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Induction of labour with Cervical Balloon (Foley’s) catheter

What is balloon induction?

Balloon induction is a mechanical form of induction of labour and is the only method used for outpatient induction of labour at present. This is because mechanical methods of induction of labour have the least chance of over stimulating the uterus and causing too many contractions (uterine tachysystole).

The procedure involves a soft silicone tube also known as a catheter being inserted into the neck of your womb (cervix). It has a balloon near the tip and when it is in place the balloon is filled with a sterile saline (salt water) fluid. The catheter stays in place for up to 24 hours, with the balloon putting gentle pressure on your cervix. The pressure should soften and open your cervix enough to start labour or to be able to break the waters around your baby.

If you are suitable for outpatient induction of labour, you can go home while the catheter is in place. You will be given a time to attend the maternity triage for removal of the catheter in 24 hours. If it falls out before this time you should call maternity triage and will be invited in for assessment.

Who is balloon induction suitable for?

Induction by the balloon method can be offered to any woman undergoing induction of labour, if she chooses to have this method. The only instance where it is not to be used is when the membranes have already ruptured.

How does balloon induction work?

The balloon rubs against and stretches the neck of the womb (cervix) to produce a hormone called prostaglandin. The prostaglandin causes the cervix to become shorter and soften (ripening). This prepares the cervix for labour and allows your midwife or doctor to break your waters. Sometimes, the release of hormones as the cervix is stretched is enough to trigger your waters to break naturally and for labour to begin.

How is the balloon catheter fitted?

First a tracing of the baby’s heart will be done to check the heart rate and ensure all is well. A vaginal examination will be then performed with your consent. This allows assessment of your cervix in preparation for the balloon to be inserted. An instrument called a speculum may be introduced into the vagina to help in the process. The catheter is then inserted through the cervix and the balloon is gently filled with water to apply pressure to the walls of the cervix. If you find the process uncomfortable, you can ask for gas and air for pain relief.

How long does it take?

The balloon catheter is kept in place for up to 24 hours. It then either drops out of the cervix or is removed. At this point, it should be possible to break your waters.

Are there any risks or complications?

Inserting the balloon into the cervix is uncomfortable, but not normally painful. There is a small risk of infection and if this is suspected you will be re-assessed and your plan of care will change.

Going home after insertion of the Foley catheter

During the time you are at home, you can do things as you would normally, for example, showering, bathing or walking. However, please avoid sexual intercourse. After going to the toilet please wash your hands and make sure the catheter is clean.

If you have any of the following:

  • Bleeding
  • Contractions
  • Concerns about baby’s movements
  • You feel unwell
  • The waters around baby break
  • The balloon falls out

You are advised to call Maternity Triage on 01296 316103. A midwife will talk to you and advise you what you need to do.

What if the balloon doesn’t work?

If the cervix is not dilated enough for balloon to be inserted or if the balloon doesn’t soften the cervix enough for your waters to be broken, a plan to continue the induction process using an alternative method will be discussed with you, if appropriate. In some cases, a caesarean section may be necessary. Your doctor will discuss this with you.

Further information

For further information about induction of labour and all other aspects of pregnancy and childbirth, please talk to your midwife or doctor.