This article contains posts and extracts from the UK Midwives and Consumers email list, a discussion group for people interested in midwifery in the UK. Open to midwives, students, mothers, and anyone interested in improving maternity services in UK. Posts in these archives express the views of the individual authors, and not those of the Association of Radical Midwives. Unless otherwise stated, the comments are personal experiences rather than evidence-based research.

Sweeping the Membranes

Membrane sweeping safe but of limited use

A review of all the literature on sweeping of the membranes at the end of pregnancy was published in May’s British Journal of Obstetrics & Gynaecology.

Membrane sweeping is performed during a vaginal examination & involves placing a finger just inside the cervix and making a circular, sweeping movement to separate the membranes from the cervix. It brings about release of hormones and has been advocated as a ‘softer’ way of inducing labour.

The review found that overall the intervention is associated with a 24% increase in chance of delivering within 48 hours, a 46% increase in chance of delivering within a week and a 74% reduction in likelihood of going 2 weeks over dates.

It is not associated with any increased risk of infection of the mother or baby, premature membrane rupture, forceps or caesarean section. It does make the vaginal examination more painful is associated with light vaginal bleeding and brings on irregular contractions not necessarily leading to the onset of labour.

In summary, as a method of induction of labour, it is poor, but at the end of pregnancy, sweeping the membranes is a safe way of doubling chances of spontaneous labour over the next week

(www.womens-health.co.uk/journ2.htm#sweep )


I’m getting frustrated with having pre labour contractions.
My due date isn’t until the 5th and I’ve had 3 long bouts of pre labour (two over the past two days). The midwife would happily sweep my membranes for me tomorrow, but I know so little about this. What does it feel like if anything? As I’m not even at my due date, what effect would a sweep have? What are the arguments for / against sweeps?

Laura

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Sweeping the membranes can be quite uncomfortable. If you are not post-mature it may not have the desired effect. It really depends on the softness of your cervix. There is naturally occurring prostin (Synthetic prostin is used in inductions) in semen which has some effect on the neck of the womb. So get cuddling with your partner : )

Rehana

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Sex, of course, is the one you will most often hear about but if you can’t face that, then female orgasm alone is great (and it’s good for getting labour started too!)! Some people swear by acupuncture, others by osteopathy, and some by homeopathy. Personally, through my teaching I have noticed the biggest success rate with a combination of nipple stimulation (3xdaily for 1 hour and for 3 days on the trot), together with a stretch and sweep.

If your midwife explains the procedure to you and you don’t much fancy it then why not do it yourself? If you squat on the loo you’ll be able to reach but you won’t hurt yourself because you’ll be in control. It feels amazing to reach your cervix and feel the baby’s head behind just nudging your fingers! I’ve also known a couple of partner’s do the honours (much more gently than a midwife – more of a bit of inquisitive searching than an in depth examination), so don’t feel that you have to rely on a midwife if you are already confident in your body.

Rachel

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I have been on the receiving end twice and it worked both times. The first time was several days after some pre-labour contractions – a doctor with what felt like very large hands did it – it was uncomfortable/painful but only while it was being done. Two days later I went into spontaneous labour.

My 2nd baby was 11 days overdue but the very junior doctor at the clinic refused to perform a sweep – in fact he looked very alarmed at my request. With my 3rd baby I was having pre-labour contractions and *knew* I was going into labour. Asked the midwife at home to sweep my membranes – within 2 hours I was contracting strongly and gave birth 3 hours later. She had much smaller hands was more gentle – it was still uncomfortable but nothing more than that.

Research does show that it often makes a difference.

Anne
NCT Teacher/Homebirth Supporter.

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I was at a consultant clinic and had been talking to a woman about sweeping her membranes as she was 41 weeks and was not keen on a medicalised IOL.

When the consultant came into the room and she mentioned this he said ‘my colleagues may do stretch and sweeps, but I don’t. It causes bleeding, and it wouldn’t be very nice for you to have to have a general anaesthetic for an examination in theatre, would it?’

Gobsmacked or what!! My conversation with her continued after he’d left the room!

Belinda.
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For more on “natural”, or non-pharmacological, induction methods, see our page on complementary therapies and midwifery.

Many thanks to Sunrise Jade for help with compiling this archive.

AH updated 15 October 2001

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