How the Method of Bladder Emptying After Epidural Placement in Labor Affects Postpartum Voiding

Intermittent Versus Continuous Bladder Catheterization in Epiduralized Laboring Patients: a Non-blinded Randomized Controlled Trial

At least ten percent of patients have postpartum urinary retention or difficulty urinating after birth, which can cause incontinence and other urinary problems long-term. After getting an epidural placed, patients should be numb in their pelvic region. This numbness makes it difficult to feel the need to urinate, so patients need a urinary catheter placed to empty the bladder. Some patients have one catheter placed throughout their labor and others have a catheter placed to empty the bladder then removed every few hours. The investigators are studying whether placing a catheter once or catheterizing multiple times affects the rate of postpartum urinary problems and infection.

This is a randomized controlled trial to assess the effect of bladder catheterization method during labor with epidural anesthesia on the rate of postpartum urinary retention.

Inclusion Criteria:

• Pregnant patients planning vaginal delivery presenting in labor or for induction of labor
• Age 18 years and older
• Live fetus
• Receive epidural anesthesia

Exclusion Criteria:

• those under 18 years old
• those with stillbirth
• those with baseline overactive bladder symptoms, neurogenic bladder diagnoses, or otherwise using bladder catheterization during pregnancy

Patients will be excluded from UTI analyses if:

• they received antibiotics intrapartum
• had bacteriuria diagnosed by a clean catch specimen showing >100,000 CFU/mL of a single bacterial species, regardless of symptoms