Foley Bulb Induction

What is a Foley bulb induction?

A Foley bulb induction is a method healthcare providers use to help dilate (or open) your cervix and prepare it for labor. Sometimes called a Foley balloon or Foley catheter, it’s a way to induce the early stages of labor. An early state of labor is when your cervix dilates to between 1 and 6 centimeters.

There are several ways to induce labor during pregnancy, and the Foley bulb is just one method healthcare providers use. Other things that begin or progress labor include medications or amniotomy (a procedure to break your water). These methods put pressure on your cervix, which helps it dilate.

Your provider selects the labor induction method that’s best for you and your baby. A Foley balloon is a safe and effective way to promote cervical dilation in pregnancy when inducing labor is medically necessary.

How does a Foley bulb work?

A Foley bulb is a catheter-like device your provider inserts through your cervix (the opening to your uterus at the top of your vagina) and into your uterus. The catheter has a balloon-like end. The balloon sits under your baby’s head, at the bottom of your uterus. Next, they inflate the balloon with saline solution. This balloon puts pressure on your cervix and encourages it to open.

Once your cervix opens, the catheter falls out. This happens once you’re 3 to 5 centimeters dilated. You must be 10 centimeters dilated before pushing can begin to deliver your baby. Active labor usually begins between 12 and 24 hours later for most people, and often with the help of medication. Active labor is when you reach 6 centimeters dilated.

When is a Foley bulb used?

Your obstetrician may recommend a Foley bulb to induce labor or encourage dilation when it's medically necessary.

What is the purpose of a Foley bulb induction?

The purpose of a Foley bulb is to help your cervix dilate. This localized pressure can help jumpstart labor and reduce how long an induction takes.

It may also make your unfavorable cervix (a cervix that's hard, closed and thick) more favorable. A favorable cervix (a cervix that's soft and thin) is more likely to go into labor and may respond better to other interventions like medication or amniotomy (procedure to break your water).

What happens during a Foley bulb induction?

A Foley bulb labor induction involves your healthcare provider inserting a Foley bulb catheter and, sometimes, a speculum into your vagina. A speculum is a duck-billed-shaped device that widens the walls of your vagina.

Once the catheter is placed through your cervix toward the bottom of your uterus, it gets inflated with saline solution. This balloon puts pressure on your cervix, causing it to soften and dilate. Healthcare providers sometimes use a drug like misoprostol with a Foley bulb to help encourage the cervix to soften.

A Foley bulb induction follows these steps:

• You lie on an exam table with your feet in stirrups.
• Your provider will monitor your baby’s heart rate and confirm your baby is head-down in your uterus.
• Your provider checks your cervix for dilation. They may use a speculum.
• Your provider inserts the Foley bulb.
• Once it’s in place, your provider inflates the Foley bulb with about 1 ounce (or 1/8 cup) of saline.
• The catheter is tied off and tucked into your vagina or taped to your thigh.

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 cervical dilation doesn’t happen and labor doesn’t start, your provider will remove the bulb and move on to another induction method.

In some cases, your cervix dilates, but labor contractions don’t begin. Your provider may decide to artificially rupture your membranes (break your water) or start you on oxytocin (Pitocin®) to induce contractions.

How long does a Foley bulb induction take?

The procedure itself is relatively quick — less than 10 minutes. Any labor induction can take hours to days. It’s common for your first induction to take longer than 24 hours from the start of the induction to delivery.

How painful is Foley bulb induction?

Everyone has a different pain tolerance. There can be slight pressure and pain associated with it. Some find a Foley bulb uncomfortable and unpleasant, especially when it’s inserted and inflated. It may feel similar to getting a pelvic exam. Others describe it as feeling like you’re wearing a giant tampon.

What are the advantages of using a Foley bulb?

A Foley bulb induction is generally viewed as safe and effective for inducing labor in pregnant people who are past term. Some of the biggest pros to using this method of labor induction are:

• Medication-free.
• Dilates the cervix within 12 hours for most people.
• Low rates of complications compared to other induction methods.
• Safe for people who’ve had a C-Section.
• It can be used in conjunction with medication (in some people) to speed up labor.

What are the risks of using a Foley bulb?

Inducing labor comes with risks. Most healthcare providers prefer spontaneous labor (your body goes into labor on its own). But, when pregnancies are complicated, inducing labor may actually lower the risk of complications to you or your baby.

While considered a low-risk procedure, some of the risks of using a Foley balloon are:

• Developing an infection or fever.
• Unsafe changes in your baby’s heart rate.
• Pain.
• It doesn’t work, or the bulb falls out.

Foley bulb induction isn’t recommended for everyone. It may not be for you if you have the following conditions:

• Placenta previa.
• Active genital herpes.
• Your baby is breech.

Can a Foley bulb break your water?

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

Does a Foley bulb start contractions?

Yes, using a Foley bulb or balloon can help start contractions. For some people, contractions begin soon after the balloon is inflated.

Can you go home after a Foley bulb induction?

It depends. Your provider will monitor your baby’s heart rate and decide if you can go home and wait for labor to start or if you need to stay in the hospital. A Foley bulb induction can be performed as an outpatient procedure, but labor can start pretty quickly for some people.

How successful is a Foley bulb induction?

The success rate of a Foley bulb induction is about 70%. Many factors affect how successful it will be, such as the condition of your cervix or if you’ve given birth before.

When should I see my healthcare provider?

If your healthcare provider inserts a Foley bulb, talk to them if you have any of the following symptoms:

• Bleeding. (Light spotting is OK.)
• Contractions. (Minor contractions are normal.)
• Your water breaks.
• Your baby stops moving.
• You feel sick, nauseous or generally unwell.

A note from Cleveland Clinic

If you’re past your due date and discussing labor induction with your healthcare provider, they may suggest using a Foley bulb. Using this method to coax your cervix into dilating is generally safe and effective. If you’re past term and discussing your options, make sure you understand this procedure, what to expect and the possible risks. Your provider is there to make sure your baby arrives safely and that you’re both healthy.