Published
Anyone out there have a policy/protocol to share?
All I can say is OWWWWWW. Do these mothers find insertion painful?
I'm in TX and have never heard of this until now. Maybe it IS a regional thing. I'll have to ask my friends over in L&D about it.
It's nice to see folks are coming up with ways to avoid dangerous drugs for induction, though.
Foley balloon cervical ripening is not a new thing. I knew the military docs did them in my last state. We "downtown" at the county hospital did not.
No one around here where I am now, does these at all, including midwives.
From those who underwent it, I heard it was very crampy, uncomfortable and felt cumbersome. The consensus was it either worked or not, just like any other artificial means to induce labor.
I'm in TX and have never heard of this until now. Maybe it IS a regional thing. I'll have to ask my friends over in L&D about it.
I'm in Texas, and foley balloons are definitely used here. My OB places them in her office, so she can monitor everything herself. She inflates with 30cc and sends you off for a long, brisk walk. She has you come back every hour to check in until the catheter falls out. She uses this form of ripening with her VBAC patients (like me) who need a little help getting started. I went in to have it done at 39 weeks. Fortunately, my cervix had changed dramatically overnight, so she sent me home. I went into labor on my own and delivered two days later.
At my small community hospital (380 deliveries/yr) we have 1 OB and 5 family docs. We use foleys for postdates.
The OB has his girls come in at noon, NST, then places the bulb, inflates to 40ml, applies traction by taping to leg, monitors for 1 hour then sends them home with an Rx for ambien to be taken at bed time. His pt's come back for SROM, UCs q 5, if they feel they need checked or 6am, which ever comes first.
The family docs do NST in office then place bulbs in office usually inflated to 30-40mls. Then they send them home with the same instructions as the OB. They come in at 6am if they don't show up sooner.
If the bulb comes out, they are instructed to throw it away and unless they are contracting regularly or have SROM they stay home until morning. Usually the foley is out by the AM and AROM or AROM + pit is started. Most of these girls do well, haven't ever seen any problems from one, though having had one these things are uncomfortable and most girls show up long before 6am.
Mine was done at 42 wks. Placed in addition to cervidil (which we don't use anymore...now we use cytotec). I walked the halls after 2 hours in bed. Mine was placed at 7am, and was out by noon (3cms), followed by AROM. I ended up with thick mec, amnio-infusion and eventually at 0100 an emergent c/s for fetal distress (I had refused a c/s at 2000 for FTP as I was only 7cms). I had a healthy 7# 12oz, brow presentation boy who is now 10yrs old.
The base hospital did not have CNMs, just OB's. This was Oklahoma several years and CNMs were not very plentiful anywhere near where I was. Our hospital only had OBs and FP docs, no midwives, either.
None of our CNMs around here that I know of, do this. (I live in WA State). It's very interesting to read the varying practices around the country.
I did talk to one of our docs. He had heard of it. Usually used as an abortifacient, like lamineria.
He said stripping the membranes is the same kind of idea.
I still think it sounds weird. I wouldn't do it. And Ambien? hmmm . . .
Things are so different depending where you live. . . .
steph
Spidey's mom, ADN, BSN, RN
11,305 Posts
I have never heard of this . . . . :uhoh21:
steph