A urinary catheter is a small, flexible tube inserted into the bladder through the urethra, designed to drain urine. Catheterization is not a universal or mandatory part of every birth experience. The need for a catheter depends entirely on the specific course of labor, medical interventions chosen, and the patient’s ability to empty their bladder spontaneously. When used, the catheter prevents bladder distention, which can interfere with the baby’s descent and slow labor progression.
When Catheterization Is Not Required
A patient experiencing unmedicated labor will generally not require catheterization. In this scenario, the patient remains mobile and maintains full sensation, allowing them to use the restroom independently. The ability to move around and change positions is beneficial, and the patient can respond to the urge to void.
The medical team monitors the patient’s fluid intake and output closely, often encouraging them to empty their bladder every two hours. Preventing the bladder from becoming too full is important because a distended bladder can impede the baby’s movement. If the patient can pass urine on their own, catheter use is avoided throughout the labor process.
Primary Reasons for Catheter Use During Labor
The most common reason a urinary catheter becomes necessary is the administration of regional anesthesia, such as an epidural. An epidural blocks nerve signals from the lower body, eliminating the sensation of needing to urinate and the muscle control required to push urine out. This loss of function means the bladder cannot be emptied naturally. A catheter is typically placed shortly after the epidural is established to ensure continuous drainage and prevent complications.
Other medical situations also necessitate catheterization. These include prolonged labor where the patient is confined to bed, or if the patient develops preeclampsia requiring close monitoring of kidney function and urine output. Catheterization is also routine preparation for an operative delivery, such as a Cesarean section, to keep the bladder deflated and out of the surgical field.
Types of Catheterization and What to Expect
The type of catheter used depends on whether drainage needs to be temporary or continuous. For temporary use, such as when a patient is unable to void but does not have an epidural, a straight catheter is employed. This is an “in-and-out” procedure where the tube is inserted only long enough to drain the bladder completely, and then it is immediately removed.
When an epidural is in place, an indwelling or Foley catheter is used. This catheter is designed to stay in the bladder for an extended period. The Foley catheter has a small balloon on the tip that is inflated with sterile water after insertion to keep the tube securely in place, allowing for continuous drainage into a collection bag. Since the indwelling catheter is usually placed after the epidural has taken effect, the patient typically does not feel the insertion. The catheter remains until the effects of the regional anesthesia have worn off, usually a few hours after delivery.
The removal of either type of catheter is generally a quick process. Patients may feel a mild sensation of pressure or slight burning as the tube is withdrawn. Some individuals experience temporary difficulty fully emptying their bladder following removal, which is a common, short-term side effect as bladder sensation and muscle function return to normal.