Foley catheter and VBAC - worth fighting for?

[Family4Christ]

Hi mamas,

My OB apparently doesn't do foley catheters. In both my labors, I didn't progress after 18 and 19 hours of very painful, strong contractions 90-120 secs apart. I'm not sure why. The first was an induction on an unripe cervix. So, no rocket science there. The second was supposed to be a homebirth, so no interventions and no dilation and cervix remained posterior and unripe.

So, I was really hoping that a foley catheter would be my best hope of dilating and now I find out my OB doesn't use them. Do they work so well that I should fight for it's use or look for another OB? My OB is the best VBAC doc in the DFW area, period. Every MW in the area recommends and loves him. I know he's my best bet, but if the foley is what allows my VBAC to happen, then I have a problem.

Thoughts?

[kltroy]

I'm not sure what the success rates are with folies, but I know that they don't work past about 3-4 cm dilation (you just cant blow them up any bigger). So it may not do you much good if you are already dilated a bit before you go into labor. I don't think that's a make or break thing. Personally, I'd have your OB start doing weekly membrane sweeps starting around 37 weeks. Lots of regular sex (2x/week from 37 weeks on -- yeah, I know it's not always very appealing!!). Statistically, these two things can both move up your baby's birth date by an average of 4 days each. (I don't have the peer reviewed articles off the top of my head, but that number is pretty close -- though I wouldn't say that the combination woudl move it up by 8 days -- simply, that it will increase your odds of going into labor on your own in a somewhat timely manner).

Best of luck!

[Family4Christ]

Hi mama,

Thanks for the info, but it's not an issue of going into labor on my own or early, but simply just to get me to dilate. I went into labor on my own at 41 weeks with my dd, but just never progressed. I have never dilated and I figure if it will get me to 3-4, that's much further than I have ever gotten. Therefore, it feels pretty important if that is the only thing that will actually get the dilation going, you know? So, I guess that is the question. Does it always get women to dilate or just sometimes? I'd sure hate to lose my doc if it's something that may not help anyway.

[Amynf1]

Have you ever had any cervical biopsies done? Colposcopy? If you have scar tissue on your cervix then that could prevent dilation and that needs to be addressed.

[steph77]

I believe you are actually asking about a Foley Ball which is different than a Foley Catheter. I wouldn't fight for a Foley Ball, but that's mainly because I had a horrible experience when I had mine. One of the resident doctors came in during the middle of the night and told me that I needed it because my induction wasn't working. The mechanics of the Foley Ball weren't explained to me, and he could not insert it. It was one of the most painful experiences I ever had and I felt violated. Finally, a midwife who was on staff came in and put it in without much trouble. Ultimately, I dilated enough for it to fall out, and did not dilate further which resulted in my c-section.

The Foley Catheter is the full name of the urinary catheter that is put in to drain your bladder. I had an awful experience with one of those too actually. I pretty much try to avoid anything that starts with the word "Foley".

[thorn]

Originally Posted by steph77

I believe you are actually asking about a Foley Ball which is different than a Foley Catheter. I wouldn't fight for a Foley Ball, but that's mainly because I had a horrible experience when I had mine. One of the resident doctors came in during the middle of the night and told me that I needed it because my induction wasn't working. The mechanics of the Foley Ball weren't explained to me, and he could not insert it. It was one of the most painful experiences I ever had and I felt violated. Finally, a midwife who was on staff came in and put it in without much trouble. Ultimately, I dilated enough for it to fall out, and did not dilate further which resulted in my c-section.

The Foley Catheter is the full name of the urinary catheter that is put in to drain your bladder. I had an awful experience with one of those too actually. I pretty much try to avoid anything that starts with the word "Foley".

no, it's the same device, just used for different things. the catheter has a balloon on the end that inflates to keep it from falling out of your bladder. when used to induce labor, the balloon is inflated to put pressure on the cervix and cause slow manual dilation.

[_ktg_]

I'm a fan of the foley and used it with my last pregnancy. I was dilated to a "tight" 2 if I was lucky.

Both my OB/GYN & I wanted it, because he didn't want to start me off on pitocin for an induction given the UR risk. I had it and dilated all the way up 4 with the cather and then to 10 after it fell out without any additional drugs.

[shenanegans]

I had it, it dialated me to a 4 then we started the induction which didn't work. My cervix and body wasn't ready for labor but my water was already broken for 5 days. Eventually I had increased infection and got a c-section. I hope it works for you if you can get it. Why won't your ob use it?

[CherryBomb]

Originally Posted by Amynf1

Have you ever had any cervical biopsies done? Colposcopy? If you have scar tissue on your cervix then that could prevent dilation and that needs to be addressed.

I agree with this. I strongly suspect scar tissue from my LEEP procedure had a lot to do with my cervix not dilating in my first labor. With dd2 I had a midwife and "popped" some "purse strings" (as she called them" and massaged the scar tissue (I still had a c/s, but for other reasons- i did dilate to 7 or 8 cm with that labor). No trouble at all dilating for my vba2c!

[Family4Christ]

Hi mamas,

Thanks for the replies.

I have not had a LEEP, but I did have 2 back-to-back D&Cs. I was convinced this was the reason, but my MW said she doesn't remember feeling anything "cellophane-y" when doing regular checks; however, she wasn't looking for it specifically (I didn't know this might have been the culprit). When I mentioned this to my OB, he said it wasn't likely and didn't understand why I never progressed. In my research, there are many women that don't progress at all and have extremely painful contractions - this has been my experience.

So, I strongly suspect that, but how do I figure out if that's actually the case? I'm sure my doc would check if I asked him, but it would seem a MW would be the better option. Can I check myself? I'm totally cervix ignorant, but I'm willing to learn! I need to learn how to do checks anyway.

I'm frustrated. There MUST be a reason this is happening and this will be a VBA2C, so I *really* want this to happen. We plan on having another baby after this, Lord willing. I'd really like to nail down a reason and solution prior to labor. I won't soon forget the awful labor with my dd and don't want to repeat it. Nothing like horrible, transition-like contractions that are 1 minute apart that do NOTHING.

[Amynf1]

I just know of a couple of women who had cervical scarring and it prevented them from dilating properly but the mw massaged the scar tissue loose and the women progressed very quickly from there. I guess if it were me, I would ask you care provider if they'd be wiling to check for scar tissue and willing to massage it if this happens.

Here's another thread on it...

http://www.mothering.com/discussions...d.php?t=931164

[maotmsmi]

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Edited by maotmsmi - 5/21/11 at 12:38pm