Induction: Membrane Sweeps

Are you reaching the end of your pregnancy and your midwife has offered you the option of a membrane sweep, not sure what it is about or whether you want to have one? Then read on….

 

 

So what is a membrane sweep?
A membrane sweep (or stretch & sweep) involves a midwife or doctor inserting their finger into your vagina and inside your cervix (neck of the womb) and making a circular, sweeping movement to separate the membranes from the cervix. They will only be able to do this if the cervix is open enough to insert a finger and if it is far enough forward to reach. The purpose of a sweep is to increase the your production of prostaglandins which your body naturally produces which help soften your cervix.

A membrane sweep is often considered a routine procedure (normally offered from 39 weeks onwards) however it is still an intervention and a form of induction of labour with benefits and risks. They can have an impact on how your birth does (or doesn’t) progress. So it is good to know that while a membrane sweep might be offered, it is also important to know that you can decline or accept this offer.

Also know that you need to give consent to a membrane sweep so it should never be done as part of a vaginal examination without your consent.

So what are the benefits and risks?

Benefits
There are no ‘proven’ benefits to having a membrane sweep as it is a difficult one to prove.
1 in 8 women will go into labour after having one, it is very likely that they would have gone into labour within 24-48 hours anyway.
A sweep might help you (and your midwife/doctor) feel like you are doing something to help labour to start. Perhaps this could help you manage your feelings of impatience around when labour will start.

Risks
Infection
Bleeding
Discomfort and pain during and after the sweep
Tightenings or contractions that don’t progress into labour (perhaps because you and your baby aren’t quite ready)
Bleeding
Infection
Waters releasing before labour starts (this can often lead to further offers of intervention to speed up labour)

Other things worth considering before you say yes to a sweep
What effect a membrane sweep could have on you, your body and your cervix will it help it to relax and soften?

Will it help or hinder the production of naturally produced prostaglandin and oxytocin that happens at the end of pregnancy?

If your baby hasn’t been born yet by 39, 40, 41 weeks, would it be okay with you to accept that perhaps they just aren’t ready to be born yet as they have no concept of due dates?

Also, consider how you might feel if you have been having some signs of your body getting ready for labour and feeling fairly positive about things starting, only to have a sweep and be told your cervix is still in a posterior position and closed. Would this make you feel disheartened and worried? (perhaps making your adrenaline increase and reduce your oxytocin) Or will you remember that your cervix is not a crystal ball and things can change very quickly?

As you can probably guess there is no right or wrong, as everyone is different. However by knowing you have a choice and the right to accept or refuse, by following your instinct you will make the right decision for you and your baby.

Some further reading about membrane sweeps:

What is a stretch and sweep by Sara Wickham

Evidence Based Birth: Evidence on the pros and cons of membrane sweeps

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