Catheter Care

There are many reasons why women/people need a catheter during and after childbirth. For example, if you have had an epidural or spinal anesthesia, or your baby was born by caesarean or instrumental birth. Your midwife or Obstetrician will explain why you need to have a catheter and how long you may need it for.

Caring for your catheter

Hygiene

• Wash your hands before and after touching your catheter
• You can bathe or shower as normal with a catheter.
• Wash the area where the catheter enters your body twice a day, using gentle downward strokes (this is to help prevent infection)
• Do not use soap – Just water.
• Do not apply any cream or talcum powder to the area

Diet and Fluids

It is very important to drink when you have a catheter to help prevent infection and to flush any debris from your bladder. Try and drink at least 1.5 – 2 litres (6 to 8 glasses) of fluids per day (unless you have been advised otherwise by a healthcare professional)

Typical volumes of common cups on the ward:

• Carton of juice = 85mls
• Plastic water beaker = 200mls
• China cup = 200mls
• Mug = 300mls
• Water jug = 750mls

Costa cup size (Costa coffee is in the main hospital foyer)

• Small= 340mls
• Medium = 450mls
• Large = 560mls

You will be given a chart to record your intake-output on.

Securing and emptying your catheter

It is very important that your catheter is secured safely so that it is not pulled out accidentally and does not cause damage to your bladder or urethra (the tube from your bladder where you wee from). When you are in the hospital setting it will be secured with a leg strap or tape. It is important that you inform staff if this is soiled or damaged so that it can be cleaned or replaced.

Important note- please remember not to do your pelvic floor exercises whilst you still have a catheter.

What is a trial without a catheter (TWOC)?

You will be asked for consent to remove the catheter. This will be within 12-72 hours of insertion. This will reduce the risk of developing a urine infection and restore normal bladder function as quickly as possible. A TWOC involves having your catheter removed by a trained member of staff to see if you can wee and empty your bladder completely. The process is quick and easy and normally pain free.

What happens when the catheter is removed?

When we remove the catheter, you will be given two bowls to wee into, so we can measure how much urine you are passing.

We would like your first attempt to pass urine to be within 4 hours of your catheter being removed. It might help to set an alarm on your phone to remind you.

Helpful hints for emptying your bladder

• Your bladder empties best when you are sitting with your feet flat on the floor, elbows leaning on your thighs, and you are relaxed. Try to avoid hovering over the toilet. If you are concerned about the cleanliness of the bathroom, please speak to a member of staff.
• Make sure you have adequate pain relief before walking to the toilet, as pain can affect your ability to empty your bladder.
• Privacy- if you feel nervous about using the toilet in the bay, let us know, so we can help find an alternative solution which would help with this.
• If you have suffered from constipation in your pregnancy, please discuss with the midwife so we can address this issue with you. Constipation can lead to difficulty in passing urine.

Do tell your midwife or health care assistant if:

• You are unable to wee
• You leaked urine and/or did not feel it passing
• You feel your flow of urine is very slow or interrupted
• You have pain in your lower abdomen/bladder area
• You feel like you have a full bladder but cannot empty it completely
• You feel pain when you wee

These may all be signs that you cannot empty your bladder completely (called urinary retention).

Don’t

• Don’t wait until your bladder feels overfull before going to the toilet. We suggest that you wee approximately every 3 hours.
• Don’t forget that lying flat in bed after you have given birth may alter the sensation of the bladder being full.

What will happen if I experience problems with emptying my bladder?

• It may be necessary to scan your bladder. This is a simple, fast and painless method of measuring urine volume in your bladder. It can give information on how we manage your bladder concerns.
• For some women/people, we may recommend having the catheter reinserted and to try the TWOC process again, 24 hours later. This will allow your bladder to ‘rest’. During these 24 hours, we can fit a leg bag, which is small and will make it easier for you to walk about and help in the care of your newborn.
• We may put an alternative plan in place depending on the amount of urine in your bladder and this will be discussed with you by the Doctors and Midwives. For a small number of women/people this may involve going home with a catheter. You will be fully supported if this does happen and taught how to care for the catheter while at home.

Ongoing Pelvic Health

• Your ongoing pelvic health is very important to us. Pelvic Floor Exercises will make up an important part of your post birth recovery once your catheter is removed and you have emptied your bladder. They then should become part of your daily routine for the rest of your life.
• You will be given a leaflet called ‘Fit for the Future’ by a physiotherapist/midwife or signposted to the link via BadgerNet. A full explanation on how to do these exercises can be found in the Wellbeing and Exercise Programme in Pregnancy Sussex WEPP (WEPP) section on the LMNS Sussex website.
• We suggest that you link them to an everyday activity that you do to remind you to do them, eg before you have breakfast, lunch or tea or, after you have finished feeding your baby. Alternatively, the NHS has an App you can download, called Squeezy: pelvic floor support app (squeezyapp.com), which sets reminders and guides you through the exercises.
• When you go home, if you experience any concerns with your pelvic health (e.g. accidental leakage from your bladder or bowel, or difficulty controlling wind) please discuss this with your Midwife, Health Visitor,or GP.
• You can also self-refer through the LMNS website to see a physiotherapist. These symptoms are treatable with the support of a specialist physiotherapist. They are nothing to be ashamed of and should not be classed as normal after you have had a baby.