If you consider a labour induction, 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.
I bet you’ve heard lots of information about natural induction methods. Such as having a membrane sweep.
Keep reading to find out everything you need to know about sweeping the membranes.
What is a membrane sweep?
Sweeping the membranes works to induce labor.
It doesn’t involve medication but the procedure stimulates your body to increase the amount of prostaglandins. These are hormones that soften your cervix and encourage contractions to start.
Are you wondering how a sweep is done?
When you’re ready and given your 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.
Using a firm circular 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 it working.
Should I have a membrane sweep?
Pregnancy isn’t considered overdue until after 42 completed weeks.
Many hospitals have a policy of inducing labour when you’ve reached 10 days past your due date.
A stretch and sweep is thought to be more natural than a medical induction because no medication is involved.
Keep in mind, membrane sweeping is still an intervention, as it interferes with the normal process of labour starting on its own.
Do membrane sweeps work at 38 weeks?
A sweep is more likely to kick things off if you are past your due date.
Commonly, pregnancy is considered term after 37 weeks. However, this doesn’t mean 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, especially with first babies.
Leading health experts strongly recommend against induction before 39 weeks, unless there’s a genuine medical need.
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 encourage labour to begin at 38 weeks can lead to disappointment and even complications.
How effective are membrane sweeps?
This is the million-dollar question. If labour begins after a sweep, the natural conclusion is the procedure has worked.
Or it’s possible you were in prelabor and baby was ready to arrive.
The general consensus is sweeping the membranes might kickstart labour within the first 7 days after the procedure, but generally no sooner than 24-48 hours.
- A study involving 190 women found a 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 sweeping every 48 hours, from 41 weeks, decreased the risk of post-term pregnancy. The 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 stripping to avoid one medical induction. The authors concluded 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 gestation when the membrane stripping occurred.
Signs a membrane sweep has worked
Right after membrane stripping, you might experience:
- Irregular contractions, which might or might not result in labour
- Broken sac or ‘waters break’.
Always contact your midwife or doctor if you have any concerns.
5 important FAQs about membrane sweeping
#1: Is a membrane sweep natural?
You might hear membrane stripping being referred to as a ‘natural’ method because there’s no medication, just your natural prostaglandins.
Unfortunately, that simply isn’t true.
Any procedure that attempts to start labour 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 labour, 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 forceps or vacuum, or even a c-section.
Your baby might also experience problems as a result of being born early.
However, if labour 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: It can be 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 provider.
During pregnancy, the cervix is closed and angled slightly back towards your tailbone (a posterior cervix).
As your body prepares for labour, 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 cushions them.
#3: Is a membrane sweep necessary?
All women need to give consent to any procedure, including a vaginal examination and a stretch and sweep.
No woman should have a medical or obstetric procedure performed, 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 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 labour.
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 trying 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 has 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.
Or just listen to your body and your baby, put your feet up and enjoy those final pregnant moments.
#5: Can a sweep 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 and is a medical emergency.
Your baby’s position should be checked before a vaginal exam, to minimise the risk of this emergency.
Your care provider might suggest other methods of induction, so it’s wise to be ready for this possibility before choosing to have your membrane sweeping.
If an induction is necessary for medical reasons, membrane stripping isn’t usually performed on its own, other methods are used.
For more information read Methods Of Induction Of Labour – 4 Different Methods.
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