In the case of rotation during delivery, the use of a forceps and vacuum extractor is generally necessary. The doctor generally administers a local anaesthetic and performs an episiotomy before using these instruments. Forceps are large, curved metal instruments which are inserted into the vagina, on either side of the baby's head. The physician then locks the forceps together and starts to move and extract the baby. While the forceps might bruise the infant's soft head and facial tissue, they can also protect a premature baby's head from pressure in the birth canal.
Any damage caused to the babies' head and face by the forceps usually clears up rapidly after birth.
The vacuum extractor is a caplike device which is attached to the baby's head. With the suction cup fitting over part of the baby's head, the physician can ease the baby through the birth canal. This instrument has the advantage of causing less trauma to the mother's bladder and vagina and lowers the risk of episiotomy. Sometimes a vacuum extractor might cause a baby's skull to swell or cause a lump on the skull.