Foley Bulb Induction

A Foley bulb induction helps dilate (open) your cervix and prepare it for labor. It can help dilate your cervix up to about 3 to 4 centimeters. (It’s fully dilated at 10 cm). It’s also called a Foley balloon, Foley catheter, cervical ripening balloon or Cooke catheter.

A Foley bulb is a small tube (catheter) with an inflatable balloon on the end. A healthcare provider inserts the tube through your vagina and into the opening of your cervix. They then insert water into the balloon to expand it. This puts pressure on your cervix, which can help it open.

This tool is just one of several ways to kickstart the early stages of labor. It’s a safe and effective way to open and soften your cervix when inducing labor.

What happens during this procedure?

Your healthcare provider will explain the steps in detail before the procedure. But in general, a Foley bulb induction involves the following:

1. Your healthcare provider monitors the fetal heart rate and confirms the fetus is head-down in your uterus.
2. You lie on a bed with your knees apart.
3. Your provider checks your cervix for dilation using two fingers.
4. Your provider inserts the Foley bulb through your vagina and the opening of your cervix.
5. Once it’s in place, your provider inflates the balloon with up to 60 milliliters (about 2 ounces) of saline (water).
6. You should be able to walk and move around normally with the Foley balloon in.

Your provider may recommend using a medication (misoprostol) with a Foley bulb to help encourage your cervix to soften.

How long does this procedure take?

The insertion of the Foley balloon is quick — around three to four minutes.

But it can take up to 12 hours for your cervix to dilate under the pressure of the balloon. The Foley bulb typically falls out on its own once your cervix dilates to 3 centimeters. If your cervix doesn’t dilate, your provider will deflate the balloon and remove it. They’ll suggest a different induction method.

How painful is Foley bulb induction?

Everyone handles pain differently. So, it’s hard to predict what a Foley bulb induction will feel like for you. Some people feel slight pressure. Some find a Foley bulb painful and unpleasant, especially when it’s inserted and inflated. Others describe it as feeling like they’re wearing a giant tampon.

Your healthcare team can walk you through your options for pain management. Let them know if you have intense pain or are uncomfortable at any point.

What are the potential benefits and risks of this procedure?

A Foley balloon is generally safe and effective. It can help jumpstart labor and reduce how long an induction takes. It may also make an “unfavorable” cervix (one that’s hard, closed and thick) more favorable. A favorable cervix (one that’s soft and thin) is more likely to go into labor.

Another benefit is that the Foley balloon is a safe induction method if you’ve had a C-section before and are trying for a vaginal birth after cesarean (VBAC).

This procedure is low risk. But possible risks include:

• Pain
• Developing an infection (chorioamnionitis) or fever
• Unsafe changes in the fetal heart rate
• It’s not inserted properly and/or it doesn’t work

Can I go home after a Foley bulb induction?

Probably not. Most Foley bulb placements happen at the hospital when you’re already admitted. Don’t hesitate to talk to your care team about the process and expectations.

How successful is a Foley bulb induction?

Many factors affect how successful a Foley bulb induction is. This includes things like the condition of your cervix or if you’ve given birth before.

According to one study, about half of women who had a Foley balloon developed a favorable cervix or labor onset within 24 hours. About 67% delivered their baby within 48 hours.

Can a Foley bulb break your water?

Yes. Sometimes, the pressure from the balloon can cause your cervix to soften and open enough that your water breaks.

Does a Foley bulb start contractions?

Using a Foley balloon can help start contractions. This is just the beginning of your labor process. Your healthcare team may need to use other methods to get you fully dilated and ready to push.