Outpatient Foley For Starting Induction of Labor at TErm

Outpatient Foley for Starting Induction of Labor at Term

The investigators are performing a randomized controlled-trial investigating starting cervical ripening in the outpatient setting with a mechanical method, the transcervical Foley catheter. This is a pilot study to establish the efficacy of this method in decreasing time as in inpatient and evaluate patient satisfaction.

Induction of labor is necessary in one-fourth of women and a large proportion requires cervical ripening. Cervical ripening is necessary to shorten the time to delivery and increases the chances of a vaginal delivery.

Outpatient cervical ripening is an attractive alternative to women and physicians because of the decreased amount of time spent in the hospital and opportunity for patients to be in the comforts of their home.

The investigators will conduct a randomized controlled trial comparing outpatient to inpatient cervical ripening using a transcervical Foley catheter. Women will be randomized to undergo inpatient or outpatient transcervical Foley catheter cervical ripening beyond their 39th week of gestation. Women and their infants will be followed until the time of their discharge.

Inclusion Criteria:

• Age ≥18
• Multiparous
• Singleton gestation
• Gestational age between 39+0 and 42+0
• Vertex presentation
• Cervix ≤ 3 cm. If cervix is between 2 and 3 cm dilated, it must be <80% effaced
• No prior cesarean section or uterine surgery
• Resides within Jefferson County, Alabama.
• Access to a telephone
• Reliable transportation

Exclusion Criteria:

• Unsuitable for outpatient Foley placement management (IUGR, oligohydramnios, prior cesarean delivery, gestational hypertension, preeclampsia, or uncontrolled chronic hypertension, complex maternal disease, provider discretion). Any patient with pregestational or gestational diabetes on medications will be excluded.
• Latex allergy
• Contraindication to induction of labor
• Evidence of labor
• Fetal anomaly or demise
• Inability to given consent (non-English speaking, inability to read or write)