Bloody Urine in Foley Catheter Postpartum?

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Hello fellow nurses! I'm sorry if this is a stupid question.

Last night my patient asked me why her urine in the Foley drainage bag would be bloody or pink-tinged if the catheter is in her pee hole (urethra)?

To me, I never gave this much thought because they are bleeding so much in the postpartum period, and I figured the blood and urine could mix, but then I thought that she does have a point and if the tube is in her urethra up to her bladder, it wouldn't mix?

I have seen pink-tinged or a bit of bloody urine/clots in the foley bags for our other PP moms and the other nurses don't seem to be concerned, so I just wanted to see what you guys thought. This has been confusing me!

- Also, I wanted to ask you if you put in foley catheters for your PP lady partsl deliveries because I find it strange that we do it on our unit. I feel like other hospitals just do I&O which I agree with because it prevents UTI incidences and encourages ambulation.

Thank you for your help.

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Specializes in Nurse Leader specializing in Labor & Delivery.

Wait, what? You catheterize your postpartum lady partsL moms? Why? WHY?

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On 4/26/2019 at 7:59 PM, klone said:

Wait, what? You catheterize your postpartum lady partsL moms? Why? WHY?

There are no stupid questions. A small amount of blood may be from slight trauma to the urethra during insertion. It should clear up quickly.

Do you work in the United States? As Klone implied...this is shocking. There are a very, very, few, rare, situations where a post partum mom would need a Foley.

I am actually hoping your post is a troll. Please ask your charge nurse or the OB attending why post partum moms are getting Foley catheters and let us know. When it is your patient who needs one encourage them, tell them, they can refuse! Then tell the doctor the patient refused (unless there is a very good reason).

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Specializes in Labor and Delivery.

Our c-section mama’s are the only ones who transfer to PP with a foley. Our lady partsl deliveries, if they have a foley in for delivery, will have it DC’d at some point in the 2 hour recovery before we take them to PP. some providers like the foley out for pushing, some don’t. If I have one already in place after a delivery, I take it out right before my last fundal check, so basically at the 2 hour mark just to keep the bladder out of the way for bleeding. If for some reason a mama needs her bladder emptied during recovery and cannot yet walk to pee, we straight cath them.

as for the color, I have seen a range. Anywhere from clear, to yellow, to pink, to colored bright red (blood tinged bright red, not to be mistaken for just straight blood). I’ve been told by providers it’s sometimes due to trauma from pushing (thus some providers like it DCd when pushing). Kind of depends. If it is straight BLOOD and not just red tinged, this would indicate a complication to look at immediately.

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On 4/26/2019 at 7:59 PM, klone said:

Wait, what? You catheterize your postpartum lady partsL moms? Why? WHY?

I'm sorry, I'm a new grad nurse and just recently started on this unit and now that I think about it - I'm not sure if I'm mixing up my c-section and lady partsl moms.

I know that almost all our c-section moms come to us with foleys, whereas it's not always the case for lady partsl deliveries, esp if they are midwife patients then midwives usually don't like placing Foleys. Having said that, I'm PRETTY sure I've had vag moms who have had epidurals come to us with foleys. I think the reasoning is because they are numb from the epi & can't get up to pee yet (altho I still think I&O are better).

I guess I should also clarify that the mom I was talking about in this post- she had a vag delivery with EPI, and actually had a postpartum hemorrhage and had to get a D&C done so that is probably why she had a catheter.

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Specializes in OB.
On 4/27/2019 at 3:42 AM, Hope888 said:

I'm sorry, I'm a new grad nurse and just recently started on this unit and now that I think about it - I'm not sure if I'm mixing up my c-section and lady partsl moms.

I know that almost all our c-section moms come to us with foleys, whereas it's not always the case for lady partsl deliveries, esp if they are midwife patients then midwives usually don't like placing Foleys. Having said that, I'm PRETTY sure I've had vag moms who have had epidurals come to us with foleys. I think the reasoning is because they are numb from the epi & can't get up to pee yet (altho I still think I&O are better).

I guess I should also clarify that the mom I was talking about in this post- she had a vag delivery with EPI, and actually had a postpartum hemorrhage and had to get a D&C done so that is probably why she had a catheter.

That makes more sense. It sounded like you were saying you insert *new* Foleys on postpartum lady partsl deliveries, which sounded like cruel, unusual, and unnecessary punishment ?

It's common for there to be abrasions to the bladder wall from the pressure/stretching of pushing. That can cause a little blood-tinged urine. Keeping a Foley in place during pushing can exacerbate that, so I'm surprised that someone would still have a Foley in place after delivery, but as we know, OB is rife with "that's just the way we've always done it."

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Specializes in Nurse Leader specializing in Labor & Delivery.

As someone who has seen a woman need pelvic floor PT due to urethral trauma from pushing out a Foley balloon during 2nd stage, I never recommend keeping a foley in place once a woman is complete and has started pushing.

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Specializes in NICU.

Years ago when I was in OB the post partum moms who could not pee 300ml x 2 and remained full bladder with sudden increased bleeding,boggy uterus we straight cathed,if over 1000 ml obtained ,cath left in and attached to bag.There is a lot of swelling down there,internally and externally.The c/s moms had foleys , the got medicated and we got up after four hours to ambulate and peri care,back rub with lotion ,and back to bed.

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Specializes in OB.
2 hours ago, Leader25 said:

Years ago when I was in OB the post partum moms who could not pee 300ml x 2 and remained full bladder with sudden increased bleeding,boggy uterus we straight cathed,if over 1000 ml obtained ,cath left in and attached to bag.There is a lot of swelling down there,internally and externally.The c/s moms had foleys , the got medicated and we got up after four hours to ambulate and peri care,back rub with lotion ,and back to bed.

Obviously a postpartum mom who can't void needs to be cathed, but they shouldn't be routine.

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Hello again fellow nurses, Happy Nurses Week!

So I asked my co-worker this the other day and turns out I was right -- apparently, we DO see vag moms come to us in PP with foleys, especially if they had an epidural.

I asked what they do with the foleys when the moms push, and she said apparently L&D will just deflate the balloon when mom pushes. I find this such a strange practice because there still could be urethra trauma even with the balloon deflated.

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Specializes in OB.

That is so bizarre and unnecessary.

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Specializes in Nurse Leader specializing in Labor & Delivery.

OP, sounds like you have the makings of a practice change project!

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