Need info on induction with Foley catheter

Fullerbirths · 01-14-2010, 04:22 PM

Hi ladies,

I have a client who was due Jan 6, a vbac, and if she hasnt gone into labour by Sunday they are going to try to induce with a foley catheter, and then if nothing happens, they will break her water Monday morning.Utrasound and non stress test has shown baby to be just fine, mom and babe are completely healthy- so reason to induce other than the fact that she is overdue. ugh. I have given them LOADS of info on natural induction methods, she has been going to acupuncture every day for the past week, and has been having marathon sex sessions. She is a little over 1 cm dilated and very thin, but dr said at last appnt that she suspects CPD because babys head is not engaged. Isnt it common for second babies not to drop until labour???

Anyways, I was wondering if anyone had any experience with foley catheter inductions? How well they work and what to expect?

Thanks!

chitowndoula · 01-14-2010, 05:21 PM

It is not a proven method of induction. So far the research suggests that it increases the chance of a c-section above and beyond the 'normal' (pit and cervidil) induction. Find out if the hospital is doing a research study on the foley for induction. I have known moms who are bullyed into this type of induction only to find out it was for research purposed. True CPD is rare and is often a scare tactic. Let the parents know their rights to refuse induction all together or request another method of induction. Also the standard of care is to allow mothers to go to 42 weeks before induction. Hospital policies vary, but 42 weeks is generally the standard of care. Good luck!

AngelsMum · 01-14-2010, 05:27 PM

Quote:

dr said at last appnt that she suspects CPD because babys head is not engaged. Isnt it common for second babies not to drop until labour???

YES! It is common for second or more babies not to drop until labour. And they can drop and move out again. The whole diagnosis of CPD is made just on this bit of information?

CPD cannot really be accurately diagnosed. There is no way of telling how much a baby can man??? during labour; no way of telling how much the pelvis will be "give" during active birth and no way of telling how much the baby's head will mold if given enough time.

The only way of diagnosing true CPD (which is extremely rare) is labour! If the woman was not malnourished as a child (eg. rickets) and hasn't had a broken pelvis, she is most likely able to give birth.

Here's a good article - Baby Not Engaged? And it has further links including "The truth about CPD". There's also great articles on inductions too.

I was looking for red flag smilies. I think we need them! If the OB is telling this woman so blatant furphies now - what's going to happen during labour?

Foley catheter is not something that is used in my local hospitals. But I found this article Foley's Catheter - How is it done? I haven't looked into any research about its effectiveness.

Comfy · 01-14-2010, 07:19 PM

Just want to say that I hope this Mom goes into labour on her own, and has the kind of birth she wants.

doulafava · 01-14-2010, 07:23 PM

Quote:

Originally Posted by chitowndoula

Also the standard of care is to allow mothers to go to 42 weeks before induction. Hospital policies vary, but 42 weeks is generally the standard of care.

Not where I live. No OBs here routinely wait that long to induce. A small handful will agree to wait when a mom has a specific request. But the standard of care here, and most places in the states I suspect, it to induce at or before 41 weeks.

rootsandwingsdoula · 01-14-2010, 11:45 PM

Quote:

Originally Posted by doulafava

Not where I live. No OBs here routinely wait that long to induce. A small handful will agree to wait when a mom has a specific request. But the standard of care here, and most places in the states I suspect, it to induce at or before 41 weeks.

Yep, that's what I see here. To go over 41 weeks takes a lot of work on mom's part - the docs try everything to get her induced before then. Past 41 weeks is pretty rare around here.

happydoula · 01-15-2010, 01:05 AM

Just as an aside... if this mom is induced on Monday, that will be 41w5d, correct (EDD was Jan 6)? Almost 42 weeks - I'm actually rather impressed!

I had not heard that a balloon catheter induction would increase the chance of cesarean above and beyond cervidil/pit - that's very interesting. chitowndoula, I'd really appreciate knowing your source (since I've had other moms ask me about it in the past!)

Angelsmum's link looks like a good description - I don't have a better source, although I'm eager to see some from the other doulas on here! :o)

Fullerbirths · 01-15-2010, 10:03 AM

Quote:

Originally Posted by chitowndoula

. Also the standard of care is to allow mothers to go to 42 weeks before induction. Hospital policies vary, but 42 weeks is generally the standard of care. Good luck!

Not here either! OUr hospital standard procedure is 10 days overdue to induce. WIth my client, she got her dr to bump her due date up 2 days to give her 2 days extra to go into labour on her own. It is very rare to go up to 2 weeks overdue, and sadly even rarer that people will not show up for their inductions. It almost goes without saying that I let all my clients know that it is their choice whether they go to the induction or not.

They are using the foley catheter first because she is a VBAC. It doesnt use any drugs to stimulate contractions, just manually tries to dilate the cervix, so I dont seee how it would increase the rate of c section more so than pit!

This mom is very afraid of a big baby, which i think the dr has been pushing on her and why the dr is suggesting CPD. FIrst baby was a section due to failure to progress and was 9 lbs 3 oz, and mom is 5'3. Drs are pushing for a scheduled c section, so I applaud my client for pushing the due date up, and not giving in to a section!

helpinghands · 01-15-2010, 10:57 AM

I recently attended my first foley induction. I actually had suggested it to the client as an alternative to cytotec, (after reading about the option here on alldoulas, fwiw). Mom started with Cervidil...which opened up things just enough to make a foley induction possible. The (seasoned) OB hadn't done one since med school, and the nurses had never seen one either, but they consented because mom was insistant that she was not going to agree to cytotec. They sort of had a compromise...the foley cath with a whiff (like...2!) of Pitocin. This took a very posterior, undilated, high cervix much lower, anterior, and 5 cm within about 10 hrs...contractions pretty regular, hard, etc. It doesn't always work, BUT.... if mom HAS to induce and doesn't like the other options, it IS an option.

Fullerbirths · 01-15-2010, 10:12 PM

Quote:

Originally Posted by EvansvilleDoulaCBE

I recently attended my first foley induction. I actually had suggested it to the client as an alternative to cytotec, (after reading about the option here on alldoulas, fwiw). Mom started with Cervidil...which opened up things just enough to make a foley induction possible. The (seasoned) OB hadn't done one since med school, and the nurses had never seen one either, but they consented because mom was insistant that she was not going to agree to cytotec. They sort of had a compromise...the foley cath with a whiff (like...2!) of Pitocin. This took a very posterior, undilated, high cervix much lower, anterior, and 5 cm within about 10 hrs...contractions pretty regular, hard, etc. It doesn't always work, BUT.... if mom HAS to induce and doesn't like the other options, it IS an option.

So how did the birth end??

helpinghands · 01-16-2010, 02:06 AM

Quote:

Originally Posted by Fullerbirths

So how did the birth end??

About 24 hrs in, cesarean. (I don't think it was related to the method of induction, it was for other factors).

summer · 01-16-2010, 04:51 AM

One of my clients had this type of induction. She was 41 weeks and about 1 cm and still firm. In about 3 hours she went to 4 cm and the foley fell out. She was very uncomfortable the whole time it was in, but it was the method of induction she chose to follow since she felt her doctor was giving her no other real options.

After the foley fell out her contractions were very regular and she was able to walk freely around the ward. They made her stay on monitors for 30 minutes after her fell out for monitoring and then she was free. She had a "normal" labor and delivered in 17 minutes (so far my longest pusher).

Pambug · 01-16-2010, 01:22 PM

One of my close friends used this method for induction as well. She had it placed at night and by morning she was 4 cm and contracting regularly. She ended with a vaginal birth.