Membrane Sweep – 6 Facts To Consider Before Having One

Membrane Sweep - 6 Facts To Consider Before Having One

A membrane sweep, also known as a stretch and sweep (or stripping the membranes), is a method used to try and start labour artificially.

It’s commonly suggested as a more ‘natural’ method of induction as it doesn’t involve any medication.

The idea behind a membrane sweep is to stimulate the production of prostaglandin, which is a hormone that prepares your cervix for labour. Your care provider inserts a finger through your cervix and firmly moves their finger around in a circular motion, separating the membranes of the amniotic sac from your cervix.

Often a membrane sweep is presented as a simple method to ‘gently’ encourage labor. It may even be recommended when there’s no medical indication for an induction, but simply because your estimated due date is approaching. While interventions have a place, even the most ‘natural’ sounding methods are still interventions with risks.

6 Facts You Need To Know About A Membrane Sweep

Here are 6 facts to know about membrane sweeps:

#1: A Membrane Sweep Isn’t Natural

Anything that attempts to kick start labour before it begins spontaneously isn’t natural. While often touted as an alternative to other methods of induction, a membrane sweep is still a mechanical form of trying to start labour ahead of time.

While induction can be necessary and a life saving intervention, there are many babies being born before they are ready due to non-medical reasons.

There are many risks involved with inducing labour and it should not be undertaken lightly.

#2: It May Lead To Further Interventions

If an induction is necessary for medical reasons, a membrane sweep can seem like a gentler option than medical methods of induction.

Yet we know as a matter of fact that many inductions are not being performed purely for medical reasons. There are increasing rates of induction for non-medical reasons such as convenience or post dates (baby has passed the estimated due date).

It can be tempting to try a membrane sweep to ‘get things going’ because it seems harmless compared to being induced with prostaglandin gel placed on your cervix or powerful synthetic oxytocin via a drip. But this is not necessarily the case. If a membrane sweep doesn’t bring on labour and your care provider doesn’t support waiting for labour to begin spontaneously, you are more likely to have a medical induction.

If your body and baby aren’t ready for labour to begin, then chances are you will have more interventions, such as forceps or vacuum assisted birth, or even a c-section. Your baby may also experience problems due to being born early, especially breathing problems.

No-one wants to be separated from their newly born baby longer than necessary, and if there are problems, it can be a while before you hold your baby — and you may not be the first to hold your baby either.

#3: It Can Be Painful

A membrane sweep can only be performed if your cervix is ‘favourable’. This means the cervix must be slightly open (usually 1-2 centimetres dilated) and softening. During late pregnancy, your cervix can be angled back toward your tailbone, making it difficult to reach. This posterior position of the cervix can make the sweep quite uncomfortable, or even painful.

If the cervix is closed but soft, your care provider can stretch or massage the cervix to stimulate it to begin to dilate. Stretching the cervix can feel very uncomfortable, and some women describe a sharp, shooting sort of pain.

After the membrane sweep, you may experience cramping and spotting or bleeding.

#4: Your Consent Is Required

Any procedure performed on you requires your informed consent. Some care providers routinely do membrane sweeps in the last weeks of pregnancy, in the belief this will reduce the length of pregnancy. You should be informed of this policy and your care provider needs to discuss with you the risks and benefits of membrane sweeping so you can make an informed choice whether to have the sweep or not.

Unfortunately, many women experience membranes sweeps during pre-natal appointments, and are not aware the procedure will be done until after it has occurred. This can be a very distressing and upsetting event.

#5: It Doesn’t Always Work

It’s a commonly held belief that approximately a quarter of women who have a membrane sweep will go into labour within 48 hours of the procedure. Studies on outcomes for membrane sweeps differ, but this independent Cochrane review of 22 trials showed sweeping the membranes didn’t produce clinically important benefits.

Most care providers will suggest another membrane sweep within 48 hours if the first sweep hasn’t kick started labour. This means repeat visits to your doctor’s office or hospital, as well as increasing the chances of more discomfort and possibly irritable uterus (when contractions begin but do not progress).

The stress of waiting and possibly dealing with ongoing unprogressive contractions can lead you to feeling very tired and over it – you may even decide to give up and accept more interventions to get it over with. The chances are most women will progress to having their waters artificially broken, followed by an artificial oxytocin drip. We also know a high percent of women who have artificial oxytocin also then seek an epidural, or other pain relief, risking further complications.

If your baby isn’t ready to be born, they simply may not be in a favourable position for labour.

This can impact the effectiveness of your contractions, causing labour to be slow and irregular. When labour is induced and doesn’t proceed in a certain pattern and timeframe, care providers are more likely to increase the pressure to speed things up. At this stage, you are likely committed to do whatever it takes to birth your baby, even if that means a c-section. It’s easy for a ‘simple’ membrane sweep to be the start of a cascade of interventions. Who would have thought?

#6: Increase Risk Of Infection And PROM

Anything inserted into the vagina has the potential to introduce bacteria, which can travel up to the cervix and beyond to the membranes. If bacteria makes its way through the cervix, there’s a chance that an infection may weaken the membranes, causing them to rupture prematurely (PROM). There’s also the chance your care provider can rupture the membranes while performing the sweep.

Once the membranes have ruptured, the seal protecting your baby from infection is no longer able to prevent bacteria reaching your baby. This increases the risks of further interventions, such as antibiotics and monitoring. If labour doesn’t begin spontaneously within 24 hours, you are likely to be scheduled for a medical induction.

If induction is necessary for medical reasons, a membrane sweep is not usually performed on its own – other methods are usually used. However, a sweep may be undertaken if your cervix is very favourable, in the hope of avoiding further interventions. The choice to have a membrane sweep should be made with full consideration of the risks and benefits for your personal situation, regardless of your care provider’s preference.

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Sam McCulloch Dip CBEd CONTRIBUTOR

Sam McCulloch enjoys talking so much about birth that she decided to become a birth educator and doula, supporting parents in making informed choices about their birth experience. In her spare time she watches Downton Abbey and has numerous creative projects on the go. She is mother to three beautiful little humans.


11 comments

  1. Wow. This appears to be a one sided, patronising article indeed, based on 6 negative facts. It would have been a much better article had it also discussed the benefits of a membrane sweep, regardless as to the authors obvious personal opinion on the matter. As such, it’s not a very helpful article at all and appears to unfairly use rather obvious scare/emotional blackmail dressed up as ‘fact’ (i.e ‘you may not be the first to hold your baby’, ‘the start of a cascade of intervention’). This isn’t birth education, it’s projecting personal bias.

    1. The article is written by a doula. I find they all are in the “natural camp”..
      I’m of the opinion that medical interventions are innovations to assist with and make troublesome things easier. There is a reason these procedures are available, and I think it’s fair to say they were designed with the best intentions as opposed to harm.

      I just had this procedure done today. That’s why I’m looking it up. Didn’t get given this much info but am grateful because I would have been so scared. I think the doctor is clever for a) choosing to do this and b) saving me the psychological trauma of anticipating it.

    2. My ob for my dd did a membrane sweep at 39 weeks during an exam without my consent. She brushed it off like it was no big deal. My water broke 24 hours later but labor never started, thus began a long series of interventions which concluded with a cesarean. These facts are much needed, and although they wouldn’t have helped me because I didnt have a choice, I’m glad that women can read about some of the side effects the doctors may not mention.

  2. I find this to be very informative. Of course you can go and do your own further research on what the pros are. However I do agree the cons outweigh them. It’s not natural. Doctors need to stop intervening in something that naturally will happen on its own. All women need and deserve to be informed.

  3. I have been told I will need to have a sweep at 38 weeks due to having Lupus. I will do whatever it takes to make sure my baby has the best possible life chance. I didn’t find this article reassuring and think that perhaps looking at both pros and cons would have made this article/ opinion a better one.

  4. The title of the article should be ‘why not to have a membrane sweep’. Extremely misleading and one sided article. Does not talk about babies that are overdue up to 42 weeks.
    Not helpful at all and seems based on the writer’s personal views.

  5. Very helpful article. I don’t understand what pros people are looking for. It’s done to accelerate birth and some women want it at whatever cost. For those of us who want to trust the nature, we want to be aware of risks of these procedures. I was overdue with my baby and I’m convinced that the only reason, I gave birth without interventions was because I was in a birthing center with midwives and not doctors. It was slow and had some irregularities, but I could do it myself without forceps and the like. I have several friends who were induced and ended up with forceps and they suffered a lot after…

  6. I was considering the sweep at 40 weeks as my midwife said I could choose that option to speed up the process if I’m late but I didn’t consider the possible after effects so actually I found this article helpful as it gave a good perspective on the possible outcomes. So I now believe it’s best to wait as long as you can for a more natural birth process but I will consider it at 42 weeks if I haven’t given birth.

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