I'm sharing my experience with a pretty rare operation that sometimes happens during childbirth - vacuum extraction of the baby. I was surprised to find that there aren't many reviews about it online, while there are 52 reviews about episiotomy. Maybe that's because this method isn't used often.

I'm not a medical professional, but I've gone through this experience and done a lot of reading about it. So, take my story for what it's worth. I'm just a mom who wants to share her honest experience.

What is vacuum extraction of the baby:

Vacuum extraction of the baby is a childbirth operation where the baby is delivered by creating a vacuum between the baby's head and the inside of a special device (vacuum extractor). The vacuum extractor was developed in 1954 by Malmstrom. The device has a set of cups with diameters from 5 to 8 cm, each of which can be connected to a vacuum apparatus with a manometer. Today, there are two modifications of the vacuum extractor: one with a hard plastic cup and one with a softer silicone cup.

Conditions for performing the operation:

• The baby is alive;
• The cervix is fully open;
• The mother can actively participate in the process of giving birth;
• The baby's head is in the pelvis;
• The mother's pelvis is the right size for the baby's head.

Okay, let's get to the good stuff. Now it's time to tell you about my experience.

This was my second delivery. I arrived at the hospital at 40 weeks and three hours after my contractions started. The cervix was 4 cm open at that time. Everything was normal: registration, blood pressure check, a tablet under my tongue (my blood pressure suddenly rose), weighing, peeing in a cup, and an enema.

We went up to the delivery room, where they checked me again on the bed and broke my water. The water was green. They hooked me up to a CTG monitor. I'm lying there, breathing, and my contractions are getting stronger and more frequent. They come to check my blood pressure and cervix dilation from time to time. When they checked me again, they found out that my cervix was fully open. To my surprise, the doctor suggested I try pushing, even though I wasn't having any contractions. I pushed, but nothing came out. They hooked me up to an IV with oxytocin, and I kept pushing. Still nothing. After a while, my contractions got really intense, and I finally started pushing. The strong contractions were making me lose control - I was completely out of it. I pushed, but nothing happened. I don't know what it was - maybe my ineffective pushing or weak labor. This whole process seemed to last forever.

After my next failed attempt, I saw the doctor walk out and come back with some device. Later, I found out it was called the Kiwi vacuum extractor. Here's what it looks like:

Photo above: Kiwi vacuum extractor

I remember the preparations before my baby was born, and then the doctors had to use the vacuum extractor to help with the delivery. I was in a bit of a state, to be honest, but they managed to get the baby out in the end. The whole experience was a bit of a blur, but I do remember feeling a bit overwhelmed.

Here's a quick rundown of the procedure:

1. They inserted the cup of the vacuum extractor and placed it on the baby's head
2. They created a negative pressure
3. They pulled the baby's head out
4. They removed the cup

It didn't go smoothly at first, to say the least. I was in a bit of a state, and I'm not even sure how many times they had to try before they finally managed to get the baby out. But in the end, they did it, and my baby was born. The doctors and nurses were amazing, and they really helped me through the whole process.

My baby was crying straight away, and they weighed and measured him. He got an 8 out of 8 on the Apgar test, which is great. We spent two hours together, and then they took him to the nursery. He was with me for five whole days, which was amazing.

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When do they use a vacuum extractor?

They use a vacuum extractor in cases where the time for a natural delivery has passed, and it's not possible to use forceps yet:
• persistent secondary uterine inertia that can't be corrected with medication;
• acute fetal hypoxia.

When can't they use a vacuum extractor?

They can't use a vacuum extractor in the following cases:
• any condition that requires stopping contractions: extragenital diseases and severe gestosis;
• mismatch between the mother's pelvis and the baby's head;
• flexion presentations;
• premature labor.

So, what was the reason for using the vacuum extractor in my case?

● This was due to fetal hypoxia. I mentioned the green waters earlier.

● I think I had uterine inertia, as contractions were weak and didn't progress. Why didn't they do a C-section? Maybe it was too late, and the baby's head had already dropped into the pelvis. But that's just speculation.

What are the possible negative consequences of a vacuum extractor for the baby and the mother?

• the cup of the vacuum extractor slipping off;
• the baby's head not moving;
• trauma to the baby: cephalohematomas, CNS injuries of varying severity, risk of hemorrhage, skin damage, facial deformities. Often, babies need special rehabilitation.
• damage to the mother's soft tissues (vagina, perineum, clitoris).
• If the cup slips off the baby's head or doesn't move, they stop the procedure and switch to other delivery methods.
• Trauma to the mother and baby usually occurs due to technical errors or delayed execution of the procedure.

What were the negative effects on my baby?

● Subgaleal hematoma on the head. The photo below is an example of a subgaleal hematoma (lower photo in the collage). My son had it on the occipital part. By the time we were discharged from the hospital (on the fifth day), the hematoma had already gone.

Lower photo: hematoma

● On the ultrasound of the brain, done on a monthly check-up, the diagnosis was initial biventricular megalocephaly. The neurologist explained that there's nothing to worry about, but we need to keep an eye on it. We went through a course of treatment with pantothenic acid and diacarb. By the time the child was a year old, the ultrasound diagnosis was confirmed, but the stage remained the same - initial, i.e., it didn't progress and that's good.

I'm not saying that the vacuum extraction was the cause of all this, but I'm not ruling it out either.

Consequence of vacuum extraction

The negative moments I experienced were:

● There were many micro-tears (according to the midwife) in the vagina, vulva, and labia. She stitched me up for a long time, probably around an hour. I even helped her hold the clamp. It's funny, if it weren't for the pain in some places, and in some places, oh so painful. The feeling was like I was being stitched up live, although the midwife claimed she had numbed me.

The suturing material was self-dissolving. Everything healed and dissolved completely in about a month. Since the perineum wasn't damaged, I could sit down immediately.

● Some time after discharge, during a follow-up examination, I discovered that something was staring back at me from that "place". A pink-colored bubble. Remembering that I had read somewhere about uterine prolapse, I started searching for info online. Comparing the pictures from the internet with my "bubble", I diagnosed myself with uterine prolapse. Sobbing into my pillow, I went to see a gynecologist the next day. She confirmed my fears - my cervix and the front wall of the vagina had prolapsed.

● I started experiencing problems with urinary incontinence. Not catastrophic, but with any cough, I'd experience a small leak. Here, timely emptying of the bladder, not letting it get too full, and special pads came to the rescue.

I was able to resolve the last issue with Kegel exercises. Of course, I didn't do everything correctly and not as many times as recommended, but still. The prolapse is still there, but the "bubble" no longer peeks out and stares at me. But prolapse can give you a hard time in old age when the ligaments weaken, and it can even lead to uterine prolapse. So, we shouldn't be complacent and do the exercises for life (!).

I also want to share a piece of advice that my gynecologist gave me belatedly at the women's consultation: you must definitely wear a postpartum girdle in the hospital, even if your belly isn't bulging and isn't hanging. It will help support your internal organs and prevent prolapse. I had a flat belly, didn't wear the girdle, and that was a mistake.

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The Verdict, would I recommend vacuum extraction? Honestly, it's a no-brainer. If it's a matter of life and death for the baby during delivery, and it's the only chance, then the operation needs to be done. Plus, the doctor won't even ask you about it - they'll just make sure they're qualified to perform the method. And I'm really glad everything went smoothly and there were no worse consequences (phew).

Thanks for reading!

My go-to pillow during pregnancy.

More medical musings:

Mammograms.

Radio-frequency ablation for endometrial polyps.

Endometrial biopsy.

My two C-sections, 10 years apart.