When the baby becomes too strenuous during childbirth, doctors may decide to use instruments such as spatulas. What is the difference with an obstetric vacuum cup or forceps? What are the risks for the mother? Answers with Marie-Claude Benattar, gynecologist.
We can imagine it, idealize it or fear it… in the end, a childbirth rarely (if not never) goes as planned. Even if it goes well and your birth plan is respected, you will still be faced with one or two surprises. Some future mothers will have to face some complications at the time of the birth of their baby. This can be very scary for a pregnant woman, especially if it is her first child.
To better understand this childbirth, it is thus necessary to be informed and to prepare for it (in particular thanks to the courses of preparation for the childbirth). Knowledge is power: it will allow you to better manage your stress on D-Day. If you have any questions, do not hesitate to ask your midwife, doctor or gynecologist for answers. The latter can in particular reassure and soothe some of your anxieties.
One of the first things to know about a vaginal birth is that healthcare professionals sometimes use instruments to facilitate the delivery of the baby. In what context are these instruments used for the extraction of the child? What is the difference between the spatula, obstetric suction cups or forceps? Answers with Marie-Claude Benattar, gynecologist and author of the books “Female Pleasure” and “Small intimate care manual for women”, published by Josette Lyon.
Read also: Childbirth with obstetric suction cup: why and when should it be used?
Spatula, suction cup, forceps… why is their use sometimes necessary?
The expulsion of the baby during childbirth is often trying for a mother, even if it is not her first child. She can quickly find herself out of breath and no longer able to push. In this case the gynecologist may choose to use instruments to help the woman give birth and avoid complications, such as fetal distress. “We decide to use spatulas, suction cups and / or forceps if we see that it is stagnating, that the mother is tired and that she cannot push but that the child really has to come out. With the monitoring, if we see that the baby is also starting to run out of steam because it’s hard, that his heart is starting to race, we will give a little helping hand with these instruments ”, explains the expert.
Please note that the instruments are only used for vaginal birth and not during a cesarean section. “They are used for the extraction of the baby when the water bag is ruptured, the cervix is already well dilated, the child’s head presents itself and his body has descended into the mother’s pelvis. In fact, when he is already engaged in the vaginal corridor. It is additional help that does not hurt ”, adds the specialist.
According to the 2016 national perinatal survey, written by INSERM and DREES (Ministry of Solidarity and Health), it is estimated that doctors use instruments for 12.2% of births. In the maternity ward and in the hospital, the use of obstetric suction cups is the most frequent with a rate of 49.8%, against 27.6% for forceps and 22.6% for spatulas. Many specialists have long thought that the epidural could involve the use of instruments. Today, epidurals are weaker and the mother can still push.
Note that in addition to the mother’s exhaustion or fetal suffering, the instruments can be used if the health of the pregnant woman requires it and she cannot push. This is particularly the case if she suffers from high blood pressure, eclampsia, heart problems, respiratory failure or has already suffered from a detachment of the retina.
Read also: Scheduled Caesarean section: in which cases is it used?
Spatula, suction cup, forceps… what’s the difference?
The suction cup is easy to differentiate since its shape is completely different from that of spatulas or forceps. It consists of a small silicone cup (about 5 cm), connected to a pipe itself attached to a pump. It is an instrument of orientation and bending.
In contrast, spatulas and forceps are quite similar in shape, although they do not have the same use. Spatulas (by Thierry or Teissier) look like two large serrated spoons, made of metal or plastic, the handles of which can be separated or connected. This instrument helps to spread the vagina of the mother to facilitate the exit of the baby and to help him to move in the basin.. If the baby is incorrectly positioned in the pelvis, “We simply help it to get back on the right axis”, specifies the gynecological. They exercise some pressure on the perineum. “A bit like forceps they are placed on either side of the baby’s head to flex it. Then when the mother pushes, we spread her vagina with the instrument to facilitate the exit ”, she adds.
Often, it is decided to use them in case of premature birth or for small babies. Rather, it is an instrument of orientation and propulsion. Spatulas are less traumatic than forceps, but also less powerful.
“With forceps, we have greater preemption”, says Marie-Claude Benattar, “We use them when the baby really does not come down, despite the dilation of the cervix, when his head is stuck halfway in the pelvis and we want to help the mother who can no longer push. We grab the baby’s head to help him turn. ” Forceps come in two forms: one with two metal spoons and parallel branches, the other with crossed branches on which an instrument is added to help pull the baby. Forceps are indeed used for pulling the baby.
Whatever instrument is used, it is important that the mother remains active and continues to help her baby come out. For the partner, it is rather advisable to stay with the mother of the child and support her rather than come and see what is happening downstairs: it can be impressive!
Spatula for giving birth: what are the risks for the baby or the mother? What consequences?
Parents often worry when they see that the gynecologist is going to use an instrument. It must be said that the shape of the latter is hardly reassuring. However, everything is done to make it painless for the baby as well as for the mother. According to the specialist, there is also little risk that a tragedy will occur. “At birth, the baby’s skull is still a bit soft, so we’re not going to fracture it with an instrument. What there might be is a little bruise, a little bruise, but normally no more than that. It is very rare that there are major accidents. “
On the mother’s side, there is a risk of vaginal tearing. “Gynecologists are sometimes obliged to enlarge the episiotomy a little, especially if the muscles of the perineum are very tight. To avoid a big tear, we take the episiotomy a bit. We pay attention to the perineum “, she concludes.
Read also: 15 things to know about childbirth
Will I give birth? How to recognize the signs?
If this is your first child, you are stepping into the unknown! It is therefore normal to have many questions about childbirth and to ask yourself if you will be able to distinguish the signs of an imminent birth. In order to help you recognize them, here are the ones that should tease you out:
- The loss of the mucous plug
- Contractions
- The rupture of the water pocket
- Tremors or chills
- Diarrhea
- Back pain
- Great fatigue
- Sleep problems, restlessness
- Nausea
- The baby moves more than usual in his mother’s womb