Why Some Birthing People Need an Instrumental Birth or an Episiotomy

PĒPI Zenaya Hafa
MĀMĀ Livimia Hafa
PHOTOGRAPHY Catherine Smith @catherinesmithphotography

Common interventions in labour include assisted births – with a ventouse or forceps – and episiotomies.

Assisted/instrumental vaginal birth

Occasionally, birthing people will need assistance to safely birth their baby vaginally, either with a ventouse or forceps.

A ventouse is a suction cup that attaches to the baby’s head and forceps are a pair of metal ‘tongs’ that are positioned around either side of the baby’s head. Both allow the baby to be gently pulled by the obstetrician performing the assisted birth while the birthing person is pushing during a contraction. The choice of instrument used depends on the circumstances and is decided by the obstetrician.

An instrumental birth may be needed if the baby is in distress or the mother is exhausted from prolonged pushing. Other reasons for an instrumental birth can be due to an underlying health condition in the birthing person where it could be dangerous for them to push for too long, or because the baby is not descending down the birth canal – possibly due to being in a position that isn’t ideal.

Episiotomy

An episiotomy is a cut made by an obstetrician or midwife in the perineum (the area between the vagina and the anus) during the pushing stage of childbirth. The purpose is to widen the space for the baby to be born more easily. An episiotomy may be recommended during an assisted birth if your baby needs to be born quickly or to prevent severe tearing. An episiotomy can only be done with the birthing person’s consent.

It’s important to ask about the risks and benefits of any procedure so you can make an informed decision and therefore give your informed consent if you would like to go ahead.