There are several different ways to jumpstart the labor process if things don’t seem to be getting going on their own. So if your doctor suggests a Foley balloon induction, what does that mean — and should you do it?
Inducing labor with a Foley bulb or Foley balloon is a safe, simple method that can be a good choice for women who’d like to try avoiding induction drugs or those who aren’t able to use them.
Here’s how the procedure works and what it feels like, plus a look at the benefits and potential risks.
What is a Foley bulb or Foley balloon?
A Foley bulb or Foley balloon is a catheter-like device that can get the cervix to soften and open when labor needs to be induced.
The catheter is inserted into the cervix and filled with a saline solution. The saline solution causes the catheter to inflate like a balloon, putting pressure on the cervix to help it dilate.
What is a Foley bulb induction?
If your cervix hasn’t started to dilate on its own when you’re ready to be induced, your health care provider might start the dilation process with a Foley bulb.
In some cases, dilating your cervix with the Foley bulb is enough to trigger contractions and get the labor process started. In others, your doctor might try to speed things up by using a Foley bulb along with a synthetic hormone like misoprostol or Pitocin.
Reasons for a Foley bulb induction
There are a few different reasons why your practitioner might recommend using a Foley bulb for induction:
You need to be induced but your cervix isn’t dilated. Usually your cervix will open up naturally on its own once your body is ready to go into labor. But if it hasn’t shown any signs of dilating, your doctor can get the ripening rolling with a Foley bulb, synthetic hormones or a combination of the two.
You want to try a drug-free induction method. Sometimes a Foley bulb alone can be enough to jumpstart labor without the use of drugs or hormones.
You’ve had a C-section. Foley bulbs are a safer way to induce labor than drugs for women who’ve previously had a C-section, since the medications can sometimes raise the risk for serious complications.
You want a shot at a faster labor. Research has shown that using a Foley bulb in combination with misoprostol or synthetic oxytocin (a.k.a. Pitocin) can result in less time spent in labor compared to using misoprostol or a Foley bulb alone.
What happens during a Foley bulb induction?
If you need to be induced, one option your doctor may discuss with you is the Foley bulb. Here's what happens during the procedure:
- You’ll lie on an exam table and place your feet in a set of stirrups like during a routine gynecological exam. Your provider will use a speculum to check your cervix, and then will apply an iodine solution to clean your cervix and reduce the risk of infection.
- Once your cervix is clean, your doctor will insert the tip of the Foley bulb into your cervix and inflate the bulb with an ounce of saline solution.
- He or she will tie off the catheter right outside your vagina to keep the water from flowing back out, and then tuck the end of the catheter into your vagina with a gauze pad.
- In some cases, you might also receive a cervical-ripening drug like misoprostol.
- Then, you’ll wait. The goal is for the inflated Foley bulb to put enough pressure on your cervix to encourage it to dilate and get labor under way, which could take 12 hours or more. The bulb might fall out if your cervix dilates a lot, but your provider might also remove the bulb if you only dilate a few centimeters.
- How far you’ve dilated after the Foley bulb falls out or is removed determines what comes next. Often a Foley bulb or a Foley bulb with cervical ripening drugs will be enough to get contractions started. But if you haven’t had any contractions, your provider might opt to strip or rupture your membranes or administer a drug like Pitocin.
Is a Foley bulb induction painful?
Having a Foley bulb inserted can be pretty uncomfortable and even quite painful for some women, but the pain shouldn’t last long (though everyone is different).
Once the balloon is in, it usually just feels like a super tampon. Your doctor may suggest giving you nitrous oxide (laughing gas) to make the insertion process less unpleasant.
Benefits of being induced with a Foley bulb
There are some significant pros to a Foley bulb induction that are worth knowing about, including:
A Foley balloon can be used with or without medication. Prefer to try a drug-free induction method? A Foley bulb alone may be enough to ripen your cervix and get labor going.
A Foley bulb might be lower-risk than other induction methods. Drug-based induction methods have the potential to overstimulate the uterus, which could result in complications.
They’re a safe option if you’ve previously had a C-section. Cervical ripening drugs can increase the risk of complications if you've had a prior C-section, but Foley bulbs don’t.
They could speed up your labor if used with drugs. When a Foley bulb is used with misoprostol, it may help you deliver a few hours sooner compared to an induced labor relying solely on either misoprostol or a Foley bulb.
Risks of a Foley bulb induction
A Foley balloon is generally a safe way to induce labor, and it can often be effective. Still, it has a few drawbacks to consider:
The insertion process can be uncomfortable. Fortunately, most women don't find it too painful. For those who do, the discomfort usually doesn't last long, and your doctor may offer meds to ease the pain.
It’s not foolproof. A Foley bulb or a Foley bulb used with cervical-ripening drugs won’t always cause a woman’s cervix to dilate and help start labor.
It can cause bleeding in women with low-lying placentas. If your doctor determines your placenta is low-lying, he or she will determine whether a Foley bulb induction is the right choice.
- It can prolong labor and cause complications that go along with an extended labor if left in the cervix for too long. Research has found that the placement of a Foley balloon for seven hours or more is associated with much longer labor, up to 11.5 hours longer (or a 37 percent increase in duration). Patients who wind up having a Foley bulb induction should be advised of the risk of a much longer labor, and told about the potential complications associated with a prolonged labor.
Other methods of inducing labor
A Foley bulb is just one way to induce labor. There are other labor induction methods, and your doctor can recommend which option is the best for you. They include:
Other cervical-ripening agents like misoprostol, a synthetic hormone
Membrane-stripping or rupturing to help your water break
Pitocin, a synthetic form of oxytocin that quickly triggers contractions
A Foley balloon can be a beneficial tool for labor induction, especially for women who’d prefer to try a drug-free option or who have previously had a C-section. But you probably don’t know for sure if you’ll actually need to be induced or not until close to your due date or when you're actually in the delivery room.
So if a Foley bulb sounds like a good choice for you, talk about it with your doctor. He or she can help you weigh the pros and cons and decide whether it's the right option if induction ends up being part of your birth experience.
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