Epidurals and caths

Where I delivered that was the protocol. Hence why when I had my first two I didn't get an epidural until the last minute literally without any time to Cath me, and my third without anything. That's right, I chose a natural labor just so I wouldn't get a piece of plastic shoved in my meatus :) they freak me out!

Both of my last jobs we automatically did Foleys with most of our epis--exceptions were short labors/fast progressing multips and if they declined. My current job does in and outs the majority of the time--I find they're overused though. I assess bladder every two hours but I don't routinely do a straight cath every 2 hours. If I have a pt with an early epi--especially primes--I'll ask for an order for a Foley.

Where I delivered, unless you were getting a c/s, you didn't need a Foley. You either get a bedpan or can get an I/O cath. After screwing up the whole bedpan thing several times, I went with getting an I/O cath as it was easier.

We do I/O caths but not routinely either - we assess for need.

Yep, this - depends on the woman and the labor, no set policy.

we usually just straight cath our epidural pts

We used to put foleys in all epidural patients, but policy changed a few months ago to straight caths as needed. The docs are adamant about keeping the bladder empty, and some will still order the foley.

Unless the mom is going fast after the epidural, we do a foley. For those of you that do straight caths, what is the reason behind this policy? Isn't repeated in and out caths introduce more infection than a short term indwelling? Also seems more cost effective to do an indwelling since an in ad out can only be used once for sterility. I am always interested in doing Evidence based. We just don't see that many epidurals in the hospital based birth center that I work at, less than 20%

All of our patients automatically get a foley catheter with an epidural. We remove it when she's complete and ready to push.

Had a baby some months ago, got a foley with my epidural and I thought it was the norm so didn't even think to question it. The one thing I'm never gonna have anyone do to me is place a foley bulb on my cervix as I thought (after the fact) it was totally unnecessary.

Our policy is apparently based on research showing that indwelling caths carry a higher risk of infection than straight caths--but I don't really believe that applies to LD, where even our Foleys aren't usually in for that long. I haven't read the studies yet.

All of our patients automatically get a foley catheter with an epidural. We remove it when she's complete and ready to push.

This is the same policy where I work. They have 6 hours to void after the foley is removed, or they get straight caths. I think the reasoning behind straight caths is to decrease risk of bleeding, but not sure.