Operative Procedures: Forceps, Vacuum, Episiotomy

Why choose an operative delivery?

While the female body is perfectly created to give birth to children, there will be times when Mother Nature needs a bit of help. The use of operative procedures, such as forceps, vacuum, and episiotomy during a vaginal delivery provides a little boost to mom's birthing process. In order for a doctor to use an operative birthing tool, the cervix will need to be fully dilated and the baby will need to be able to move into the birth canal without disruption.

There are two main times when an operative delivery is chosen. If you have been pushing for hours without any progression, the doctor may want to help by pulling on the baby while you push. Operative births are also used in cases where the baby is not progressing down the birth canal and when there are potential issues with the baby's health.


One of the most known operative tools used in vaginal deliveries is the forceps. The forceps is a large hinged tool that is formed to fit snugly around the head of the baby in the birthing canal. When you can no longer push due to exhaustion, the baby is too large for the vaginal opening, or additional pushing is not advised due to some complication in labor, forceps are used to pull the baby out of the vaginal canal. The use of forceps often requires an episiotomy or small incision in the perineal area.

Due to the fact that the newborn skull is very pliable in order to fit into the birthing canal, forceps will sometimes leave marks on the sides of the head. These marks will fade over time and the baby’s head will return to a normal, round shape.


Along the same lines as the forceps, the vacuum offers a bit of help with moving the baby down the birthing canal. The vacuum offers a large suction cup that is attached to the top of the baby’s head. The suction allows the doctor to pull the baby while you are pushing. The suction cup will often shape the baby’s head into a cone shape that will round out with time.

Most often if with the vacuum or the forceps, the baby still does not progress down the birthing canal, a cesarean section will likely be recommended for the health of both baby and mom.


It is true that labor requires something the size of a watermelon to fit through a hole the size of a lemon. The female vaginal canal and the vagina itself are able to stretch to great lengths in order to allow the baby to move out of the body. There are times, however, that will require a bit of extra room.

The episiotomy is a small incision placed at the bottom of the vaginal opening in order to give baby more space during birth. The incision can be made straight down towards the rectum (median episiotomy) or to the side (mediolateral episiotomy). The episiotomy will often require local anesthesia and stitches after the birthing process is complete.

Read More:
Labor and Delivery Guide
Stages of Labor
Labor Contractions Counting Calculator