Urinary Catheter Use in Labor and Delivery

Urinary catheter materials sitting on metal tray

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A catheter is a hollow tube that is inserted into the bladder through the urethra to remove urine from your bladder. It can be left in place for hours or days to alleviate your need to go to the bathroom or to use a bedpan if you are restricted to bed or are numb and can't feel the need to urinate.

A full bladder in labor can become distended and cause the baby to have trouble moving down into the pelvis. It may also prevent a baby from being able to rotate into a good position for birth. This is one of the reasons it's recommended that laboring women go to the bathroom once an hour in active labor onward.

Reasons for a Urinary Catheter During Labor

There are a few times during labor that a urinary catheter might be used. In labor and delivery, such as when you receive medications like epidural anesthesia or have a c-section. It is used during these procedures because you are not able to get up and move around to use the bathroom and because you may not feel the need to urinate. 

The bladder catheter would ideally not be placed until after the epidural is working well. This will prevent you from feeling the insertion. While putting in a catheter isn't terribly painful, it is uncomfortable, particularly when you're also having contractions. If someone asks to do the catheter before you get an epidural, ask them if there is a reason that it can't wait until after the epidural is in and working. This is usually not a problem.

During a cesarean, in addition to the above reasons, the bladder is at risk of being injured during the surgery. A catheter helps to ensure that the bladder is empty and as small as possible, keeping it away from the surgical field. There are also other measures in place to protect the bladder.

A catheter can also be used temporarily, this technique is called an in/out catheter. This may be done if you are having trouble locating the muscles needed to urinate. This can happen occasionally in late labor when you have so much going on in your body, or if there is swelling.

Other tricks to help you urinate are typically tried including running water, having you get in the shower to try to urinate there, and lots of alone time in the bathroom. This can help alleviate the pressure you may feel because a full bladder can be painful, and help the baby and labor progress normally. This can happen, even if you do not have medications.

A catheter may also be used if you must stay in bed for any reason and a bedpan isn't working or appropriate for you (some mothers prefer a catheter to a bedpan). It may also be used if the doctors need to collect your urine for testing for any reason.

Catheter Removal

The catheter will usually be removed once the birth is imminent, and may be replaced after the birth, staying several hours postpartum or the next day if all is going well. You may wind up keeping the catheter a bit longer if you have had surgery. This depends on your ability to get up and move around.

Some people find it difficult to urinate after the catheter is removed. If this happens, tell the hospital nurse caring for you (or if you are at home, call your doctor or midwife for advice). Sometimes the tricks mentioned above, like showering or just listening to running water, can help. You may also want to rinse your vaginal area with a peri-bottle before and after urinating.

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2 Sources
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  1. Onuoha OC. Epidural Analgesia for Labor: Continuous Infusion Versus Programmed Intermittent BolusAnesthesiol Clin. 2017;35(1):1–14. doi:10.1016/j.anclin.2016.09.003

  2. Salman L, Aharony S, Shmueli A, Wiznitzer A, Chen R, Gabbay-Benziv R. Urinary bladder injury during cesarean delivery: Maternal outcome from a contemporary large case seriesEur J Obstet Gynecol Reprod Biol. 2017;213:26–30. doi:10.1016/j.ejogrb.2017.04.007

Additional Reading

By Robin Elise Weiss, PhD, MPH
Robin Elise Weiss, PhD, MPH is a professor, author, childbirth and postpartum educator, certified doula, and lactation counselor.