? about Foley Bulb used for Induction - Page 2

[nashvillemidwife]

I've never heard of anyone inserting a foley with ruptured membranes. The infection risk is just too high.

[maxmama]

Originally Posted by nashvillemidwife

I've never heard of anyone inserting a foley with ruptured membranes. The infection risk is just too high.

I've seen it done once, on a VBAC mom who SROMed and wasn't laboring 24 hours later. But she was prophylaxed.

I think the PP was mixing up rupturing membranes and stripping/sweeping membranes.

[BeckiCNM]

Originally Posted by 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.

I've placed quite a few foleys, and I've never ruptured membranes putting one in. I also would never try putting one in if she wasn't dilated at least a little bit - around 1 cm or so. Anyone who can get one in a closed cervix is better at it than I am.

I think if you have to be induced, foleys are not a bad way to go. No chemicals have to be involved, and they tend to work for me. I find the pain varies from person to person - some feel them a lot, some don't.

[Doula Dani]

I was induced with a Foley with my new guy (just a few weeks ago). I was 2cm dilated when the bulb was placed. I honestly did not find it uncomfortable in the slightest- it wasn't even as bad as having my cervix checked imo. I had also been taking epo for about a week at that point. It worked to start my labor and I felt for me it was a good choice. I should note because it is posted on this site in a few places, that I did end up with a c/s for this birth, however, I believe it was in no way connected to being induced with the Foley. Also, I was able to labor at home with the Foley in. I would certainly talk to your physician about that. I don't feel there is any need for you to be at the hospital just waiting to maybe go into labor, ykwim? I would try to be very confident when speaking with him (her?) about it if you choose to do the foley, and just simply say that if you do consent to this, that you choose to labor at home until you feel you're ready to come in. Make it a closed ended comment so it's harder for doc to rebuttal. You can do it mama!!!!

[doctorjen]

You don't have to either rupture or strip membranes to place a foley catheter. In fact, in general it's consider contraindicated to use a foley bulb with ruptured membranes (although the case maxmama describes sure sounds like a good reason to make an exception and try something safer for a prior cesarean mama than medicinal induction.)
I can usually get them through a closed cervix, too - almost always there is enough give even if the cervix feels closed on digital exam to get a thin tube through it. I place them with a speculum and use a ring forceps to slide the catheter through. Most mamas describe it as causing crampiness, but not terribly uncomfortable (I place IUDs a lot in non-pregnant women and I would say they in general have more discomfort sliding the IUD in than women having a foley placed do - but there are exceptions to everything.)
The foley bulb is inflated inside the uterus, and then we like mamas to walk around so that the baby's head can be pushing the bulb against the cervix. It usually falls out on it's own in a few hours and mama is usualy 3-4 cms at that point - but often not effaced all the way. Still, dilation is the single biggest predictor of successful induction, so those 3-4 cms definitely help.

I do not get how a doctor could not be sure how many babies are in there. At term, no competent ultrasonographer should miss twins. There's either 1 head or two, you know? The being induced at 40 weeks for a mama on insulin thing doesn't bother me much from a decision making point of view, but not knowing how many babies are in there is scary in a person who is making other aggressive medical decisions (I mean, if you are having a homebirth and choose not to have ultrasound, I can see not knowing, but if you are having such close medical care and treatment as to have insulin and inductions and whatever else, they should know how many babies are in there.)

[maxmama]

Originally Posted by doctorjen

The foley bulb is inflated inside the uterus, and then we like mamas to walk around so that the baby's head can be pushing the bulb against the cervix. It usually falls out on it's own in a few hours and mama is usualy 3-4 cms at that point - but often not effaced all the way. Still, dilation is the single biggest predictor of successful induction, so those 3-4 cms definitely help.

)

That's what's been really cool about using the two-bulb catheter instead of the Foley -- effacement is usually about 70-80% when the bulb is taken out 12 hours later, and you don't have to tape it on the leg for traction, so it's easier for moms to be up and around.

[Doula Dani]

Originally Posted by maxmama

That's what's been really cool about using the two-bulb catheter instead of the Foley -- effacement is usually about 70-80% when the bulb is taken out 12 hours later, and you don't have to tape it on the leg for traction, so it's easier for moms to be up and around.

I didn't have a hard time being up and around- in fact I was told to be up and around so that there'd be the added pressure of the bulb against the cervix.

[April422]

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.

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.

At 34 weeks you're not sure if you're having twins or not?

[maxmama]

Originally Posted by Doula Dani

I didn't have a hard time being up and around- in fact I was told to be up and around so that there'd be the added pressure of the bulb against the cervix.

Right, but the traction on the bulb has to be maintained, so you have to check and make sure there's still traction. The tape loosens with movement.