A Foley balloon induction is a mechanical method for preparing the cervix for labor. It uses a soft, flexible catheter with an inflatable balloon to gently encourage the cervix to soften and open, a process known as cervical ripening. This approach is a non-hormonal way to initiate the early stages of labor when medically indicated.
Medical Reasons for a Foley Balloon Induction
A healthcare provider may recommend a Foley balloon induction when there is a medical reason to deliver the baby, but the cervix has not yet started to dilate or efface on its own. This state is referred to as having an “unfavorable” cervix, meaning it is still firm, thick, and closed. The goal is to make the cervix more favorable, increasing the likelihood that subsequent steps of the induction will be successful.
This procedure is recommended in situations where continuing the pregnancy poses a greater risk than delivering the baby. One common reason is a post-term pregnancy, where an individual has gone significantly past their due date. Other maternal health conditions that might necessitate an induction include preeclampsia, a condition characterized by high blood pressure, or gestational diabetes.
Fetal concerns can also lead to a recommendation for a Foley balloon induction. For instance, if there is evidence of fetal growth restriction, where the baby is not growing at the expected rate, a provider might decide an earlier delivery is the safest option. The Foley balloon is considered a safe method for individuals who have had a previous cesarean section, as some medication-based induction methods can carry higher risks.
The Foley Balloon Placement and Removal Process
The procedure uses a Foley catheter, which is a thin, flexible tube with a small, uninflated balloon at its tip. A healthcare provider uses a speculum to visualize the cervix, just as they would during a Pap smear. The tip of the catheter is then gently guided through the vaginal canal and into the opening of the cervix.
Once the tip of the catheter is correctly positioned inside the cervix, with the balloon between the amniotic sac and the lower part of the uterus, the provider uses a syringe to fill the balloon with a sterile saline solution. The balloon is inflated with about 30 to 80 milliliters of fluid, creating gentle, consistent pressure on the internal side of the cervix. This pressure mimics the natural pressure of a baby’s head, encouraging the cervix to dilate.
The external end of the catheter is often taped to the individual’s inner thigh to maintain a slight tension. The balloon is left in place for up to 12 hours, though this can vary. In many cases, the balloon will fall out on its own once the cervix has dilated to approximately 3 to 4 centimeters. If it does not fall out within the designated timeframe, a provider can remove it by deflating the balloon and gently pulling out the catheter.
Patient Experience During Cervical Ripening
The sensations experienced during a Foley balloon induction can vary significantly. During the initial placement of the catheter, some individuals report discomfort similar to a routine cervical check or a Pap smear. The feeling is often described as a sense of pressure or a brief, sharp cramp as the catheter is inserted and the balloon is inflated.
Once the balloon is in place, the most common sensations are cramping and mild, irregular contractions. The intensity of this cramping can range from barely noticeable to feeling like strong menstrual cramps. For many, the discomfort is manageable and may come and go in waves.
To manage any discomfort, individuals are encouraged to change positions, walk around if permitted, or use a heating pad on their lower back or abdomen. Breathing techniques learned in childbirth classes can also be effective in managing the cramping sensations. It is also common to experience some light spotting or pinkish discharge while the Foley balloon is in place, which is not a cause for concern.
Potential Outcomes After Removal
After the Foley balloon falls out or is removed, a healthcare provider will assess the cervix to determine how much it has changed. If the cervix has become softer, thinner, and has dilated to at least 3 centimeters, the induction is considered to have moved in a positive direction. The next step is often the administration of medication, such as Pitocin, to initiate or strengthen contractions and move into the active phase of labor.
In some instances, the mechanical pressure from the Foley balloon is enough to stimulate the body to begin labor on its own. For these individuals, contractions may start and progress steadily without the need for further medical intervention. This allows the labor process to continue more naturally.
Occasionally, the Foley balloon may not lead to significant cervical change. If the cervix remains unfavorable after the designated time, the induction attempt is considered unsuccessful. In such cases, the healthcare provider will discuss the next steps, which could involve trying a different cervical ripening agent or moving toward a cesarean section.