Instrument-Assisted Birth Injuries: Risks, Signs, and Legal Options
Vacuum extractors are meant to be a gentle and careful way of helping to remove the baby from the birth canal. The doctor will use a soft suction cup and attach it to the baby’s head.
This is the vacuum extractor, and it’s what is then used to gently try and guide the baby through the mother’s birth canal. Vacuum extractors are meant to be used to avoid things like C-sections and to lower the amount of distress the baby might be in during childbirth.
As it stands, in the United States, about two-thirds of all vaginal deliveries are assisted through the use of vacuum extractors.
However, despite how many deliveries use the extractors, there are still risks associated with them.
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Risks of Vacuum Extractors
Using vacuum extractors counts as a medical procedure and as with all medical procedures, there is always the risk of something going wrong. When a doctor decides to use the vacuum extractor, they need to pay careful attention to see if it’s working.
If the vacuum extractor isn’t working, they could be putting undue pressure on the baby’s head, which can cause damage to the head and body. This can cause nerve damage (such as brachial plexus injuries), head injuries (like cephalohematomas), and other brain injuries (like hypoxic-ischemic encephalopathy).
Any or all of these may occur on account of medical malpractice that happens during a vacuum-assisted delivery.
Times When Vacuum-Assisted Delivery Is Recommended
There are certain criteria that the delivery has to meet to qualify for a doctor to use vacuum extractors, at least according to the Mayo Clinic.
The specifics are as follows: the mother’s cervix should be fully dilated, her membranes should already have ruptured, and the baby should be positioned headfirst in the birth canal. If all this is true – and if progress on the actual birth – has halted, a vacuum extractor is the only thing that might help in this case.
It should be noted that vacuum extraction is only allowed in birthing centers and hospitals where a C-section can also be done if that ends up being necessary.
Assuming that the delivery meets these very specific criteria, a healthcare professional might decide to suggest a vacuum-assisted delivery:
- The mother is exhausted
- The mother is pushing, but labor isn’t progressing
- The baby’s heartbeat is abnormal
- The mother has a health concern that leads the doctor to limit her time in labor
Times When Vacuum-Assisted Delivery Should Not Be Recommended
According to The Mayo Clinic, there are several reasons that a vacuum-assisted delivery should not be recommended for a birthing mother. There is a list of complicating factors that doctors should also be aware of before they decide to try and recommend the use of a vacuum extractor, such as:
- A pre-term birth of 34 weeks or less
- The baby has a condition that affects the strength of their bones or a bleeding disorder like hemophilia
- The baby’s head hasn’t moved past the midpoint of the birth canal, or the position of the head is unknown
- The baby is positioned for a breech birth
- The baby is too large to fit through the birth canal
If any or all of these are occurring, a doctor should not recommend a vacuum-assisted delivery.
Potential Injuries Caused by Vacuum-Assisted Delivery
In a terrible ironic turn, vacuum extraction is meant to prevent birth complications, but if done incorrectly, it can also cause birth complications.
These complications can not only cause injuries to the baby, but they can cause injuries to the mother as well.
Risks for mother include:
- Genital pain and tears
- Blood loss and subsequent anemia
- Muscle and ligament weakness around the pelvic organs
- Short-term difficulty urinating
- Short-term or long-term urinary or fecal incontinence
Risks for babies include (but aren’t limited to):
- Scalp wounds such as cephalohematoma
- A higher risk of the baby’s shoulder being stuck after the head has been delivered, which can result in brachial plexus injuries
- Skull fracture
- Brain hemorrhages, which can lead to cerebral palsy
- Hypoxic-ischemic encephalopathy
How to Tell if a Doctor Has Been Negligent
A doctor has to be very precise and use a lot of care if it comes time to perform a vacuum-assisted delivery. Any deviation from the standard protocol can cause permanent injury in the child.
If the vacuum extractor isn’t used in these very limiting, specific practices, you might be able to blame a vacuum extractor as the cause of injury:
- A maximum of three contractions in the descent phase (until the baby’s head descends to the outlet of the pelvis)
- A maximum of three contractions in the delivery phase
- The cup dislodges a maximum of two to three times
- The procedure takes a total time of 15-30 minutes
- These guidelines should be reduced for premature or low-birth-weight babies, as they have more delicate bones and softer tissue than full-term babies
In addition, the doctor must place the suction cup correctly on the baby’s head.
The leading physician must also have specific knowledge and the wherewithal to know when they must abandon the procedure. If this happens, they must immediately switch to an emergency C-section if the vacuum extraction method isn’t working.
If the physician switches from a vacuum-assisted delivery to an emergency C-section, they should not use forceps at any point during the delivery process. If the doctor delays C-section too long, this can lead to infant hypoxia which can lead to even more birth complications.
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