15 Sept 2025 • A study of over 750,000 women compared assisted vaginal birth (AVB) and second-stage cesarean section (SCS), revealing key trade-offs.

Key Findings:

• Vacuum extraction had higher failure rates than forceps (7.6% vs. 3.3%) but a lower risk of anal sphincter injury (4.7% vs. 8.0%).
• Spatula use reduced neonatal cephalohematoma versus vacuum (0.7% vs. 5.5%) and forceps (0.7% vs. 3.5%) but increased postpartum hemorrhage (10.8% vs. 5.5%).
• SCS carried higher risks of NICU admission (17.2% vs. ~6%), low Apgar scores, skull fractures, and neonatal death.

While AVB carries maternal risks, it may offer neonatal safety advantages over emergency SCS in the second stage of labor.

Source: Science Direct | Read Full Story