? about Foley Bulb used for Induction

[HopelessPoet]

Hello. I'm new here and I had a question regarding use of a Foley Bulb/Catheter for labor induction/cervical ripening.

A bit of history: I am GD and Insulin Dependent. My OB has stated that I will have to be induced on my due date because he fears placenta failure at that point. After weighing my options it's best for me to stay as his patient and just try to do things as naturally as possible.

He understands my concerns to labor as naturally as possible as we went over my birthing plan so that he would be aware of my opinions. He told me today that IF induction becomes necessary that he would like to try a Foley Bulb first since that is not a medicinal induction. He did state that a membrane sweep is something else they do with that. (I'm not 100% sure I'm comfortable with that yet but I do know that I favor that over medications.) That will allow me to stay off constant fetal monitoring, they will not demand an IV, and I will be able to labor in the shower, down the hall, on the bed, on a birth ball, or where ever I deam is most comfortable.

I would like to know all I can about the Foley Bulb and it's uses for induction. What do you guys think?

[alegna]

Not a professional, but RUN and find a new care provider

-Angela

[HopelessPoet]

Originally Posted by alegna

but RUN and find a new care provider

I can't do this for multiple reasons.

[alegna]

In that case I would just turn down the induction. You have a right to refuse anything.

-Angela

[ktbug]

I don't know the details of your situation, and the devil is certainly in the details, but in general, you don't have to be induced just because the doctor says so. On a totally nonscientific level, I get pretty wary any time a doctor says anything to me along the lines of "you have to, because I say so".

If you're to give birth in a hospital, which it sounds like, you don't have to consent to anything the doctor wants to do to you. Just because he says to show up on the morning of your arbitrary, possibly faulty due date doesn't mean someone's going to come to your house and drag you to the L&D unit. If you feel comfortable, in your particular situation, waiting to go into labor on your own within a reasonable timeframe of your due date, then wait. When you arrive at the hospital in labor, there is decidedly less they can 'do to you', at least in terms of inductions.

If you're set on having an induction ... well, the Foley method basically involves introducing a thin tube (a foley catheter) into your cervix and inflating it, like a balloon, sort of like angioplasty. Manually dilating your cervix, basically. At that point, they would likely want to rupture your membranes, thinking the stimulation of the cervix and loss of integrity to the amniotic sac would trigger labor. It's not the best way, but most induction methods are imperfect. The other options usually used in a hospital birth are pitocin and cytotec, and they're not so great, either.

There are some tried-and -true herbal preparations to be used in the weeks before birth which ripen and prepare your cervix and uterus to do their jobs. A good midwife can tell you more about all of these things. If it's at all possible, I encourage you to at least speak with a midwife, in a professional consultation. It can even be over the telephone, but in a way that she can ascertain the details of your medical history and personal circumstances to better assist you with your decisionmaking process.

As I'm sure you're aware, sometimes mainstream OBs can get on a bit of a power trip with their patients, and the concept of informed consent goes out the window a bit when it comes to labor and delivery.

None of what I write is to suggest that insulin-dependent diabetics need not seek obstetrical care, or that you likely don't have extenuating circumstances which compel you to seek mainstream OB care. I just think it would help you be in a better mindframe about your birth experience if you were to get the professional input of a midwife. It is not against the law to get a second opinion.

[CookieMonsterMommy]

They can't really place a foley balloon without stripping the membranes, because otherwise the balloon would have no where to go. It gets inflated inside the uterus, past the cervix. The membranes would have to be stripped from the internal cervical opening in order to place the catheter.

If you have specific questions about a foley induction, I'd be more than happy to try and help you.

Edited to add that sonograms can be done to check placental function. They don't just fail overnight, it takes time for them to become calcified.

Also to clarify that the balloon is NOT inflated in the cervix, but rather past it, in the uterus. Pressure is then applied to stimulate the release of natural prostaglandins and put pressure against the cervix as a baby's head would. It will usually fall out on it's own when you are 3cm or so dilated.

As far as inductions go, this is considered the safest way. I hesitate to say natural, because in all reality, tricking your body into going into labor using man-made interventions isn't natural.

[HopelessPoet]

I know that I can refuse anything he suggests however at 40wks, possible twins, possible failing placenta, with no other caregiver options he then also has the right to refuse to be my doctor. If that happens then I'm stuck in a very unsafe situation.

As far as being able to get a midwife's second opinion there are no midwifes/doulas within 120 miles of where I live.

I also understand that the Foley bulb is a man made induction technique. If it were a perfect world then I would be having a homebirth with a midwife but it's just not a possibility.

ETA: He knows that I will not consent to ROM because that puts me on a clock.

[alegna]

Originally Posted by HopelessPoet

I know that I can refuse anything he suggests however at 40wks, possible twins, possible failing placenta, with no other caregiver options he then also has the right to refuse to be my doctor. If that happens then I'm stuck in a very unsafe situation.

Actually, at 40 weeks he can NOT refuse to be your dr.

-Angela

[CookieMonsterMommy]

Originally Posted by HopelessPoet

I also understand that the Foley bulb is a man made induction technique. If it were a perfect world then I would be having a homebirth with a midwife but it's just not a possibility.

I'm sorry, mama. I didn't mean to make you feel badly. I just wanted to clarify what I was saying. I was trying (ineffectively) to articulate that a foley induction is considered the least un-natural of all the inductions because it actually stimulates your body to make its own hormones.

Please also know that ANY induction puts you on a clock, though maybe a less stringent one. I don't know of any doctors that will leave a foley in for days, for example. If you "fail to progress", you could end up with pitocin started before your cervix is ready. If that fails to dilate you in a "reasonable" (as defined by each doctor and possibly hospital poilicy) amount of time, a c-section may be done.

[ktbug]

Originally Posted by alegna

Actually, at 40 weeks he can NOT refuse to be your dr.

-Angela

Right, and the hospital can't refuse you treatment. There's always an OB on call.

As for the midwife consultation, it's something you could do remotely. You wouldn't have to go into an office for an appointment. Just find a trained birth professional to talk to about the specifics of your situation, and see if there are any perspectives out there you haven't thought of.

Also please be aware that it isn't unheard of to rupture membranes without consent, "as long as they're already in there".

It sounds like you don't yet know if you're having twins, which makes me wonder why the doctor automatically suspects placenta problems, too?

Anyway, enough blind speculation. Good luck, and I hope you find the answers and the perspective you need.

s and good birthing vibes to you.

[nashvillemidwife]

HopelessPoet, I think the foley induction is a good idea for you. I'm sorry that so many responses to your question have not been helpful to you. ktbug and CookieMonsterMommy have given you some good information about the foley. Have you been using EPO or borage oil on your cervix?

[BrooklynDoula]

It sounds like the best option for you might be to have this baby (babies?) before you get to 40 weeks! Are you drinking your RRL tea? You can also insert evening primrose oil gel caps that are pricked open into your vagina as a cervical ripener. Long walks. Lots of sex (and orgasms). Nipple stimulation as you get closer (this can even be done with a pump if you really want to induce - this also stimulates your own body hormones). Accupuncture (although it might not be available locally), homeopathic treatments, and more.

I think visualizing your birth and planning it out for the perfect situation is a wonderful way to putting your intentions and desires out there and hoping for those to come true. Starting at 37 weeks, you might spend 20-30 minutes everyday meditating on your labor and thinking really beautiful, calm, relaxed, ready-for-birthing thoughts.

Then, if 40 weeks comes, the foley sounds like it might be a good idea for you.

Good luck to you mama.

[Defenestrator]

Originally Posted by HopelessPoet

I know that I can refuse anything he suggests however at 40wks, possible twins, possible failing placenta, with no other caregiver options he then also has the right to refuse to be my doctor. If that happens then I'm stuck in a very unsafe situation.

I'm confused by this -- he feels that he knows your case well enough to determine if there are issues with a possible failing placenta but not well enough to know how many babies you are carrying?

[Defenestrator]

Oh, and more on topic -- I have heard of some midwifery practices placing a foley and then allowing their clients to go home until it falls out or until contractions start with some regularity. Would that be an option for you?

[maxmama]

There is a catheter used specifically for induction made by Cook Medical that has two bulbs, and sort of squashes the cervix between them. We have EXCELLENT results with a Cook catheter as long as each bulb is filled to 80cc (the recommended amount).

We don't monitor Foley inductions. We place it and send them home for 12 hours.

[Robinna]

hi hon... just stalking you.
xo Robin

[HopelessPoet]

I'm going to try and address all the issues that have come up here. I'm actually out of town on a holiday vacation so this might be quick but I'll do my best to make sure I'm not confusing.

Twins: My OB said that it's most likely that I'm not having twins but that I'm far enough along now that it's possible for one to be hiding. I'm genetically predispositioned for twins as they run in my fathers family. We're talking at least 4 sets in recent memory.

EPO/RRL Tea: I am not doing any tea or EPO at this time. I have no idea how to find that tea but I'm going to ask about it when I go to the local natural food store when we return home. Money is also an issue so if it's expensive then it's just not an option. I plan to start oral/internal EPO at 37wks.

Placenta Problem: Being insulin dependent means that I'm at an increased risk for placent failure. There is already some signs of calification but we think that since I'm controlling my sugars very well now that the calcification is stopped or at worst slowing down.

Foley Induction: To my knowledge, which is limited at this time, he would not want me to come home. It's possible that I could talk him into it but at this time I have no idea. That is something that we'll talk about more later on.

General Discussion: I agree that I need to go into spontanous labor before 40wks!!!!!! We are going to do everything we can starting 37 wks to get my body as primed as possible that way if I haven't went into labor that the Foley will do it's job and I will have my definition of a natural birth from there out.

Robin: Hi hon. I'm so glad that you're stalking me!!! Makes me feel very special.

Disclamer(LOL): If I've missed anything please don't hesitate to repost it.

[Knitting4me]

I'm here stalking you too hon!


- Erika

[HopelessPoet]

Hi Erika!!!

[cristeen]

TBH, the placement of the foley is not pleasant, especially if your cervix is still closed. If you're already beginning to ripen and efface it is not so bad. But, having had all 3 (cytotec, pit and foley, at the same time), the foley was by far the easiest to deal with. Once it was in, it was fine. The membranes will kind of depend on the position of the baby... if he/she hasn't dropped yet it is possible to place it without rupturing membranes, although not easy. My membranes ruptured just a few minutes before the foley came sliding out.