The document provides guidelines for using a Foley catheter to induce cervical ripening. A Foley catheter can apply mechanical pressure to the cervix to induce ripening. Its use is restricted to patients with intact membranes and an unfavorable cervix who are 35 weeks gestation or more, after consulting with a pediatrician. The document outlines the steps for proper placement and monitoring of the catheter.

1. Use of the Foley Catheter
for Cervical Ripening
NLC P/P# 6600.0607

2. Purpose:
Induce cervical ripening by providing mechanical pressure
directly on the cervix using the balloon device of a Foley catheter.
Policy:
Use of an indwelling balloon catheter for cervical ripening is
restricted to patients with intact membranes and an unfavorable
cervix.
Caution should be used if this procedure is performed for women
with a history of reconstructive uterine surgery.
In patients who are 35 weeks gestation or less, the mother’s
physician must consult with the Pediatrician before initiation of
cervical ripening using the Foley catheter.

3. 1. Assemble all necessary equipment.
2. Explain to patient the reason the physician has ordered the procedure.
3. Obtain written consent.
4. Assist patient in finding comfortable position in labor bed.
5. Apply Fetal Monitor to patient.
6. Obtain reassuring FHR pattern (notify physician if FHT strip not reactive).
7. Record blood pressure, FHT, contraction frequency, duration and
quality (if present), pulse, respirations every thirty to sixty (60) minutes in
Labor Progress Notes.
8. Assist physician with placement of balloon dilator and inflation with
normal saline.

4. 8. Position catheter bag on bed in between patient’s legs to help put
pressure on the cervix.
9. Document procedure, patient response to procedure, blood pressure,
FHT’s, contraction frequency, duration and quality (if present), pulse,
and respirations in the Labor Progress notes immediately following
the procedure.
10. Continue to monitor and document patient’s blood pressure, FHT’s,
contraction frequency, duration and quality (if present), pulse,
respirations every thirty to sixty (30-60) minutes in Labor Progress
Notes.

5. 11. Deflate the Foley bulb and remove if the following occur:
• Rupture of membranes
• Fever
• Bleeding
• Uterine hyper-stimulation
• Patient’s blood pressure is over 20 mm/hg – systolic, and/or if
SBP 140 or greater/DBP 100 or greater.
12. Notify physician immediately if any adverse reaction to procedure is noted
in mother or fetus, and document notification and appropriate nursing
actions taken in the Labor Progress Notes.
13. Check current FHR pattern with baseline pattern to ensure fetal well
being.
14. Remove catheter balloon six (6) hours after insertion, or at the time of
spontaneous expulsion, or rupture of membranes (whichever occurs first).