Instrumental delivery

About one in eight women has an instrumental delivery, where forceps or a ventouse suction cup are used to help deliver the baby's head.

This can be because:

  • there are concerns about the baby's heart rate
  • your baby is not in an ideal position
  • you're too exhausted

Occasionally they might be performed for some women for whom the length of the second stage of labour should be limited, for example if you have certain cardiac conditions. 

Both ventouse and forceps are carried out by doctors who have had training and only used when necessary for you and your baby. 

Sometimes, as the baby is being born, an episiotomy may be needed to make the vaginal opening bigger. Any tear or cut will be repaired with dissolvable stitches. Your midwife or doctor will ensure you have appropriate pain relief for this procedure. 

Depending on the circumstances, your baby can be delivered and placed onto your tummy, and your birthing partner may still be able to cut the cord if they want to.

A neonatologist should be present at the delivery to check your baby's condition after the birth. 


A ventouse (vacuum extractor) is an instrument that is attached to the baby's head by suction. A soft or hard plastic or metal cup is attached by a tube to a suction device. The cup fits firmly onto your baby's head. During a contraction and with the help of your pushing, the obstetrician gently pulls to help deliver your baby.  

The suction cup leaves a swelling on your baby's head, called a chignon. This will disappear over the next few days. The cup may also leave a bruise on your baby's head, called a cephalhaematoma.

3.3% of deliveries at the Rosie in 2013 were ventouse.


Forceps are smooth metal instruments that look like large spoons or tongs. They're curved to fit around the baby's head. The forceps are carefully positioned around your baby's head and joined together at the handles. With a contraction and your pushing, an obstetrician gently pulls to help deliver your baby.

There are many different types of forceps. Some forceps are specifically designed to turn the baby to the right position to be born, for example, if your baby is lying facing upwards (occipito-posterior position) or to one side (occipito-lateral position).

Forceps can leave small bruises on your baby's face but these will disappear quite quickly.

7.9% of deliveries at the Rosie in 2013 were forceps.

Delivering in theatre

If your obstetrician has any concerns, you may be moved to an operating theatre in order that a caesarean section can be carried out if needed, for example if the baby cannot be easily delivered by forceps or ventouse. 


You may spend some time in the recovery or close observation area if you have gone to theatre, and your care will continue on the postnatal ward (Lady Mary ward).