Try this one on for size.
I had a client delivering at my least favorite hospital (because they are so medical). Her water breaks at 10:00 pm, by 1:00 am she's headed to the hospital with some mild contractions - I'm instructed to stay home and rest (OK!). She's 1cm upon admission.

We talk throughout the night, I join them at 9:00 am - still 1cm after a good night of consistant contractions. Dr. decides Pit would be good, mom and dad agree it's started at 9:30 am - by 3:15 pm STILL 1CM (but baby is low [+1])! Yep I said it STILL... my heart broke, dad cried - mom was strong and yes without an epi - it can be done ladies.

So the NURSE says "why don't we try to insert a foli-cath into your uterus and manually try to help you out?" I jump up and down screaming YES YES YES (ok not physically, just internally) my clients agree. Midwives will do this sometimes but I have never heard it done in the hospital.

They insisted that I go eat lunch, I warned her that when she opens up, it's going to be fast and she will need to adjust quickly - they smiled. I left, was eating my choc pudding when the cell phone rang 20 minutes after leaving them "ah Rena', you better get back up here, she's 7cm" ... I run, she deliveres after two good pushes.

I couldn't have been more excited for this couple... it was looking grim but it all made a huge turn and they deserve it! Now the hospital isn't my least favorite any more, as long as we have those nurses and that same doctor again!

what's a foil cath? is that like the normal cathather so that you can urinate?

It's a foley catheter - and it has a little balloon they can inflate to force open the cervix. And yes, it is one type of urinary catheter.

hmmm.. but I guess you would need to have an epi in, in order to have this?

what's a foil cath? is that like the normal cathather so that you can urinate?

Yes, you know how they usually insert it into the bladder, fill the tip with water so that it stays in place - same thing here... just inserted into the uterus and it will normally fall out when mom reaches 3cm (that's how much saline they usually insert to make the balloon about 3cm in diameter).

Does that help?

hmmm.. but I guess you would need to have an epi in, in order to have this?

NO, NO epidural at all - it's a little more pressure but not more painful (than say pitocin) which by the way they turned off completely after they insterted the cath.

Oh good grief.. one thing I hate is those darn cathathers! they are so painful! :blink but would they do this without an epi?

Thanks that's good to know! oh will they do this only at the begining..or let's say if mom is stuck at 5cm will they do it then?

Heh, I insert foley catheters all the time without any kind of anesthesia (not on laboring women, natch).... But remember that inserting one in the vagina is going to feel VERY different from having it in the urethra. It's a much bigger passage.

The cath won't fill up that much, the balloon reaches it's capasity I believe at 3-4cm, so my guess is NO to the 5cm stalled ma'ma.

I hate urinary caths too, but this time it was really really a blessing and it wasn't anywhere near the bladder. Mom was able to walk with it, sit with it, even go potty on her own with it - it didn't change any of that.

But switching gears - there are times when I have seen the cath needed and really needed to drain a bladder, so I don't hate them when they bring comfort for a mom who can't pee and her bladder is visibly full.

I just throught this was a great alternative to a mom who had been ruptured over 15 hours, still at 1cm and with any other cautious ob would have sent her in for a c-section.

I just throught this was a great alternative to a mom who had been ruptured over 15 hours, still at 1cm and with any other cautious ob would have sent her in for a c-section.

YES! of course.. now sorry I keep on and on with this.. but I like to get informed!
does this go inserted in the urethra or the vagina?

It's the kind of catheter that's NORMALLY inserted through the urethra into the bladder, but used this time by inserting up the vagina to the cervix... does that make sense?

yeah okay.. so it shouldn't be that painful.. :whew

Sounds like a huge infection risk.

Does it further limit the time that the docs will wait before suggesting a c-section?

While of course it's an infection risk any time you introduce a foreign object into the body, catheters are sterile and nurses use sterile technique to insert them. Also, the catheter won't be in that long, further reducing infection risk.

Not sure what you mean by your second question--in this case the catheter was used as a sort of last resort (I think it generally is) and probably prevented a c-section.

While of course it's an infection risk any time you introduce a foreign object into the body, catheters are sterile and nurses use sterile technique to insert them. Also, the catheter won't be in that long, further reducing infection risk.

Not sure what you mean by your second question--in this case the catheter was used as a sort of last resort (I think it generally is) and probably prevented a c-section.

I guess what I meant was this:

Some docs only like to wait 24 hours after the water breaks until c-section time.

If you were to get this catheter and make some progress, say up to 4 or 6 cms and then stop again, will the doctor cut hours out of that 24 hour limit because of the infection risk that was presented by the use of the catheter?

Folly catheters are used frequently here and I'm surprised to read they used one on a mom who had ruptured. Follies can be great but they have their down sides as well. The catheter is inserted and slowly filled with saline so the end blows up like a water balloon which in turn, dilates the cervix. The nurse will tug on it every now and then and it comes out when mom is about 4 cm. They usually will get mom to 4 cm pretty quickly but then many moms sit at 4 for a while as their brain has to catch up to their body. The the nurses don't even chart mom as 4 cm...they call her a "folly-4".

I'm happy it worked well (and fast) for you client.

geez.. what a mess with this whole thing.. the reason I'm so into this.. it's b/c when I had my dd (no doula, didn't know about them, and wasn't educated!!)
Anyways.. I was induced.. and stayed at 1cm.. for an entire day after pitocin..
so of course I had the c-sec.. bla-bla-bla- but for my next when ever that may be I will have a vbac.. :)

Yes, there is a doc here that does balloon inductions here. It is inserted behind the cervix and therefore strips membranes while dilating so you have the release of prostaglandins and he inserts in then sends them on their way to check back in within 24 hours. It is a great form of induction when you are up against the wall in a hospital where there is much pressure to get things moving and way less invasive than pit or even cervadil. The idea is to get the bishop score higher so if labor doesn't start on it's own pit can be introduced with a more successful vaginal birth. I forgot the % but it's pretty good that labor starts on it's own without further intervention. Definitely worth mentioning to docs..BUT it is an art (this OB says) and can be painful if the doc doesn't know what he is doing..it shouldn't hurt and it shouldn't fall out.

a manual dilation can also be done with, well it is called manual, the fingers. I have seen it done a few times.

a manual dilation can also be done with, well it is called manual, the fingers. I have seen it done a few times.

Yes, I've seen that done too. The nurse tried that first, hoping she had the magic fingers - and we waited not much noticeable change 9without an exam) so they did the foli-cath and at that time she was still the same.

Honestly, they were awesome about leaving their hands out - checked her upon admission, left her alone until doc arrived at 9:00, then again at 3:00 something - then the insert of the foli and a check when it came out. (4-5 times) more than I would like, but given her circumstance I thought they stayed out better than I have seen in the past.

No infection transpired, mom and baby are home and everyone is doing fantastic. They seem so happy with their birth - what more can you ask for?

My doula partner was induced with a foley catheter. It is a heck of a lot better than prostiglandin gel and pit. I will go tell her about this thread, so maybe she can comment.

On the subject of the "magic fingers," this is just what I've heard, but can't that also irritate the cervix and cause swelling? Sounds like the foley catheter would be a better alternative IF DONE CORRECTLY! Seems like it could definately have some scarey risks, but I think it seems much less risky that pit or cervadil! Just my own :2cents
Ash

I am delightful doula's partner and i was induced in August due to blood incompatibility. I was having a vba2c and absolutely didn't want any pit or gel used on my uterus. So i went in for a foley induction. I was three weeks early and my cervix wasn't favorable at all. So they placed the catheter and nothing much was happening until i began manual nipple stimulation. It got my own oxytocin going and i starting haing regular contractions. After having it in for 17+ hours and still not being a three (at which point it would have fallen out) i decided to have them take it out because it was a constant reminder that i was still not at a three and it was very discouraging. I had early laborish contractions all that day and that evening (about 36 hours into the induction) i decided to try a breast pump for nipple stimulation... and it sent me into active hard labor. Baby was born at 2:50 a.m. almost 42 hours after they initially placed the catheter.

It can be done. He was well positioned (LOA) and i think that helped once things finally got started. But i never had a contraction that my own body didn't make. It can be a good tool if used properly.

This sounds really neat. I'll have to read up on the foley catheter. Thanks.

N/M...found the answer to my question further down the thread:blush

I am familiar w/ foley cath inductions, but have never seen one. I am wondering how effective this would be to break open scar tissue that is affecting dilation.

I have been at 2 births where it was done...at one of the births mom had been ruptured for 3 days and her temp was running a little high but she was at 1 cm and not cx regullarly so OB decided on a foley b/c he didn't want to stress baby any more than necessary. When she got to 4cm the foley fell out and moms cxs ended, then they started pit and mom had a vaginal delivery w/ vacuum. I'm not sure what all that means, but that is just my experience on the subject.....but it is definitely something to bring up and see if the provider and mom are willing to do

it is used here in atlanta with midwives and docs a lot when the mom is refusing pitocin or if the mom is a vbac who is facing another cesarean birth otherwise. it is a risk factor for infection if the water has been broken- as is anything including a gloved hand- but when the bag is intact and the cervix is virtually closed- it works great - and it is not painful- and it usually falls out at 3cms...

I see foley inductions all the time where I work. They are especially helpful in inductions for moms with an unfavorable cervix. I also see them used quite a bit for VBAC and VBAmC.

Foley inductions are common where I work too (I actually had one with my own first labour - though I can't say that it is something I would jump to do again if I could do it all over ;) ) I have to say though that they have their time and place for usefulness and it was interesting to read about one being used following ROM.

What WONDERFUL information!! thank you for sharing, I have never heard of this technique and it is great to know and tuck away so that my clients can request it if their back is against the wall!

I think it sounds like a great option. I have never heard of it, but how great that it helped. Also, I don't see why it would be any more of an infectin risk than a vaginal check.

I had not heard of this method before reading this thread. It is not offered/performed at any of the three hospitals in my area. Out of curiosity, I Googled the topic and found an article on BHJ by typing "foley induction". (Sorry I couldn't include the link - I'm too fresh!)

What I gather from their study is that the most frightening risk is cord prolapse, so I would be cautious were the baby "riding high". As it is an induction/augmentation tool, I will be sure to know the station before pulling this article out of my binder.

Thanks for the info!