Vacuum Extractor Delivery: Serious Potential Risks Involved

Vacuum extractor delivery (also sometimes known as a Kiwi delivery, named for a specific brand of vacuum extractor) is a form of assisted delivery. If used properly, these tools can assist mothers in labor and help safely deliver the baby. If used improperly, vacuum extractors can cause head trauma and brain damage that can lead to cerebral palsy, intellectual and developmental disabilities (I/DD), and other disabilities.


Just as every pregnancy is unique, so is the labor and delivery process. The length of time it takes to deliver a baby varies from one woman to the next. In some cases, labor and delivery can begin and end in just a few short hours, while for other women it can take a full day or more. In other cases, the delivery process is unusually difficult. Some deliveries get to a certain point, and then labor fails to progress. When this happens, a physician or other healthcare provider may choose to use an instrument to assist in the delivery. One such device is called a vacuum extractor. A delivery that utilizes a vacuum extractor is often known as an assisted delivery, operative delivery or vacuum extractor delivery.

Vacuum Extraction

A vacuum extractor uses a small, soft cup that is applied to the top and back of the baby’s head. A tube runs from the cup to a vacuum pump that provides suction. During a contraction, the physician pulls or applies gentle traction to the baby’s head while suction from the vacuum assists in pulling the baby’s head out of the birth canal so the baby can be delivered.

Vacuum extractors can be very useful tools when used properly and in the appropriate circumstances. However, when used incorrectly or when not indicated, vacuum extractors can be dangerous and cause birth trauma. In fact, the Food and Drug Administration (FDA) cited its concerns in a Public Health Advisory on vacuum-assisted delivery devices:

“This is to advise you that vacuum assisted devices may cause serious or fatal complications…While no instrumented delivery is risk free, we are concerned that some health care professionals who use vacuum assisted delivery devices, or those who care for these infants following delivery, may not be aware that the device may produce life-threatening complications.”

To minimize the risks, vacuum extractions should not be performed when the baby is less than 34 weeks gestation, the baby is too large or the mother’s pelvis is too small, the baby’s head is too far up the birth canal, the baby requires rotation or repositioning in order to be delivered, or the mother is not fully dilated. A cesarean section may be the safer choice in these instances.

As with any medical device, there is a correct and incorrect method for using a vacuum extractor. The cup must be placed on the baby’s head about 3 centimeters back from the soft area of the skull called the anterior fontanel. This placement avoids injury to the baby. The diagram below illustrates the correct placement.

Because a baby’s head is so fragile and susceptible to injury, it is critical that the cup is placed in the right location. Incorrect placement can result in significant and permanent brain damage. The diagram below shows locations where the cup should not be placed. The physician performing the vacuum extractor delivery must have experience using vacuum extractors. Likewise, the practitioner’s technique used to pull the baby out is equally important. Twisting the head or neck, pulling too hard, or pulling for longer than 10 to 15 minutes should be avoided as they can injure the baby. Also, if the vacuum pops off 3 times during use, the physician should move on to C-section to deliver the baby.

Birth Injuries Associated With Incorrect Vacuum Extractor Usage

When vacuum extractors are used improperly or if errors are made by medical professionals during a vacuum extractor delivery, birth injuries can occur. These range from minor bruising and lacerations to devastating and permanent brain injuries. Some of the most common are listed below:

  • Skull fractures
  • Retinal hemorrhages
  • Brachial plexus injuries/Erb’s PalsyThis occurs when the brachial plexus (a group of nerves to the arms and hands) is injured. It frequently occurs in births involving shoulder dystocia (difficulty delivering the baby’s shoulders). As a result of this type of injury, the baby cannot flex and rotate its arm. Sometimes the injury resolves itself. However, if the nerve is torn, there may be permanent damage.
  • Brain hemorrhages or bleeds: Probably the worst potential complication of a vacuum extractor delivery is a subgaleal brain hemorrhage. The vacuum ruptures a vein which bleeds into a space between the scalp and skull. This condition is life-threatening with a mortality rate as high as 20%. About 90% of all subgaleal hemorrhages are related to vacuum extraction. This type of bleeding is most likely to occur with excessive force, prolonged cup application, or if forceps are also used. This often leads to neurological impairments and cerebral palsy.
  • Hypoxic ischemic encephalopathy (HIE)
  • Prolonged NICU stays
  • Seizures
  • Brain damage
  • Cerebral palsy
  • Hemiparesis

Symptoms including lethargy and seizures may occur within hours of a vacuum extractor delivery and are usually indicative of a serious brain injury.

For more information on the potential injuries and warnings issued by the FDA, please see “FDA Public Health Advisory: Need for CAUTION When Using Vacuum Assisted Delivery Devices.”

Vacuum extractor; vents; fetal head injury; smbgaleal hematoma; intracranial hemorrhage; nuchal cord; vacuum extraction; subarachnoid hemorrhage; infant brain damage; neonatal brain injury

Video: Vacuum Extractor Use During Labor & Delivery


Did You Have a Vacuum Extractor Delivery? Legal Help for Vacuum Extractor Injuries

If your child was born using a vacuum extractor and sustained permanent damage, we can help. The birth injury attorneys at Reiter & Walsh ABC Law Centers have over sixty years of joint experience handling complex vacuum extractor delivery cases. We can help you understand your legal rights and the actions you can take to obtain the compensation you and your child deserve.

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39 replies
  1. natasha says:

    my sister yesterday deliver a baby by vacuum extractor the baby have one side of his head very soft is there some thing serious

  2. Reiter & Walsh, P.C. says:

    Thank you for leaving your comment on http://www.abclawcenters.com. Based on what you related, we would encourage your sister to contact an experienced birth trauma attorney regarding her potential case. The facts and circumstances of injury from vacuum delivery can vary greatly from case to case. Please be aware that there is a Statute of Limitations in any potential medical malpractice case. That is a finite period of time under the law you have to pursue a legal matter. After that time expires, then you are forever barred from pursuing a claim regarding that matter. From the information you provided we are unable to advise as to what the Statute of Limitations may be – therefore we advise her to contact an attorney about her potential case immediately. If your sister would like to speak with our firm – our attorneys can be reached by phone at 888-812-6009 or by leaving information in the contact form.

  3. Monique says:

    I had a c section and my baby had to get vacuumed out. Now he possibly has fluid on his brain. What should I do

  4. Reiter & Walsh Staff says:

    Thank you for your comment, Monique. You have been contacted by a member from the Reiter & Walsh, PC team. Please reach out with any additional questions or concerns!

  5. Jennifer says:

    I have a question about my daughter she is now 4 and I’m getting very concerned about her. She does not talk and she was also delayed at crawling and walking they used the vacuum on her. I’m just wondering could that be the cause of why she’s so delayed? Thank you in advance

  6. Reiter & Walsh Staff says:

    Thank you for your comment, Jennifer. You will be contacted by a member from the Reiter & Walsh, PC team. Please reach out with any additional questions or concerns!

  7. Ally says:

    My friend had a baby six months ago, they used the vacuum to get her baby out she was on the canal for hours. Baby has been in n out of the hospital. Almost every month baby has sezuires, they did a ct and compare from when baby was born to today her brain is shrinking. Dr say is because she has a syndrome. I don’t believe that.

  8. Reiter & Walsh Staff says:

    Thank you for your comment, Ally. You will be contacted by a member from the Reiter & Walsh, PC team. Please reach out with any additional questions or concerns.

  9. ulricka says:

    Hello the doctor who delivered my son used,a vacum which was,3 years,ago. Since then I notice the back of his head has premanant dents in the back it is noticeable. My aunts been said when I had him the doctor should did c section, because it was a stressful delivery. Just wondering what I should do is it normal for the back of his head to have a dent in it from vacuum suction.

  10. Reiter & Walsh Staff says:

    Thank you for your comment, Ulricka. You will be contacted by a member from the Reiter & Walsh, PC team. Please reach out with any additional questions or concerns.

  11. Amy says:

    My daughter will be 12 January 15 she had to be assisted out took a long time with vacuum ,she had a fluid filled pocket on her head for months . Her hair doesn’t grow could the vacuum affect the hair faliculs?

  12. Gen says:

    Hello, my baby was born by c-section, but before they tried the vacuum though he was too big / my pelvis was too small. Looking at the photos, the positionning was too far back. No obvious brain damage… is there something to do?

  13. Reiter & Walsh Staff says:

    Thank you for your comment, Gen. You will be contacted by a member from the Reiter & Walsh, PC team. Please reach out with any additional questions or concerns.

  14. Reiter & Walsh Staff says:

    Thank you for your comment, Amy. You will be contacted by a member from the Reiter & Walsh, PC team. Please reach out with any additional questions or concerns.

  15. alisha says:

    Our son at birth the docter used the vaccume on him. They had trouble getting him out. He was born at 36 weeks. His cord was around his neck. So im confused on why they thought the vaccume was a good idea. The docters didnt get consent to use tool. I didnt know anything was wrong untill after he was born. Because they didnt say anything. He came out not crying right away. So fast forward to six months old. He started having seizures. He cried continuously for hours and he would arch his back while crying. And he cried the currdling cry like he was in pain. He also had three hernias. I knew something wasnt right. I just didnt know my options and what i could of done. He is older now and has learning disabilities. Social disabilities and epilepsy. Its very hard because he has limitations and cant do things other kids can do by them selfs.
    I just want to know do you think our sons epilepsy and learning disabilities are caused because of birth deffect.

  16. Reiter & Walsh Staff says:

    Thank you for your comment, Alisha. You will be contacted by a member from the Reiter & Walsh, PC team. Please reach out with any additional questions or concerns.

  17. Bill Chaffee says:

    Does it matter if forceps are applied to the front and back of an infants head instead of the temples? Every illustration of forceps delivery that I have seen has shown the forceps applied to the temples. However my mother said she noticed forceps marks of the front and back of my head. After she mentioned the she doesn’t remember me being born, I asked her if she remembers my siblings being born and she said that she did (I’m the third of five). I wonder if she was given a combination of scopolamine and morphine. When was the practice of that drug combination discontinued? My cerebral palsy was misdiagnosed as a psychological problem until after she statute of limitations expired. Also, I’m from a family that doesn’t know the difference between autism and cerebral palsy. Autism has been in the news a lot more than cerebral palsy and I suspect that some of the increase in autism might be from people with other neurological conditions being misdiagnosed as autistic.

  18. Reiter & Walsh, P.C. says:

    Dear Mr. Chaffee,

    Thank you for leaving a comment at http://www.abclawcenters.com. We are a law firm handling birth trauma/medical malpractice cases in the United States. Regretfully, I believe we will be unable to assist you, as we are attorneys and not doctors, we are unable to provide medical advice. If you are seeking only medical advice, we will be closing your file with our office effective immediately. We advise you to please contact a licensed doctor immediately.

    Again, we regret that we cannot assist you at this time. We wish you the best of luck.

    If you believe that we can be of assistance with a potential medical malpractice case in the future, please do not hesitate to contact us by phone at 888-419-2229. Please be aware that in any medical malpractice case there is a “statute of limitations.” That is a finite period of time under the law you have to pursue a legal matter. After that time expires, then you are forever barred from pursuing a claim regarding that matter. Based on the information provided we are not able to advise you as to when any statutes of limitation for your potential claims may expire. If you wish to have this matter reviewed by another attorney, we recommend you do so immediately.

    Sincerely,
    The Reiter & Walsh, P.C. Team

  19. Sadia Qasim says:

    I had a vacuum delivery.my son is now 4months old.His problm is that he cannot move one of his eyes towards one direction. (Right eyes has no movement towards right side).it only moves from left side to the centre and vise versa but not to the left.is this delivery the reason.

  20. Reiter & Walsh, P.C. says:

    Dear reader,

    Thank you for leaving a comment at http://www.abclawcenters.com. Because we are a law firm handling birth trauma and medical malpractice cases in the United States, our attorneys are unable to provide medical advice. If you are seeking only medical advice, we will be closing your file with our office effective immediately. If you believe that we can be of assistance with a potential medical malpractice case, please do not hesitate to contact us by phone at 888-419-2229. Or, you may provide us with your contact information and a member of our team will contact you.

    Sincerely,
    The Reiter & Walsh, P.C. Team

  21. Alex says:

    I have had 2 vacuum assisted deliveries. One was 7 years ago and the doctor was very gentle and guided my baby out without excessive force.

    The second delivery was so much different. My doctor pulled hard and yanked and twisted my baby out very forcefully. My baby had to go to the NICU for breathing issues immediately after delivery and was cyanotic. At 1.5 months old my baby was diagnosed with infantile spasms (a form of epilepsy) and has now gone on to develop other seizure typed now at 3 months old. We do not have a family history of seizures. Brain imaging has been done and we have tried to find a cause for the seizures but so far we haven’t found a cause. I’m wondering now if the forceful and traumatic birth could be a cause for my baby’s seizures. I definitely want to look into it.

  22. Reiter & Walsh, P.C. says:

    Thank you for your comments on http://www.abclawcenters.com. A member from our team will reach out to you shortly. Please contact our office toll-free at (888) 812-6009 or if you have any other questions.

    Kind Regards,
    The Reiter & Walsh, P.C. Team

  23. Kara says:

    Is torticollis a injury from a vacuum birth? I felt I needed a c section after a long labor that wasn’t progressing. I had issues that he wasn’t turned in the correct position and was also too large for me to delivery as why they used the vacuum because he was so stuck. They insisted on a vacuum birth but I felt this was wrong and cause more damage. He now has torticollis and a scar on his head because it ripped a full layer of skin off.

  24. Reiter & Walsh, P.C. says:

    Dear Kara,

    Thank you for leaving a comment on abclawcenters.com. We’re sorry to hear about your baby’s torticollis and vacuum birth. A member from our team will reach out to you shortly. Please contact our office toll-free at (888) 812-6009 if you have any other questions.

    Kind regards,
    The Reiter & Walsh, P.C. Team

  25. Roxane says:

    My son was delivered via vacuum extraction. He was full term and a smooth pregnancy. I had a very tiny frame and he was 11lbs at birth! He ended up with a cephalhematoma that never did resolve. It calcified instead and turned to bone. He developed severe plagiocephaly/brachecephaly and was treated with head molding at 5-11months and travelled to another country for this treatment. After the birth I had a postpartum hemmorhage and develloped postpartum bell’s palsy, both in the first week after birth.
    My son is now 15 years old and suffers from many developmental issues and is diagnosed with ASD along with other comorbid symptoms/diagnoses.
    Do you feel this could have been a preventable birth injury?

  26. Reiter & Walsh, P.C. says:

    Dear Roxane,

    Thank you for leaving a comment on abclawcenters.com. We’re sorry to hear about your child’s cephalhematoma, plagiocephaly and ASD. A staff member will be reaching out to you shortly. Please contact our office toll-free at (888) 812-6009 if you would like immediate assistance.

    Kind regards,
    The Reiter & Walsh, P.C. Team

  27. yurak says:

    HI dear I have nonverbal 5 years old boy who got diagnosed with severe autism when he was 18 months old. I had a difficult pregnancy with lots of back pain which I was in bed rest for four and half months prior to delivery and I was over due date. I got treated with minimum attention while I was in moments of delivery the nurse was sitting and reading novel, so any way baby was too large and got stuck and they had to use forceps or vacuum and I don’t remember much cause I was panicking he was turned blue out of pressure on him. any ways after delivery when I was coming home the nurse told me that the baby might be in pain for a while because they had to pull him tartly. my son was extreme screaming crying days and nights I didn’t know what to do, I tried to check his shoulder and he got much better but he only could sleep on his left side and now that every day of my life goes skyrocketed high with frustration understanding what my son wants, just I want to find a way to ask them why there is C section exist and what was my fault to put me and my son to this miserable pain that doesn’t have much treatment, what should I do, I like to make them remember the expectant mom goes with a world of hope to have their baby but they don’t know that… instead of going to doctors to save us. (devils)

  28. yurak says:

    I am sorry that I’m writing again, but under a covered roof I’m lost with my son and questioning my self every minute that passes if that time doctor who treated me from beginning of my pregnancy and the same doctor who delivered the baby, didn’t think that I was in bed rest for such a long time I had a large belly. She couldn’t estimate the baby would be big he was close to 10 pounds(why the doctor didn’t suggest C section) still his head on the right side is pushed inside he is 5 and he couldn’t sleep in that side for 8 months when he was a babe. I forgot to mention that because I cant control my pain, I seriously think that his developmental and mental issues and nonverbal caused by doctors.. What is your advice.. Please help.

  29. Reiter & Walsh, P.C. says:

    Hello, Yurak, and thank you for reaching out to ABC Law Centers. One of the firm’s team members will reach out to you shortly. Thank you!

  30. Jacqueline morris says:

    Today i went to see my grandson (who i raised ) and his partner at the maternity hospital gold coast qld. I was shocked to see the top of the baby’s head had one big bruise. She explained to me that she had a suction birth and dr. Told her it would be gone in 10 days. Im sorry but ive seen so many mishaps with forceps deliveries. Am i being worried for no reason. Or should they be looking for signs that are not right. Is the baby in any pain. She cried a lot in the time i was there in her first 9th hour of birth.

  31. Reiter & Walsh, P.C. says:

    Hello, Jacqueline, and thank you for reaching out to us! We’re sorry to hear about the head bruising your grandson’s child sustained from vacuum birth. A member of our team will be reaching out to you shortly via email.

  32. Julia Acosta says:

    I had a natural birth with the help of the vacuum procedure. The doctors said he’s perfectly healthy. My son is about to be 2 years old. We’ve been seeing every doctor in town as to why he is not walking and very limpy. We did MRI scans and everything. We’re so confused. I did some research and stumbled across this page. I feel like this can give us some answers.

  33. Reiter & Walsh, P.C. says:

    Dear Ms. Acosta,

    Thank you for reaching out to our team at Reiter & Walsh ABC Law Centers; we’re glad you were able to find a few answers on this page. We’re so sorry to hear that your son is having difficulty walking. A member from our team will contact you shortly to assist you further.

    All the best,
    Reiter & Walsh ABC Law Centers

  34. Mani says:

    Hi, I had a assisted vacuum and forcep delivery 2 month ago. He had a one big bruise on his head. But after few weeks it’s completely recovered, but than now bruise come again same like before. Don’t know how.please provide some feedback.
    Mani.

  35. Reiter & Walsh, P.C. says:

    Dear Mani,

    Thank you for contacting Reiter & Walsh ABC Law Centers. We’re so sorry to hear about your baby’s injury. One of our firm’s team members will be reaching out to you via email shortly.

    All the best,
    The Reiter & Walsh ABC Law Centers Team

  36. Brooke Stover says:

    The doctor had to use the vacuum extraction on my daughter. Her birth was so hard. I pushed for 2 hours and the doctor put the vacuum on her head. He was pulling so hard that the vacuum slipped off her head and the doctor flipped off the stool he was sitting on. She finally came out on the 2nd try. She was diagnosed with epilepsy when she was 13, she is now 22. Have you heard of vacuums causing epilepsy?

  37. Reiter & Walsh, P.C. says:

    Hello, Brooke,

    Thank you for contacting ABC Law Centers. We’re so sorry to hear about your daughter’s epilepsy; someone from our team will be reaching out to assist you shortly.

    All the best,
    The Reiter & Walsh, PC Team

  38. Lisa Rodriguez says:

    My pregnancy was totally normal (so I was told by my doctors) and uneventful. It was uncomplicated and lasted full term. I eventually spontaneously gave birth to my baby whose delivery was assisted with the vacuum extractor. There she was, alive and breathing and 3 hours later, she was pronounced dead. I was initially told it was due to her heart, her autopsy revealed it was due to infected lungs, and an independent pathologist states it could’ve been due to improper use of the vacuum extractor which caused bleeding in the brain. Very confusing. I don’t know what to believe and worst part of all, I may never know the true reason why this happened. May my little angel rest in peace.

  39. Reiter & Walsh, P.C. says:

    Dear Ms. Rodriguez,

    We’re so sorry to hear about your daughter. A member from our team will reach out to you shortly to assist you.

    All the best,
    The Reiter & Walsh ABC Law Centers Team

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