Many care providers suggest a membrane sweep as a gentle way to induce labour.
You’re very pregnant, uncomfortable and tempted to get things moving along.
You would do anything for labour to start.
You try all the natural methods first, but then your care provider suggests something that sounds pretty uncomfortable.
A membrane sweep, also known as a stretch and sweep. Is it worth trying?
Membrane Sweep – What You Need To Know Before Having One
If you’ve never had a membrane sweep before, you’ll likely be wondering what it is, how it’s done and whether you actually have to consent to one.
Deciding to have a membrane sweep might seem quite simple.
But there are plenty of things you should know before going ahead.
What are the potential impacts on your body, your baby and your birth?
Keep reading to find out everything you need to know about membrane sweep.
What Is A Membrane Sweep?
A membrane sweep is a method used to start labour before it happens on its own. You may also know it as a stretch and sweep or stripping the membranes.
It’s suggested as a means to start labour before trying medical induction methods, as a sweep doesn’t involve any medication.
A membrane sweep is used to stimulate the production of prostaglandin, which is a hormone that prepares your cervix for labour.
What Does A Membrane Sweep Involve?
A membrane sweep is an easy procedure, often performed at your care provider’s clinic. You will lie down, bring your knees together, then legs fall apart.
Your care provider inserts a gloved finger into your vagina and up to the cervix. The cervix is assessed for effacement and dilation, and then your care provider will insert their finger through the cervix.
Using a firm circular motion, your care provider will ‘sweep’ the membranes and separate them from the cervix. This is also called ‘stripping’ the membranes.
To increase the chance labour will begin, your care provider may stretch the inner cervix. This means inserting two gloved fingers into the cervix to stretch them apart and encourage the cervix to dilate.
Why Have A Membrane Sweep?
Most women offered a membrane sweep will be close to or just over their estimated due date.
Many hospitals have a policy of induction 10 days after the estimated due date (41 weeks 3 days). This is despite the fact a pregnancy isn’t considered overdue until after 42 completed weeks.
A membrane sweep can seem like a better alternative to being medically induced.
After all, it relies on the body’s natural hormones to kick labour off, reducing the use of synthetic hormones and their risks.
However it’s important to know a membrane sweep is still an intervention, as it interferes with the normal process of labour unfolding on its own.
When Can You Have A Membrane Sweep?
A membrane sweep should only be performed from 39 weeks or later.
Until recently, a pregnancy was full term from 37 weeks onwards. However leading health experts have made strong recommendations about induction before 39 weeks gestation, unless there is a medical need.
Researchers discovered being born too early puts babies at higher risk for health and developmental problems. Important development on organ such as the brain and lungs occurs during the last weeks in the womb.
The American College of Obstetricians and Gynecologists has redefined the meaning of term pregnancy into four distinct categories:
- Early Term: Between 37 weeks 0 days and 38 weeks 6 days
- Full Term: Between 39 weeks 0 days and 40 weeks 6 days
- Late Term: Between 41 weeks 0 days and 41 weeks 6 days
- Post Term: 42 weeks 0 days and beyond.
It’s commonly believed once you reach our estimated due date you are ‘full term’ and your baby needs to be born. However, only 3-5% of babies are born on their due date, with many pregnancies extending into 41 weeks, especially first babies.
Membrane Sweeps Effectiveness
How effective is a membrane sweep? This is the million dollar question. Most women who have a membrane sweep were close to going into labour, or even in pre-labour and not aware of it.
If labour begins after a membrane sweep, the natural conclusion is the procedure started labour, and not labour being an inevitable outcome of the end of pregnancy.
The general consensus is membrane sweeps are likely to kickstart labour, especially within the first 7 days after the procedure.
- A study from 2014 involving 190 women found membrane sweeps at 38 weeks reduced total gestation time. Half the women had membrane sweeps and 90% of those went into labour compared to 75 who didn’t have a sweep. Of the membrane sweep group, only 10% went past 41 weeks compared to 25% in the non-sweep group.
- This study involving 800 women, found membrane sweeps reduced the time between induction and labour, increased the vaginal birth rate and lowered the use of synthetic oxytocin. However the researchers used other induction methods along with the sweep.
- A study from the Netherlands showed serial sweeping from 41 weeks decreased the risk of post-term pregnancy. The women were randomly assigned to have their membranes swept every 48 hours until labour commenced up to 42 weeks of gestation, or no intervention. The sweep group had 23% of pregnancies go to 42 weeks compared to 41% of the non-sweep group.
- This independent Cochrane review of 22 trials showed eight women would need to have their membranes swept to avoid one medical induction. The authors concluded membrane sweeps didn’t produce 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 what gestation the sweep occurred.
5 Facts You Need To Know About A Membrane Sweep
If you’re tempted to have a membrane sweep to kickstart labour, or because you’re facing induction, here are 5 facts to know:
#1: A Membrane Sweep Is A Form Of Intervention
One of the upsides to membrane sweeps is it doesn’t involve any medication.
You may even hear it being referred to as a ‘natural induction’ method.
Unfortunately that simply isn’t true.
Any procedure that attempts to kickstart labour before it begins on its own is doing so by artificial means.
We know a little about the complex process of labour initiation and science has shown it involves a baby’s readiness for the outside world.
You can read more about this in What Causes Labour To Start?.
If you’re simply tired of being pregnant, you’re not alone. Most women get to the final weeks of pregnancy and have had enough. Patience is tricky but waiting gives your baby the best start to life.
When continuing on with pregnancy puts mothers and babies at risk, induction is a life saving intervention. This means the option of a non-medical induction method may put you at ease with being induced.
#2: A Membrane Sweep Can Lead To Further Interventions
When you’re 38 weeks pregnant and feeling every one of those weeks, a membrane sweep is tempting. Perhaps your care provider is already talking induction in your future.
You might feel completely over being pregnant. Or you’re worried your partner might not make it to the hospital in time.
But if a membrane sweep doesn’t bring on labour and your care provider doesn’t support waiting for spontaneous labour, you’re more likely to have a medical induction.
If your body and baby weren’t ready for labour, you may end up with 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, or being admitted to the NICU.
If an induction is necessary for medical reasons, a membrane sweep can seem like a gentler option than medical methods of induction.
If you’re in this situation, your care provider can assess your cervix and determine how likely a membrane sweep will help things along.
You can read more in Bishop’s Score During Pregnancy – What Is It and How Is It Used?
You can also prepare for further medical intervention and have a plan for how to make those decisions.
#3: A Membrane Sweep Can Be Painful
One of the first questions pregnant women ask is “Is a membrane sweep painful?”.
If your situation recommends a membrane sweep, it can help to know what to expect.
During pregnancy, the cervix is closed and angled slightly back toward your tailbone (called posterior).
When your body begins to prepare for labour, the cervix will soften and possibly even open slightly (around 1-2 finger widths).
The position of the cervix can change and shift more forward.
However, the timing of cervix changes in preparation for labour can differ between women and even different pregnancies.
Some women have these changes happen in the weeks leading up to labour, others won’t until labour is noticeably beginning.
A membrane sweep is more easily performed when your cervix is ‘favourable’.
The cervix is soft, has shifted forward and is slightly open.
If the cervix is still posterior, it will be difficult for your care provider to reach, which can make the sweep uncomfortable or even painful.
If the cervix is soft but closed, 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: You Have The Right To Decide To Have A Membrane Sweep
In a perfect world, no woman would ever have a medical procedure performed without her consent during pregnancy or birth.
Your care provider may have a policy of routine membrane sweeps in the last weeks of pregnancy.
While this may be an option for women facing medical induction, it’s still a procedure which needs your informed consent first.
Your care provider must discuss the risks and benefits of a membrane sweep with you.
This means you can make an informed choice whether to have the sweep or not.
Unfortunately, many women experience membranes sweeps during prenatal appointments without consent. After the procedure they are told or suspect it happened.
This is very distressing and upsetting, especially for women in vulnerable situations such as domestic violence or sexual abuse survivors.
It’s important to inform your care provider you don’t want a membrane sweep (or other procedures) without your consent.
You also have the right to refuse a vaginal exam if you don’t want one.
#5: Membrane Sweep Can Cause A Rupture Of The Amniotic Sac
There’s an increased risk, although small, of your membranes rupturing prematurely after a membrane sweep.
This means the amniotic sac surrounding your baby breaks and fluid can leak out.
There’s an increased risk of infection if this happens and labour doesn’t begin within a certain timeframe.
Your care provider may want to move to more medical methods of induction and it’s wise to be ready for this possibility before choosing to have a membrane sweep.
If induction is necessary for medical reasons, a membrane sweep isn’t usually performed on its own – other methods are usually used.
However, a sweep is an option if your cervix is very favourable, in the hope of avoiding further interventions.
It’s your decision to have a membrane sweep after full consideration of the risks and benefits for your personal situation, regardless of your care provider’s preference.
- Natural Labour vs Induced Labour – 6 Main Differences
- What Causes Labour To Start?
- How To Bring On Labour Naturally – 11 Natural Methods
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