Quote from jrring1019
If you deflate the bulb, how can you keep her from pushing out the foley? We recently had someone push out a FULL bulb, which caused much damage and I think had to go home with leg bag. We d/c foleys when pt begins pushing and cath later if needed. I have never had a problem doing that and one extra straight cath is better than damage to the bladder.
Answer is you can't prevent it falling out fully. Just make sure it's taped well to the leg, let it empty passively by attaching a 10cc syringe to it, (leaving the syringe in place), and hope it does not....fact is, 50% of the time, the foley falls out. So obviously, about 50% of the time it stays in. This makes it worth it to try.
If it stays in, we reinflate it. If not, it comes out, IV fluids are slowed, epidural turned off and voiding is urged within 2-3 hours after birth. It works fine where I work doing it this way. I RARELY have to do PP straight caths unless the labia are extremely edematous.
The doctors say they are receiving fewer post partum complaints about bladder problems/infections doing it this way, so they now pretty much order it done. Pushing out a full bulb is definately something we want to avoid, as you illustrate so clearly above.