If you consider a labor induction with a membrane sweep, you’re probably feeling very pregnant.
Maybe your estimated due date has come and gone.
Or perhaps you’re uncomfortable and tempted to try to get things moving along.
Your healthcare provider might even have suggested having a sweep as a way of making labor start ‘naturally’. And if your midwife is suggesting it … surely it’s alright?
Although it might sound like a natural option, remember anything that starts labor before it begins on its own is intervening with the natural process.
Having said that, there might be a compelling need to get labor going, and if you’re trying to avoid more medical interventions, this could potentially help.
Keep reading to find out everything you need to know about to ‘sweep a membrane’.
What is a membrane sweep?
Sweeping the membranes is essentially stimulating your body to release prostaglandins. They act on the cervix to soften and ripen it, which then encourages dilation in response to contractions.
Often this stage is already happening ‘behind the scenes’. You might not notice or pay much attention to that low ache in your pelvis or lower back. During late pregnancy, everything hurts, so what’s one more ache to pay attention to? Often it’s only in hindsight you realize that it was probably your cervix getting ready for the main show.
If this process of ripening and softening of the cervix is already underway, membrane sweeping might be more effective at getting contractions started and established.
Unlike having artificial oxytocin (Pitocin or Syntocinon) for induction, a membrane sweep doesn’t involve medication. As with any labor induction method, however, the more favorable your cervix is, the more likely the method will be successful.
How is a membrane sweep done?
It doesn’t sound very glamorous, but membrane sweeping is similar to having a cervical check or a Pap smear.
When you’re ready and have given your informed consent, you lie on your back with knees apart and ankles together.
This can determine how ‘ready’ your cervix is. This is called your Bishop’s score. Remember, the more favorable your cervix, the more likely membrane sweeps are to work.
Using a firm circular or sweeping motion, your midwife or doctor will sweep and separate the membrane of the amniotic sac from the cervix. Some providers also stretch the cervix to increase the chances of the membrane sweep working.
Should I have a membrane sweep?
Pregnancy isn’t considered overdue until after 42 completed weeks.
Many hospitals have a policy of inducing labor when you’ve reached 10 days past your due date.
A ‘stretch and sweep’ (stretching the cervix and membrane sweeping) is thought to be more natural than a medical or formal induction method because no medication is involved.
Keep in mind, though, membrane sweeping to induce labor is still an intervention, as it interferes with the normal and natural process of labor starting on its own.
Do membrane sweeps work at 38 weeks?
Commonly, pregnancy is considered a term after 37 weeks. This doesn’t mean, however, your baby is ready to be born yet. And reaching your due date doesn’t mean you’re overdue.
Only 3-5% of babies are born at 40 weeks and many pregnancies go beyond that –especially with first babies.
Leading health experts strongly recommend against inducing labor before 39 weeks, unless there’s a genuine and pressing medical reason.
Being born early puts babies at higher risk for health and developmental problems. Important brain and lung development occurs during those last weeks in the uterus.
If your body and your baby aren’t ready, trying to stimulate labor to begin at 38 weeks can lead to disappointment and an even greater risk of complications.
How effective are membrane sweeps to induce labor?
This is the million-dollar question. If labor begins after a sweep, the natural conclusion is the procedure has worked.
It’s possible, though, you were in prelabor and baby was ready to arrive.
The success of a membrane sweep really depends on whether you have a favorable or unfavorable cervix. This is explained above in the information about the Bishop’s score.
The general consensus is sweeping the membranes might kick-start labor within the first 7 days after the procedure, but generally no sooner than 24-48 hours.
- A study involving 190 women found a membrane sweep at 38 weeks reduced total gestation time. Of the membrane stripping group, only 10% went past 41 weeks, compared with 25% in the non-sweep group
- This study showed membrane sweeping every 48 hours, from 41 weeks, decreased the risk of post-term pregnancy. The membrane sweep group had 23% of pregnancies go to 42 weeks, compared with 41% of the non-sweep group
- This Cochrane review showed eight women would need to have membrane sweeping to avoid one medical induction. The authors concluded membrane sweeping didn’t produce a clinically important benefit.
When taken overall, the difference in numbers is small and the length of pregnancy reduction is a matter of days, not weeks.
The outcome also depends on the number of weeks of pregnancy when the membrane stripping occurred.
Signs a membrane sweep for labor induction has worked
You might experience these symptoms a few hours after having the membranes swept. Be mindful this might be because the cervix is irritated and spontaneous labor might not occur.
Right after membrane stripping, you might experience:
- Cramping with mild discomfort
- Light bleeding, as blood vessels begin to break when the cervix starts to dilate
- Irregular contractions or tightenings
- Broken sac or ‘waters breaking’
- Release of the mucous plug.
You shouldn’t have severe pain or heavy bleeding. If you experience heavy bleeding or any severe pain, or if you have any concerns, always contact your midwife or healthcare provider
5 important FAQs about membrane sweeping
#1: Is a membrane sweep natural?
You might hear membrane stripping to induce labor being referred to as a ‘natural’ method because there’s no medication used, just your natural prostaglandins.
Unfortunately, that simply isn’t true.
Any procedure that attempts to start labor before it begins on its own, is doing so by artificial means.
Find out more in our article What Causes Labour To Start?.
If membrane stripping doesn’t bring on labor, you’re more likely to have a medical induction. If your body and your baby aren’t ready for birth, you can end up having more interventions. These can include a forceps or vacuum birth, or even a c-section.
Your baby might also experience problems as a result of being born early.
However, if labor induction is necessary for medical reasons, a sweep could be a better option. You can prepare for further medical intervention and have a plan for making those decisions.
For more information check out Induction of Labour – What Are The Risks Of Being Induced?
#2: Is it painful to have a stretch and sweep?
The answer depends on each individual, as everyone is different. It helps to discuss your questions with your care providers at home or at your doctor’s office. They can provide medical advice that will help with your decision to have labor induced.
During pregnancy, the cervix is closed and angled slightly back towards your tailbone (a posterior cervix).
As your body prepares for labor, the cervix shifts forward, softens, and even opens slightly.
These changes can happen in the weeks before or up to the time you notice signs of labor.
When your cervix hasn’t moved forward and is higher in the vagina, the vaginal examination can be a bit uncomfortable or even painful.
Your baby won’t feel the exam as the amniotic fluid acts as a cushion.
#3: Is a membrane sweep necessary?
All women need to give consent to any procedure, including a vaginal examination and a stretch and membrane sweeping.
No woman should have a medical or obstetric procedure performed, either during pregnancy or birth, without her consent.
Your healthcare provider must discuss the risks and benefits with you before the procedure.
This lets you make an informed choice, in the context of your health information, whether or not to have the membrane sweep.
It’s important to inform your healthcare provider of the procedures you do or don’t want.
You also have the right to refuse a vaginal exam if you don’t want one.
If you need to have an induction, here are 8 Tips For A Positive Induction Birth.
#4: Can I sweep my own membranes?
When you’re 42 weeks pregnant, you’re thinking, ‘Come on uterus, do your thing!’
You might consider getting things started on your own.
In my practice, many women have used a finger to feel their own cervix, during pregnancy and even during labor.
And some women have tried to ‘stretch’ their cervix with their fingers. Or had their partner try a membrane stripping.
Midwife Dawn Reid agrees. She’s had many clients perform a self-sweep, in an effort to avoid medical induction methods.
Dawn says, ‘I would always recommend waiting for babies to choose their birthday and use the stretch and sweep as a last resort’.
She also found a self-sweep was ‘often not successful and imaginably quite tricky’.
Midwives and doctors have years of knowledge and experience, so wait and have them perform one.
Alternatively, just listen to your body and your baby, put your feet up and enjoy those final pregnant moments.
#5: Can membrane stripping break your waters?
There’s a small increased risk of your waters rupturing prematurely after a membrane sweep.
This means the protective sac surrounding your baby breaks and amniotic fluid can leak out.
If contractions don’t start within a certain time frame, there’s an increased risk of infection.
When the amniotic sac breaks, the baby’s head needs to be well engaged in the pelvis to avoid cord prolapse. This is when the cord flows out past the baby’s head; it is considered a medical emergency.
Your baby’s position should be checked before a vaginal exam, to minimize the risk of this emergency.
Your healthcare professional might suggest other methods of induction, so it’s wise to be ready for this possibility before choosing to have a membrane sweeping.
If an induction is necessary for medical reasons, membrane stripping isn’t usually performed on its own; other induction methods are also used.
For more information read Methods Of Induction Of Labour – 4 Different Methods.