Hesperian Health Guides

Catheters (a tube to help urine come out)

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HealthWiki > A Book for Midwives > Chapter 19: Advanced skills for pregnancy and birth > Catheters

a pregnant woman lying on her back with an overfull bladder.
When the bladder is overfull, it may bulge from the lower belly. Do not let the bladder get this full!

If a woman does not urinate — or urinate enough — for several hours, her bladder may become too full. A full bladder can stop the womb from contracting well. This can slow or stop a labor. After a birth, a full bladder can cause a woman to bleed heavily.

There are many ways to help a woman urinate:

  • Let her listen to the sound of running water.
  • Ask her to squat.
  • Ask her to sit in clean warm water and urinate into it.
  • Have her pour clean warm water over her genitals.

If the woman has tried each method but none of them has worked, you may need to use a catheter to let the urine out.

MW Ch19 Page 352-2.png
Catheter — a tube that lets urine out of the bladder.

To use a catheter, you slide a sterile tube through a woman's urethra (the hole the urine comes out of) into her bladder.

WARNING!    Use a catheter only when it is truly necessary, when you have been trained to do so safely, and when you have a sterile catheter. Putting anything in the bladder puts the woman at risk of infection. It can also be very uncomfortable or painful.

How to insert a catheter

  1. Prepare your tools:
    MW Ch19 Page 352-3.png
    sterile plastic gloves
    sterile catheter
    antibiotic cream or sterile lubricant
    sterile cloths
    (Never use a catheter that is not sterile.)
    (Do not use lubricant out of a tube that has already been opened — it is not sterile.)

    You will also need a bowl or bucket and a good source of light. If the catheter is in a sterile package, open the package, but do not touch the catheter. Open a package of sterile lubricant, but do not touch the lubricant or the catheter.

    Squeeze some lubricant out onto the end of the catheter.

  2. MW Ch19 Page 353-1.png

  3. Wash the mother's belly, thighs, and genitals well with disinfectant soap and boiled water that has been cooled.

  4. Put sterile or very clean cloths under the mother.

  5. Wash your hands well for at least 3 minutes. Put on sterile gloves. Keep one hand sterile — it should only touch the catheter, nothing else.

  6. Have a helper shine the light on the woman's genitals
    so you can clearly see what you are doing.
  7. illustration of the below: inserting a catheter.

  8. Hold the inner lips of the woman's vulva apart with one gloved hand, so that you can see her urethra (it may be hard to see).

  9. With the other hand, slowly and gently put the catheter into the woman's urethra. Usually the catheter goes straight in. But if the baby's head is in the vagina, you may need to point the catheter up at first, so it can get over and past the head. If the catheter stops moving in, roll it gently between your fingers, but do not force it. Forcing it might injure the mother.
  10. urine flowing from the urethra through a catheter into a bowl.

  11. When the tip of the catheter gets to the mother's bladder, urine will start to drip or flow out the other end. You should have a bowl or bucket ready to catch it.

  12. Take the catheter out when the urine stops.

Ask the mother to drink plenty of liquids during the next few days so that she urinates often. This will help clean any germs out of her bladder. Tell the mother to watch for signs of infection for the next few weeks.