While not every individual requires a urinary catheter during childbirth, it is a common medical procedure under specific circumstances. The decision to use a catheter depends on various factors, including pain relief methods and the course of labor. Medical professionals use catheters to ensure the well-being of both the laboring person and the baby.
When Catheterization May Occur During Labor
A urinary catheter may be used during labor when natural urination becomes difficult or medical monitoring is needed. A frequent reason is epidural anesthesia. An epidural numbs the lower body, which can prevent the laboring person from feeling bladder fullness or the urge to urinate, making it challenging to empty the bladder independently. A full bladder can hinder the baby’s descent into the pelvis and potentially slow labor progress.
For individuals undergoing a Cesarean section, a catheter is routinely inserted before surgery. This helps keep the bladder empty, providing a clearer surgical field and reducing the risk of injury during the procedure. In cases of prolonged labor or when certain medications are used for labor induction, a catheter might be necessary to prevent bladder overdistension or to monitor fluid balance. Some medical conditions, such as preeclampsia, may also necessitate continuous monitoring of urine output, which a catheter facilitates.
Understanding the Catheterization Process
A catheter is a thin, flexible tube designed to drain urine from the bladder. In labor, two main types are typically used: intermittent and indwelling Foley catheters. An intermittent catheter is inserted to drain the bladder and then immediately removed for temporary relief of a full bladder. An indwelling Foley catheter remains in place for a longer period, secured by a small balloon inside the bladder to prevent it from slipping out. This type is commonly used with epidural anesthesia or during a Cesarean section.
The insertion of a urinary catheter is performed by trained medical staff using sterile techniques to minimize infection risk. If an epidural is in place, the catheter is often inserted after pain relief takes effect, which helps to reduce any potential discomfort during the procedure. The process is quick, and for an indwelling catheter, a drainage bag is attached to collect the urine continuously.
Addressing Common Concerns
Concerns about discomfort or pain associated with catheter insertion are common. When an epidural is effective, the insertion of a urinary catheter is often not painful, with some individuals reporting only a sensation of light pressure. However, if no epidural is in place, or during procedures like Foley bulb induction, the insertion can cause temporary discomfort or a brief stinging sensation, which typically subsides once the catheter is in place.
While the catheter is in place, some individuals may experience a mild sensation of fullness or slight discomfort. The primary potential risk is the development of a urinary tract infection (UTI). Medical staff employ strict sterile techniques during insertion and maintenance to reduce this risk. Other less common issues can include bladder spasms, which feel like cramps, or leakage around the catheter. Serious complications are rare.
Post-Delivery Considerations
Once labor and delivery are complete, the urinary catheter is typically removed. For vaginal births, this usually occurs shortly after delivery when the individual can comfortably move and urinate independently. Following a Cesarean section, the indwelling catheter is generally removed within 6 to 24 hours after the procedure, once recovery is underway and the patient can ambulate.
After the catheter is removed, bladder sensation gradually returns, and the first few times urinating may feel different than usual. Medical staff monitor the individual to ensure proper bladder function and complete emptying, reducing the likelihood of urinary retention. If difficulty urinating persists, further assessment or temporary re-catheterization may be considered to ensure bladder health.