You'll all feel better (but still sleep deprived for the next 6-8 weeks).
Congratulations on your new family addition!

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M.B.

answers from Austin on

As far as the jaundice, that is fairly common with newborns.

Along with the Rh incompatibility, there is also an increased risk of jaundice between blood types, known as an "ABO incompatibility". That happened to me.. I am type O, and hubby is type A .... one of my daughters was type A, and had to spend a couple of extra days in the hospital under the bilirubin lights because of jaundice.

Her difficulty breathing can just be part of the transition from womb to unassisted life outside the womb...... the newborn stage has a lot of changes your infant has to adjust to.

The risks of not getting her delivered quickly if she was being stressed vs using the vacuum assisted delivery are much greater. The doctor was trying to avoid the c-section, as that can also come with risks to both the fetus and the mother.

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S.A.

answers from Chicago on

S., my second baby had breathing difficulties and jaundice and it was not a vacuum assisted birth. We also have the same blood type and he still got jaundice.

The point is, breathing problems and jaundice are VERY common in newborns. I don't think your daughter will have mental defects due to the vacuum. I do not think you should ask them to do a CAT scan and expose her to radiation unnecessarily.

The doctor should have made you aware of the large bump that the vacuum would cause. I think that was his only mistake.

Congrats on your baby girl!

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S.H.

answers from Des Moines on

My daughter was also delivered that wasy. She was basically stuck in the birth canal. It was a long painful delivery...the dr and nurses did everything they could to get her down...but it was either the vacuum or a c section.

She had that bump....the hematoma for about a month. She also was in the nursery for jaundice. For about a day. Came home with blankets. No difficulty breathing though.

I never connected the two. One of my other kids was jaundice too.

I don't think a cat scan is necessary.....that may cause a host of other problems especially if they have to sedate her for it.

My daughter is as healthy and smart as can be.

If it was a very difficult birth....everything you mention could be a normal side effect. Why dis he use it? I never once regretted using the vacuum. It was necessary.

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I.G.

answers from Seattle on

S., I am sorry you and your wife had a traumatic birth experience.
It is difficult to say whether the problems your child is experiencing are the result of the vacuum assisted delivery or simply the result of a difficult delivery that would not have been any different if she had been born by c-section. Many babies that experience a traumatic birth have difficulties breathing. I would suggest that if your baby hadn't been in some sort of trouble during the birth the doctor would not have needed the vacuum. Difficulties breathing are also common for babies born via c-section.

The cephalohematoma, while it can look pretty brutal is usually benign and will resolve within a few weeks.

Many babies have jaundice. The bilirubin is a waste product that is created when red blood cells are broken down, so yes, a large hematoma can contribute to this. So can an incompatibility of blood factors. In addition to rhesus incompatibility (the most commonly known) there is ABO incompatibility also called neonatal hemolytic disease. It is usually treated with light therapy just like a regular newborn jaundice.

I am not sure why you would want a cat scan for your baby and what you are hoping to see on it, but I would recommend that you talk to the pediatricians that are treating your child about your concerns. Looking up things online can be helpful but it can also lead to a lot of confusing and conflicting information.
Good luck (and congrats on the new baby).

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V.T.

answers from Washington DC on

I think it's unlikely that she will have a mental defect, as everything you describe sounds normal. That being said, with one of my twins, his brain was measuring larger than normal. After birth they simply did a sonogram on his head and found everything to be normal. Before you ask for a CAT scan, maybe a sonogram could do the trick to calm your fears.

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P.K.

answers from New York on

Do not think jaundice and breathing problems were the result of the vacuum birth. Why CAT scan? Give your baby a few days and I think you will be surprised at how well she will do. Congratulations.

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D..

answers from Miami on

I cannot answer to any of your post. I can only say that my first child was delivered this way and had no problems at all. He had been in my birth canal for a very long time and it saved me hours of pushing. (I should add here that his heart rate kept dropping during every contraction, and getting him birthed before his heart rate stayed down was a major goal.)

No one here can tell you if a CAT scan is an option for a newborn. We are not NICU experts. There are nurses here who work in NICU, but they are not doctors and would not presume to tell you that a doctor they don't know, whose work they did not witness is telling you lies.

I hope your baby gets better soon.

Dawn

T..

answers from Dallas on

My first son was born via use of the vacuum, too. I pushed for over an hour and he got 'stuck'. My doc used the vacuum for what seemed like forever (prob less than 20 mins or so). He had the large bump on his head. He is now 12 and perfectly healthy and more intelligent than he needs to be. ;) He had a problem regulating his body temperature when he was born - but that was all. My mother lost both of my brothers at birth b/c of the Rh factor - things happen at birth, good and bad. By no means am I saying your doctor did everything right or anything wrong - just saying what I have experienced in my life. Best of luck to your little one - hope she grows up to be the beautiful daughter you want her to be.

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L.F.

answers from San Francisco on

I am so sorry this happened to your daughter~ In my experience with labor and delivery, it is not uncommon for babies heads to be elogated or "cone shaped" for several hours or few days after. Bruising can occur but isn't as common. Jaundice is very common and isn't because of anything your wife did or didn't do.

I would however talk with the hospital nursing supervisor and also make a grievance claim against the hospital and doctor etc. It sounds like they didn't use the vacuum properly and your baby was seriously hurt. If you feel a CAT scan would help, I would definitely advocate for your daughter. If they say no, have her transferred to another hospital where you feel more comfortable. I am so sorry this happened. Please let us know what happens and if there is any resolution.

As for your question, I don't know if your baby will have any mental issues from this. I would encourage you to ask for specialists and even a neurologist to look at your baby so you can have peace of mind. Good luck~

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