Even after your cervix is fully dilated and you have been pushing, you may need help getting the baby out because of several reasons such as: 1) After pushing for several hours, the baby may no longer be moving down through the birth canal. 2) You may be too tired to push any longer. 3) The baby may be showing signs of distress and need to come out faster than you can push it out on your own 4) A medical problem may make it risky for you to push. Your doctor might recommend an assisted vaginal delivery if you've been pushing for a long time, you're worn out or if baby's nearly out but his heart rate is "non-assuring". The doctor uses either a vacuum device or forceps to help your baby out of the birth canal. If the head is too high, a C-section will be recommended. All things said, naturally it is safer for you and your baby to deliver on your own.
My friend tried to push baby out for long time and gynae tried to pull the baby out but in no avail and emergency c-section was performed and found out baby's right arm was tangled by his umbilical cord. However, this might be one of the very rare cases baby not able to be pushed out due to umbilical cord. In normal case, doctor will use assisted birth instrument such as forceps or vacuum to get the baby out.
Usually midwife and doctor will guide mommy to push during delivery when mommy is fully dilated. If baby is not able to come out even after several attempts of pushing, the doctor will try to assist the delivery by using forcep or vacuum pump. Worst case scenario if baby is not able to pass through the birth canal, doctor will proceed to emergency cesarean section to get the baby out.
If after two to three hours of pushing, the baby is still not out, the doctor may guide the baby out with an instrument while the mother continues to push. Instruments used during such situations may be forceps or vacuum extractor. The baby is not “pulled out” but rather guided by the instruments.
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thanks