OP, having a baby without pushing is not the usual way of doing things, but if 3 doctors/midwives suggested it, it's not as crazy as some here seem to be thinking. Certainly discuss it with your doctors, but a planned VE must be very different than one in distress.

You probably looked at the wikipedia page for ventouse extraction, which noted some medical reasons why a mother may have a vaginal delivery without pushing. It's good that you have lots of excellent doctors looking out for you. Good luck with your birth, either vaginal or c-section.

Recovering from a section is not worse than recovering from a fourth degree tear. Btdt (both ways). Think about where the tear/incision is: which area do you think is more sensitive?

This sounds like a tough situation. It seems like the chance of getting baby low enough in 15 minutes of pushing (even when laboring down first) would be pretty low - most first time moms push for at least an hour even after laboring down with an epidural. Maybe the midwives have seen this type of plan work okay if laboring down is allowed to last a really long time? I think if this were me, i'd probably just opt for a c-section to avoid the situation of going through labor and getting all the way to pushing only to find baby isn't low enough to use the vacuum. Even if baby is low enough for vacuum, there are risks to the baby of using the vacuum and also risk of injury to you. I'd be hesitant to deal with both an injury from the vacuum (for baby or me) and then a pretty high chance of a c-section anyway on top of that. At birth i've heard multiple doctors say that they think risk of injury is higher with vacuum than with forceps so I think it would be good to talk to the midwives about what the risks of c-section and vacuum are so you can weigh the options. I'd also want to know their thoughts on the likelihood of the laboring down + vacuum plan actually working.

Anonymous wrote:I would want the epi just for the inevitable episiotomy.

NO! Episiotomy is absolutely not inevitable for a vacuum assist. As a doula I've witnessed many vacuum births, and with a good provider (and barring a true emergency) the baby can be brought to crowning then allow mom to push out in a normal way. I've seen vacuum births where mom gave the final 2-3 pushes and delivered with an completely intact perineum. The key is making sure everyone has the same goals and making sure the provider has experience with a gentle approach.

Yes, there are risks with a vacuum but overall it is a fairly safe way to bring a baby down faster when needed.