Mechanical Induction of Labour (Balloon Catheter)

This leaflet will explain to you the process of a procedure called Mechanical Induction of Labour, and how it differs from other methods to induce Labour.

When you are invited to attend the hospital for an induction, we would ask you to pack a bag with everything you need for the birth, and either bring it with you to the appointment or have it available in case you are needed to remain in the hospital throughout your induction.

In order for a baby to be born, the cervix (the neck or opening to the womb) has to shorten, soften and open, and there must be contractions. Contractions gradually open your cervix, and are when the powerful muscular wall in your womb tightens and then relaxes.

In most pregnancies labour starts naturally between 37 to 42 weeks and is called ‘spontaneous labour’. Induction of labour is a process used to encourage this to start.

Options for induction of labour

There are currently three options for induction of labour:

1)         Artificial rupture of membranes

2)         Mechanical induction of labour

3)         Hormonal induction

For further information on the artificial rupture of membranes or the hormonal induction of labour, please see the Trust information leaflet PIL1089 – Induction of Labour. This is on the Trust website and available on Badgernet (maternity portal).

The induction of labour pathway always involves women attending the hospital for an appointment to discuss their options, take part in an examination, and talk through the process in detail, and we would encourage you to ask as many questions as you want.

If either an artificial rupture of membranes or a hormonal induction is to be followed, you will be admitted as an inpatient until your baby arrives.

If a mechanical induction is appropriate, you may be able to return home until labour is established.

What happens at the hospital?

When you arrive at the University Hospital of North Tees the midwife will introduce themselves, and there will be time to discuss the induction process with you to make sure you understand your options and what will happen at each step.

Please feel free to ask any questions or voice any concerns or anxieties. We are here to help at all times.

When you arrive, the midwife will invite you for a full antenatal check. Your baby’s heartbeat will be monitored using a Cardiotocograph (CTG) machine that gives a paper recording of their heartbeat, and we will perform an ultrasound scan to confirm that your baby is in the correct position for induction of labour.

A vaginal examination will be offered to assess your cervix and determine whether it might be appropriate to break your waters (Artificial Rupture of Membranes).

If this is not appropriate then you may be offered an induction with a balloon catheter (mechanical induction of labour). This technique is used in multiple hospitals both regionally and nationally and is recommended as a method of inducing labour by the National Institute for Health and Care Excellence.¹

What does a mechanical induction involve?

The procedure involves a catheter (a soft latex tube) that is placed in your cervix (the small canal that connects your uterus and vagina). Once inserted the balloon on the end is inflated.

The pressure from the balloon helps your cervix to open.

The catheter stays in place for up to 24 hours, with the balloon putting gentle pressure on your cervix. The bottom of the catheter can then be taped to your leg if you prefer.

The pressure should soften and open your cervix enough to start labour or to be able to break the waters around your baby.

What happens next?

You would need to stay in hospital after a mechanical induction if;

• Your baby appears small for their gestational age.
• You have reduced fetal movements and continue to not feel your baby move as normal.
• You are already an inpatient when your induction of labour is booked.
• You have been diagnosed with severe pre-eclampsia (raised blood pressure associated with protein in your urine).
• You have an excessive amount of fluid around your baby (polyhydramnios).
• You have communication difficulties or do not have any friends/family who can contact the hospital in case you need advice or if there is an emergency. 
• The medical team are concerned about any other risks in your medical history or that have developed during your pregnancy.

If none of the above apply you might be allowed to go home. If you do go home and then have any of the following symptoms you should call the labour ward at North Tees Hospital on 01642 382818:

• Bleeding
• Contractions
• Concerns about the baby’s movements
• You feel unwell
• The waters around the baby break or the balloon falls out.

A midwife will then advise you as to what to do next.

How do I decide if a mechanical induction is right for me?

It is important that you feel able to make the decision that feels right for you and your baby.

The following is some information that we hope will help you to understand the benefits and risks of a mechanical induction.

Please ask your midwife or consultant to explain anything that is not clear and ask as many questions as needed for you to feel comfortable about your decision.

Benefits of a mechanical induction:

• It may reduce the amount of time you will need to stay in hospital before your labour begins.
• Promotes fewer vaginal examinations.
• If you are planning a pool birth you may still be able to do this, but speak to your midwife first.
• It is a safer option when you have had a previous caesarean section due to this being a mechanical method rather than hormone method. This is due to:
  • It being medication free.
  • A lower chance of hyper stimulation (having too many contractions).¹
  • The fact that around 20% of women will go into labour from this method alone.
  • There is a high chance that you will be suitable to have your waters broken following mechanical induction.
  • The procedure could be uncomfortable but not usually painful.

Associated risks for a mechanical induction?

• It can take a little longer to work.

Contact numbers

Once you are home, if you have any concerns or questions, please contact the Labour Ward at North Tees Hospital on 01642382818.

PLEASE RETURN TO WARD 18/19 TO CONTINUE THE INDUCTION OF LABOUR PROCESS AT THE DATE AND TIME YOU ARE TOLD TO.

References

1. NICE (National Institute for Health and Care Excellence), Induction of Labour, NG207, 2021. https://www.nice.org.uk/guidance/ng207 (accessed 31/05/2024)

Comments, concerns, compliments or complaints

Patient Experience Team (PET)

We are continually trying to improve the services we provide. We want to know what we’re doing well or if there’s anything which we can improve, that’s why the Patient Experience Team (PET) is here to help. Our Patient Experience Team is here to try to resolve your concerns as quickly as possible. The office is based on the ground floor at the University Hospital of North Tees if you wish to discuss concerns in person. If you would like to contact or request a copy of our PET leaflet, please contact:

Telephone: 01642 624719

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Leaflet feedback

This leaflet has been produced in partnership with patients and carers. All patient leaflets are regularly reviewed, and any suggestions you have as to how it may be improved are extremely valuable. Please write to the Clinical Governance team, North Tees and Hartlepool NHS Foundation Trust, University Hospital of North Tees, TS19 8PE or:

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