Stretch and Sweep: A shortcut to labour?
Have you been offered a ‘stretch and sweep’.. do you actually know what is it, what it involves and what it might mean for your labour and birth?
A membrane sweep involves a vaginal examination, where your midwife or doctor will insert a finger into your cervix (so an effective sweep requires your cervix to be open at least a little), sweep their finger around the inside of the cervix, in order to separate the membranes (or sac) surrounding your baby, and potentially stimulate the cervix enough to bring on contractions. It can be a particularly uncomfortable procedure and may or may not be a helpful first stage of induction. (But it is that, a method of induction).
There have been several randomised controlled trials into membrane sweeping, and if you’re faced with the offer of a sweep, it’s helpful to know what they showed! I’ll give you a very brief summary and link to the papers below if you want to read more!
For women who opted for a sweep at 41 weeks (1 week after their due date) it decreased their chances of reaching 42 weeks from 41% down to 23%, so pretty much halving their changes of a ‘post dates’ pregnancy. Most trials also showed a decrease in the overall length of pregnancy by around 4 days. If you’re opting for a formal medical induction, starting with a sweep can also reduce the chances of you requiring syntocinon to bring on labour.
Sounds good right? SIGN ME UP!
Before you jump the gun.. it’s important to understand both sides of the picture when making a decision. For around 1 in 10 women, the stretch and sweep will cause their waters to break, which may put them in a situation where labour is brought on very quickly (breaking your waters is the second step of a medical induction), or leave you in a position where you are not in labour, but your waters have broken- which after 24 hours in the UK will lead to the offer of a medical induction. For some women a stretch and sweep may cause spotting or bleeding, and for many it lengthened the ‘early’ stop, start stage of labour, giving women irregular contractions, but not putting them into active labour.
It’s important to consider both sides of the picture when making your decisions, discuss your choices with you healthcare providers, as well as listening to your instinct. If you’re opting for a medical induction anyway, it’s certainly not a bad place to start!
To read more hints and tips for a positive birth experience read more here.
If you are interested in taking the next step to a positive birth, Positively Birthing Hypnobirthing and Antenatal Classes run throughout Surrey and SW London- areas including Surbiton, Esher, Teddington, Cobham, Twickenham, St Margarets, Thames Ditton, Molesey, Richmond, Wimbledon, Kingston, Sunbury, Epsom, Ewell, and beyond. All bookings can be made here.
References
Boulvain, M., Stan, C.M., Irion, O. (2010). Membrane sweeping for induction of labour (review). The Cochrane Library 2005(1).
De Miranda, E., van der Bom, J.G., Bonsel, G.J., et al. (2006). Membrane sweeping and prevention of post-term pregnangy in low-risk pregnancies. BJOG (113), 402-408.
Hill, M. J., McWilliams, G. D., Garcia-Sur, D., et al. (2008). The effect of membrane sweeping on prelabor rupture of membranes: a randomized controlled trial. Obstetrics and Gynecology 111(6): 1313-9.
Tan, P.C., Jacob, R., Omar, S.Z. (2006). Membrane sweeping at initiation of formal labor induction. Journal of Obstetrics and Gynecology 107, 569-577.
Wong, S.F., Hui, S.K., Choi, H., & Ho, L.C. (2002). Does sweeping of membranes beyond 40 weeks reduce the need for formal induction of labor? BJOG (107), 632-636.
Yildirim, G., Güngördük, K., Karada, Ö. İ., et al. (2010). Membrane sweeping to induce labor in low-risk patients at term pregnancy: A randomised controlled trial. Journal Of Maternal-Fetal & Neonatal Medicine, 23(7), 681-687.