There are several indications to use a vacuum extraction to aid delivery: The woman is placed in the lithotomy position and assists throughout the process by pushing.

Correct placement of the cup directly over the flexion point, about 3 cm anterior from the occipital (posterior) fontanelle, is critical to the success of a vacuum extraction.

Preferably the operator of the vacuum extractor needs to be experienced in order to safely perform the procedure.

In 1849 the Edinburgh professor of obstetrics James Young Simpson, subsequently known for pioneering the use of chloroform in childbirth, designed the Air Tractor which consisted of a metal syringe attached to a soft rubber cup.

Originally made with a metal cap, new materials such as plastics and siliconised rubber have improved the design so that it is now used more than forceps.