Written by midwife Sally Underwood…
As you will possibly be aware there are currently several different methods of induction routinely being used by health care professionals. These include a cervical sweep, a propess pessary, prostoglandin gel, an artificial rupture of membranes and then ultimately a syntocinon (artificial oxytocin) infusion.
The most common reason for induction of labour is a prolonged pregnancy. Normal Labour (term) indicates spontaneous labour between 37 – 41 + 5 days. Research indicates that after 41 completed weeks of pregnancy, there is an increased risk of a baby developing problems as the placenta becomes less efficient. There may be other reasons which would indicate a need for an induction of labour such as diabetes or preeclampsia. These conditions can slow the growth rate of your baby in the latter stages of pregnancy, making early delivery safer than continuing the pregnancy.
A balloon induction is a rather less routine option but offers good results. A special balloon catheter is inserted into the cervix (diagram above) and inflated with normal saline to encourage dilation.
I can remember learning about this method of induction but within all my years as a midwife…which is a lot…I have not actually seen it being used until recently on our labour ward. It apparently dates to the1860’s – where Mr Barnes used air in the balloon for pre labour dilatation and then again in 1960s when Mr Embrey realised the potential for using liquid instead. Balloon induction is mainly used for women that have previously had a caesarean section aiming for a vaginal birth. This is because it is potentially more natural and does not involve any hormones. It works as the inflated balloon rubs against and stretches the cervix causing it to produce prostaglandin. The prostaglandin causes the cervix to become shorter and soften (ripening). The balloon generally stays in place for 12 -24 hrs.
With our current rise in induction of labour rates (around 30 -40%) and the associated risk of instrumental births and caesarean section within most NHS trusts today, I think we may be seeing this method used more often.
Be interested to hear if any of you have ever experienced this method of induction?
Illustration by Alex Baker, DNA Illustrations, Inc. from https://www.contemporaryobgyn.net/view/transcervical-foley-balloon