Ripening of the cervix at home with the use of a Foley catheter

A balloon catheter or Foley catheter helps to open your cervix using gradual physical pressure. The Foley catheter is inserted into your womb while deflated, then slowly inflated with saline solution until it’s about the size of a ping pong ball. As the balloon fills, it puts pressure on your cervix and encourages it to dilate, stimulating your labour to start. The increased pressure also causes a release of hormones, triggering the ripening of the cervix.

The Foley catheter will be inserted at the Triage department of the hospital.  The doctor or clinical midwife will make arrangements with you for a date and time to place the Foley catheter. The Triage department is also an emergency department for pregnant women. If there are a lot of urgent cases, your appointment might need to be rescheduled.

Always call ahead

To avoid an unnecessary trip to the hospital we ask you to call ahead about half an hour prior to your appointment to check if your allotted space is still available. Call the Triage department on 088 250 6459. If the line is busy you can call the labour ward on 088 250 6042. It occasionally happens that you may need to call back later on the day or that your appointment could need to be set back a day.

Arrival

Upon arrival you may register at the labour ward reception desk (afdeling Verloskunde). You will then be asked to take a seat in the waiting room.

Preparations in the hospital

Before the Foley catheter is inserted, a nurse will monitor the baby for  30 - 60 minutes with the use of a cardiograph (CTG). A nurse will bring you to the examination room.  Your partner may also accompany you. Here you may remove your undergarments and sit in the examination chair.

Details of the procedure 

The doctor or clinical midwife shall carefully evaluate the cervix with an internal vaginal examination using two fingers.  The Foley catheter can then be inserted through the vagina and into the cervix using either two fingers or a speculum instrument. The actually insertion of the Foley catheter can sometimes feel uncomfortable however any discomfort usually dissipates soon afterwards.  The external end of the Foley catheter is visible and is taped to the inner thigh.

Duration of the procedure 

The procedure consists of three steps:

• The nurse will monitor the baby for 30 to 60 minutes with the use of a cardiograph (CTG).
• The insertion of the Foley catheter takes approximately 10 to 15 minutes.
• The baby is monitored again by the nurse for 60 minutes after the Foley catheter is inserted.
   

After the Foley catheter is placed the baby is monitored for one hour to confirm good condition.

At home

If the cardiograph (CTG) of your baby is optimal and you feel well enough you may go home and wait there as the Foley catheter ripens the cervix.

The possible side effects

The following side effects may occur:

• Abdominal or backache, similar to menstrual pains 
• Braxton hicks or light painless contractions 
• The balloon could fall out. Should the balloon / Foley catheter fall out you may discard it in the bin and contact us.  
• The balloon could burst. You might feel the burst and could lose some fluids. This is not a problem, but please do inform us. We can place a new Foley catheter depending on the time of the day.

Does the baby experience difficulty because of the Foley catheter?

It is likely that the baby is not affected by the Foley catheter as the balloon is placed outside the membranes.

Advice for at home

You can walk around as normal, use the toilet and shower. We advise against taking a bath or engaging in sexual intercourse due to a higher risk of infection. It is wise to stay at home during these days and take enough rest for the oncoming labour.

Problems at home

Please call 088 250 6459 in the following instances:

• If you feel unsettled or worried. 
• If the balloon / Foley catheter falls out. 
• If your waters break. 
• If you experience regular contractions every 5 minutes that last 50-60 seconds. 
• If you experience much bright red vaginal blood loss (more than a menstruation). 
• If you experience much pain or feel the baby’s movements less than usual.

Follow-up appointment 

The nurse will schedule a follow-up appointment for the following day to evaluate your cervix and determine if it is ripe enough to artificially break the waters (membranes). For this follow-up appointment please ensure that you bring your belongings with you that you wish to have for the birth. Should your cervix be ripe enough you will be brought over to the labour ward where you will have your own private room.  Here your membranes can be artificially broken and you will receive an intravenous drip with hormones (oxytocin) that cause contractions. Should your membranes break spontaneously we will then determine with you the best course of action with regards to inducing the labour. Should your cervix not have ripened after placing the Foley catheter, there are three additional options:

1. The Foley catheter can be replaced or further filled to increase its size.  If the cardiograph (CTG) of your baby is optimal and you feel well enough you may go home and wait there as the Foley catheter ripens the cervix.
   
   In the case of options 2 and 3 you will be admitted to hospital.
    

2. Misoprostol (Angusta®) = 1 capsule containing 25 µg) You will be given a capsule every 2 hours to take with water. The CTG is repeated if you have contractions, if your water breaks or if you have received a maximum of 8x Misoprostol. If necessary, an internal examination will be carried out.

3. A hormone (Propess) insert in the shape of a shoelace can be placed behind the cervix to soften and ripen the cervix.

Ripening of the cervix may take several days.

Should you have questions regarding the contents of this information leaflet you may contact the Triage department. The telephone number is listed on the back of this leaflet. 

Triage Gynaecology and Midwifery
088 250 6459

Labour ward
088 250 6042

Do you find something unclear? Or is information missing? We would like to hear that. You can submit comments about the text via [email protected]