Foley Balloon Catheter Induction of Labor

pregnant woman in the hospital
Foley Balloon Catheter Induction. Wavebreak/istock

The use of a Foley balloon catheter for labor induction is not as common as it once was, but it may be gaining popularity for women who are not good candidates for an induction with medications.

The balloon portion of the Foley catheter, used to keep the bladder empty, is inserted, while deflated, into the uterus either by having your practitioner visualize the cervix during a speculum exam or with the fingers, feeling that the balloon is between the amniotic sac and the lower uterine segment (bottom of the uterus) on the other side of the cervix.

The balloon is then inflated with saline solution and left in place while being taped to your thigh to provide gentle traction.

Previously other methods were used to apply pressure to the catheter. Sometimes this involves weights, like a liter of fluids or even pulling or tugging on the catheter two to four times per hour. This does not seem to be common anymore.

The Benefits of the Foley Catheter

The goal of this induction is to cause the cervix to mechanically open. Sometimes this will start labor spontaneously and sometimes it will simply make the cervix more favorable for a Pitocin, other drug induction or amniotomy (breaking the bag of waters). The good news is that the use of the Foley balloon catheter has been shown to provide a very good track record of having women give birth within 24 hours of insertion. It also has similar or lower cesarean rates associated with its use than combinations of the other methods of induction.

There is also the benefit that it is less likely to cause changes in your baby's heart rate, fetal distress, than other methods of induction. This may be why the cesarean rate is lower in some usage combinations. You may have to have your baby's heart rate monitored before, during, and just after the procedure to see if the baby tolerated this process, but this is less likely to cause fetal distress.

The Risks of a Foley Catheter Induction

The risks of using the Foley balloon catheter includes:

  • fever (3 percent)
  • non-reassuring fetal heart tones (2 percent)
  • vaginal bleeding (1.8 percent)
  • pain requiring the removal of the catheter (1.7 percent)
  • baby moving from the head down to breech (1.3 percent)

There are a couple of different types of catheters that can be used. Which is used may depend on what is available at your hospital. If you are interested, talk to your doctor or midwife about the type of catheter that is being used when discussing all of your options for induction of labor or waiting. 

What's It Like to Use a Foley Catheter?

There is certainly a range of experiences that will depend on the condition of your cervix at the time of insertion, the technique used, and even if you've had a baby before. Most moms say that insertion is the most uncomfortable, but tolerable. After that, it's just annoying.

"I was most worried about the possible discomfort of having the foley inserted. Thankfully it was only a slight cramp and I found it to be a very easy way to progress before starting other methods of induction," says Ashley.

Vaginal Birth After Cesarean and the Foley Catheter

Many times the Foley catheter is suggested because of a previous cesarean section or scarred uterus.

The use of this method of induction for mothers who are hoping for a vaginal birth after cesarean (VBAC)  is limited but positive. The rate of vaginal birth in this small group was 54 percent. The complications were within the normal range of expected. This is something that should continue to be investigated.

Outpatient Use of the Foley Catheter

A small study of just over 100 women looked at the use of this method of induction in the outpatient setting, meaning the women were not admitted to the hospital. They found that the benefits of the Foley balloon were still present and there were no complications in the group.

That looks promising, but at this point, it is still too few women to say that it's the best case scenario. There may be reasons that it might be the perfect choice for you after a discussion with your practitioner.

Overall, the use of the Foley balloon catheter is a safe, effective, and low-cost method of induction for most pregnant women.


Jozwiak M, Bloemenkamp KWM, Kelly AJ, Mol BWJ, Irion O, Boulvain M. Mechanical Methods for Induction of Labor. Cochrane Database of Systematic Reviews. 2012, Issue 3.

Kilpatrick, S. The Transcervical Foley Balloon. November 2013. 

Maslovitz S, Lessing JB, Many A. Complications of Transcervical Foley Catheter for Labor Induction Among 1,083 Women. Arch Gynecol Obstet. 2010;281(3):473–477.

Sarreau M, Leufflen L, Monceau E, et al. Balloon Catheter for Cervical Ripening on Scarred Uterus With Unfavorable Cervix: Multicenter Retrospective Study of 151 Patients. J Gynecol Obstet Biol Reprod. (Paris) 2013

Sciscione AC, Muench M, Pollock M, Jenkins TM, Tildon-Burton J, Colmorgen GHC. Transcervical Foley Catheter for Preinduction Cervical Ripening in an Outpatient Versus Inpatient Setting. Obstet Gynecol. 2001;98(5.1):751–756.