Membrane sweeping - What is a stretch and sweep?
A stretch and sweep is a procedure that can be done by your midwife or obstetric doctor which involves them sweeping a finger around and/or within the opening of your cervix. It is done while doing a vaginal examination for which you would usually be lying on your back.
Why is a stretch and sweep offered?
A stretch and sweep is a form of Induction of Labour, therefore it is offered to stimulate the uterus and bring on labour earlier than it might otherwise spontaneously start. Many midwives offer this because it is considered an easier form of induction than a chemical or mechanical induction such as synthetic oxytocin or a Foley Bulb. Some midwives offer this because they are asked to as part of their hospital trust’s guidelines.
How does a membrane sweep work?
Your midwife or doctor puts a couple of lubricated, gloved fingers into your vagina and inserts their index finger into the small opening of the cervix or neck of your womb.
They then use a circular movement to try to separate the membranes of the amniotic sac, from your cervix. This action may release hormones called prostaglandins that may prepare the cervix for birth and may initiate labour.
Does a stretch and sweep work?
The most recent Cochrane review of the research on this topic by Boulvain et al (2005) found that, while these may help bring on labour a bit sooner than otherwise would be the case, eight women need to have a stretch and sweep in order for one woman to go into labour without needing more induction interventions. However, this figure assumes that all women would decide to have induction, which is not the case.” (Wickham 2018).
(See Dr Sara Wickham’s Inducing Labour, Making Informed Decisions)
Do you have to have a membrane sweep?
No.
Nobody can put their fingers into your vagina without your agreement. Although the stretch and sweep has been normalised by its regular use and lack of discussion about the pros and cons - it is far from normal.
Feedback from women ranges from the positive ‘I went into labour that afternoon and had my home birth’ to the negative ‘It was very painful, I had three and nothing happened’. To the worst ‘the midwife ruptured my waters while doing the sweep, after 24 hours I felt pushed into a full induction’.
What are the risks to a membrane sweep?
Infection, light bleeding, discomfort, irregular surges which may be associated with a longer, more uncomfortable early labour and accidentally rupturing the amniotic sac.
Whose choice is it to make?
Yours.
Where can I get more information?
Visit the websites of Rachel Reed’s Midwife Thinking or Dr Sara Wickham for a great breakdown of the evidence and pros and cons.
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