Foley Bulb for Induction – Benefits, Risks and Procedure

From conception to birth, as an expectant mother, you always want to make the right decision for the well-being of your unborn baby. It is essential to be well-equipped with all the knowledge relating to labour and delivery as you near your due date. Sometimes, due to various reasons, some women fail to experience labour when they should. Hence, there are different methods of inducing labour. Here, we shall discuss the Foley bulb for labour induction. The Foley bulb or Foley balloon for induction is a widely used mechanical method, offering a non-pharmacological alternative to stimulate cervical dilation and prepare the body for delivery. Read on to learn more about the Foley bulb procedure.

What Is a Foley Bulb Induction?

The Foley bulb induction is a procedure that is used for dilating a woman’s cervix during labour. The doctor inserts a catheter with balloon into the cervix, which has a deflated end. Once the catheter is placed into the cervix, the doctor fills the catheter with saline. This process is used to put pressure on the cervix or the uterine walls and cause dilation. The catheter falls out on its own as soon as the cervix dilates to 3 centimetres. This method is not a popular induction method, but this option might be considered for women who wish to opt for a non-medicinal induction process (1) (2).

Reasons Why Pregnant Women Need a Foley Bulb Catheter Induction

In some cases, a pregnant woman may need a Foley balloon catheter induction, and some of these reasons for this are:

• In case your water breaks, but your contractions have not started.
• In case you are overdue or have crossed your due date.
• In case, you have a certain medical condition such as hypertension, your baby might not be getting ample oxygen, or you have an infection etc.

What Are the Benefits of a Foley Catheter?

Though this is not a very popular method of induction, a balloon catheter for induction of labour has its own sets of benefits. It may not only mechanically open up the cervix, but it may sometimes simultaneously start the labour procedure too. Also, it has been observed that women who used a Foley catheter that is popularly known as Foley bulb effectively, gave birth within 24 hours after the insertion. The use of this induction method is also believed to lower the chances of a caesarean delivery when it is used with or without other induction methods. The use of this induction method puts less stress on your baby’s heart rate, in comparison to other procedures of induction (5).

What Are the Risks of Using a Foley Catheter for Labour Induction?

Here are some potential risks of using a Foley catheter for labour induction (3) (4):

• It may cause intense pelvic pain to the pregnant woman, and thus may require immediate removal.
• It may cause fever.
• It may lead to vaginal bleeding.
• It may make your baby move from the head down to breech position.
• It may lead to non-assuring foetal heart rate.
• It may increase the chances of infection.
• It may increase the chances of caesarean delivery.
• It may lead to uterine rupture.
• It may cause umbilical cord complications in babies.
• It may cause lower fetal heartbeat when used along with other labour inducing medicines.

The Procedure of Labour Induction Using a Foley Balloon/Bulb

Before the procedure of Foley balloon for cervical dilation begins, your midwife/doctor will take your blood pressure, temperature, check your pulse, and view your pregnancy records. Your baby’s position will be established, and your baby’s heart rate will be monitored too. Here’s what may happen during the procedure (5):

• You will be told to lie down on your back, with your knees wide open. Your doctor will insert a balloon catheter inside your vagina.
• The balloon will be filled with saline, which may cause pressure on your cervix, and encourage it to soften and dilate.
• As your cervix opens, the catheter will fall out on its own. In case your cervix does not dilate, the catheter will be removed.
• In either case, you will stay in the hospital until the procedure is complete.

How Long Does It Takes?

The Foley bulb procedure itself is relatively quick, typically taking less than 10 minutes to insert. Once the induction process begins, it usually takes around 12-24 hours from the insertion of the Foley bulb to delivery. However, in some cases, the process may take longer depending on how the body responds to the induction and other factors.

How Does It Feel After the Insertion of a Balloon Catheter?

The experience may vary from one woman to another, but the factors that may determine how you feel may depend on:

• The condition of the cervix
• The procedure that has been adopted
• Having had a baby before

In most cases, it is established that the insertion of the catheter balloon may cause varying levels of discomfort, but it may be within the tolerable limits.

Things to Keep in Mind After the Insertion of the Foley Catheter

The Foley catheter may make the cervix softer and stretchier, and this aids the cervix to open up. However, some things need to be remembered after the insertion of the Foley catheter, and these include:

• You may be allowed to take showers or baths if you want to.
• You may be allowed to move around unless your doctor advises you against it.
• You may be able to pass your urine and bowels without any problem.
• You may check the Foley balloon by giving it a gentle push, and see if it is working.
• You may get some spotting for a few hours after insertion, which is very normal.
• You may experience cramping, similar to the spasms experienced during your periods, and it may stay until the catheter falls.

However, if you experience heavy bleeding, your water breaks, or you think you are going into labour, call your midwife or doctor right away.

Foley Catheter Induction and VBAC

In case, a woman has had a previous caesarean birth or has a scarred uterus, the doctor might suggest the Foley catheter induction. Though the intracervical Foley catheter for induction of labour for women who wish to opt for VBAC is very limited, the results might be positive. In a study conducted on approximately 150 women, who opted for foley catheter induction for a vaginal birth after caesarean delivery, it was observed that the success rate was more than 50 per cent. However, there were complications reported too, but those were within the expected limits (6).

Some Other Induction Methods

There are several other methods available, each chosen based on the mother’s medical condition, the baby’s readiness, and the state of the cervix. Here are some commonly used induction methods (7):

1. Prostaglandin

Prostaglandins are hormones that help soften and ripen the cervix to prepare for labour. These are often administered as a vaginal gel, suppository, or oral medication. The process can take several hours and is typically done before other induction methods are used.

2. Oxytocin (Pitocin)

Oxytocin, a synthetic form of a natural labour hormone, is delivered via an IV to stimulate uterine contractions. This method is frequently used after the cervix is partially dilated or softened, helping to speed up labour.

3. Stripping the Membranes

This technique involves a doctor gently sweeping their finger around the cervix to separate the amniotic sac from the uterine wall. This releases hormones called prostaglandins to encourage labour. The process may cause some discomfort and spotting.

4. Artificial Rupture of Membranes (Amniotomy)

In this method, the doctor uses a small instrument to break the amniotic sac, often referred to as “breaking the water.” This can help increase the intensity of contractions and move labour forward if the cervix is already partially dilated.

FAQs

1. Who should not use a Foley bulb for induction?

It is not recommended for individuals with conditions like placenta previa, active infections, or if the baby is in a breech position, as these scenarios pose additional risks.

2. Can you move around with a Foley bulb in place?

Yes, in most cases, you can move, walk, or sit comfortably with the Foley bulb in place. Movement may even help the cervix dilate more quickly due to increased pressure.

3. Can the Foley bulb be used in multiple pregnancies (Twins)?

Yes, the Foley balloon induction can be used in pregnancies with twins or multiples, provided there are no contraindications such as placenta previa or other complications.

Foley catheter induction is a safe and effective way of induction. It is necessary that you discuss the various pros and cons of this method of induction with your doctor before you decide to opt for this procedure.

References/Resources:

1. Induction of labour with a cervical balloon (Foley’s) catheter; NHS; https://www.buckshealthcare.nhs.uk/birthchoices/pifs/induction-of-labour-with-cervical-balloon-foleys-catheter/

2. Gu. N, Ru. T, Wang. Z, et al.; Foley Catheter for Induction of Labor at Term: An Open-Label, Randomized Controlled Trial; PubMed Central; https://pmc.ncbi.nlm.nih.gov/articles/PMC4556187/

3. Maslovitz. S, Lessing. J. B, Many. A; Complications of trans-cervical Foley catheter for labor induction among 1,083 women; PubMed; https://pubmed.ncbi.nlm.nih.gov/19488776/

4. Sanchez-Ramos. L, Heinemann. J, Kaunitz.A; 338: Infectious complications of pre-induction cervical ripening with the intracervical foley catheter balloon: A systematic review with meta-analysis; American Journal of Obstetrics & Gynecology; https://www.ajog.org/article/S0002-9378(07)01554-2/fulltext

5. Foley Balloon Catheter Induction of Labour; NHS; https://www.ulh.nhs.uk/patients/patient-information-library/foley-balloon-catheter-induction-of-labour/

6. Gonsalves. H, Al-Riyami. N, Al-Dughaishi. T, et al.; Use of Intracervical Foley Catheter for Induction of Labour in Cases of Previous Caesarean Section: Experience of a single tertiary centre in Oman; PubMed Central; https://pmc.ncbi.nlm.nih.gov/articles/PMC5135455/

7. Inducing Labor; Nemours KidsHealth; https://kidshealth.org/en/parents/inductions.html

Also Read:

Bishop Score for Labour Induction
Nipple Stimulation to Induce Labour
Using Reflexology for Inducing Labour
Acupuncture Usage for Inducing Labour
Does Essential Oils Help to Induce Labour?

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