How to do a membrane sweep
Stretch and sweep | Pregnancy Birth and Baby
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What is a stretch and sweep?
A stretch and sweep or membrane sweep is a relatively gentle way of trying to start labour. It is a simple procedure that sometimes initiates labour, reducing the risk of babies being born over the due date (42 weeks of pregnancy).
When is a stretch and sweep offered?
Your midwife or doctor may offer to perform a stretch and sweep when you have reached full term (38 weeks) to try to start labour. Some hospitals and doctors recommend the procedure only if you are 40 to 41 weeks pregnant in an attempt to prevent an overdue delivery, which may place the baby at risk.
What to expect from a stretch and sweep
The procedure is carried out by a midwife or doctor as part of an internal vaginal examination. They put a couple of lubricated, gloved fingers into your vagina and insert their index finger into the 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, containing the baby, from your cervix. This action, which releases hormones called prostaglandins, prepares the cervix for birth and may initiate labour.
Your midwife or doctor will:
- check the estimated date of delivery
- ask you to empty your bladder and lie down
- detect your baby’s position by feeling your abdomen
- do an internal examination to find if your cervix is closed or open
- massage around the neck of your womb if it is soft but closed — this 'stretch' can stimulate your body to release prostaglandins, which encourage the cervix to open
- insert an index finger into the neck of the womb, if it is open, and use circular motions to loosen or 'sweep' the amniotic sac membranes from the top of the cervix — this triggers the release of hormones and may start labour
If you find the procedure too uncomfortable, ask your midwife or doctor to stop.
Afterwards you might experience:
- discomfort
- mild or occasionally strong pain
- slight bleeding
- cramps or irregular contractions
Take paracetamol and have a warm bath if you are in pain. If your membranes rupture, the pain is bad or you have fresh, red bleeding, contact your midwife, doctor or maternity unit.
The process can be repeated if labour does not start over the next couple of days.
What are the benefits and risks of a stretch and sweep?
Stretch and sweep procedures at 41 weeks of pregnancy greatly reduce the percentage of women who deliver their babies beyond term. They may be offered as an alternative to inducing birth through medication or by rupturing the membranes.
The procedure is safe in a normal pregnancy. There is a slight chance the membranes may break during the procedure.
Ask your doctor or midwife about the benefits and risks before agreeing to a stretch and sweep procedure.
Sources:
BabyCenter (What is a membrane sweep?), Queensland Health (Queensland Clinical Guidelines, Induction of labour), The Royal Hospital for Women (Sweeping membranes to encourage spontaneous labour), Cochrane (Membrane sweeping for induction of labour), NSW Health (Pregnancy beyond 41 weeks)Learn more here about the development and quality assurance of healthdirect content.
Last reviewed: January 2021
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Does It Speed Up Your Labor?
Written by WebMD Editorial Contributors
In this Article
- Understanding Labor Induction
- How Membrane Sweeping Works
- Pros and Cons of Membrane Sweeping
- Risks of Not Having Labor Induced
When you near the end of your pregnancy, your medical team watches you closely for signs that they may need to induce your labor.
If your baby needs to be born sooner than everyone else counted on, membrane sweeping, also called sweep and stretch or membrane stripping, may be the labor-induction method your doctor chooses.
Understanding Labor Induction
Usually, a woman’s body goes into labor without much prompting, in preparation for a baby’s birth. But if you or your baby is at risk, your doctor may want to induce your labor sooner.
There may be other, practical reasons why a doctor may want to induce. But labor induction techniques should not be used before 39 weeks’ gestation unless there is a medical reason.
Your cervix prepares for labor by:
- Ripening, which is also called softening
- Opening, also called dilation
- Thinning, also called effacement
These things may start to happen but then stall. Or your water may break, but contractions don’t follow. In these cases, a doctor may choose to induce labor, to stimulate the body’s progress.
Other conditions that call for inducing labor include:
- Status of one or two weeks past the estimated due date
- High blood pressure
- Placenta detached from the uterus
- Infection
- Lung disease
- Diabetes
If your doctor doesn’t try membrane sweeping or another labor induction method, it increases your risk for a cesarean section delivery.
While a C-section is sometimes necessary, it is considered higher-risk, so your doctor may want to avoid doing one if possible.
How Membrane Sweeping Works
Your doctor inserts a gloved finger into your vagina and up into your cervix to separate your water (amniotic) sac, or bag, from your uterus without breaking the sac. Your doctor uses this technique to urge your body to release prostaglandins, hormones that stimulate labor. As the water sac separates from your uterus, your cervix may soften and contractions may begin.
Your membranes can only be swept once your cervix opens enough for your doctor to insert a finger. Membrane sweeping to induce labor works for one in eight women. It’s one of the less risky labor-induction techniques.
Pros and Cons of Membrane Sweeping
Pros of membrane sweeping. The idea of forcing your body into labor may be daunting, but this technique has been used for decades.
Compare membrane sweeping to other ways to induce labor:
- Taking medicine that softens your cervix
- Taking medicine that causes your uterus to contract
- Using a balloon catheter to encourage the cervix to open
- Having medicine inserted vaginally to ripen your cervix
When membrane sweeping works and labor begins, there’s no need to help labor along with drugs like oxytocin, by breaking your water, or by using other, more invasive methods.
It’s considered a safe way to speed up your labor without increasing your risk for infection. It can also prevent you from needing to deliver via C-section.
Cons of membrane sweeping. You may start to feel uncomfortable afterward, with irregular contractions and some bleeding. In addition, if membrane sweeping brings on too many contractions, your uterus may be overstimulated.
Too many contractions can put you at risk for:
- Irregular fetal heart rate
- Too much pressure on your umbilical cord
- Uterine tear
- Increased risk of cesarean birth
- Fetal death
Medical problems you may have had before or during your pregnancy can also contribute to these complications. Your doctor will weigh the pros and cons of membrane sweeping before using it to induce your labor.
Risks of Not Having Labor Induced
Your health. If your doctor wants to sweep your membranes or use any other labor-induction technique around the time of your due date, take this into account: If you let your pregnancy go past full-term, you will be at greater risk of a difficult delivery as your baby continues to grow in utero.
You’re also at an increased risk for a type of high blood pressure that's associated with pregnancy, after your due date.
Your baby’s health. Your baby is also at risk as your pregnancy stretches on. With each passing week, the placenta becomes less effective at passing nutrients and blood to your baby. A baby that grows larger than your birth canal will allow for, may be stressed during delivery. A C-section may become unavoidable.
Staying pregnant longer can increase the risk of your baby passing their first meconium stool in utero. If your baby breathes meconium in the birth canal, it greatly increases their risk of developing an infection. A baby born after 42 weeks of gestation also has an increased risk of sudden infant death syndrome (SIDS).
what to do when you don't feel like doing anything
motivation
2 3 minutes of reading
So, it's morning and it's time to get out of bed.
Children must go to school, and you and your spouse must be ready to go to work. But there's a problem, you don't want to get out of bed. Instead, you'd rather be in bed all day with warm blankets hidden from the world.
I've been here. I know what it's like to be afraid to hear the alarm go off in the morning, signaling that it's time to start the day. It's not a good feeling, especially when you know you have to get up. If you are a mom, you can agree that if you don't get up, the whole house is in danger. nine0003
Here are some tips and motivations to start your day:
Go to bed early
If you are a night owl, you can stay up late and even work better at night. But when you have kids, a job, a spouse you care about, you probably need some rest. It's tempting to go to bed after midnight to have some "quiet time," but perhaps you should put the kids to bed earlier so you can have that quiet time. It may take your body some time to adjust, but you will eventually get used to going to bed at normal hours.
nine0008 Take a break
If it has been some time since you took a holiday or holiday, you may have a holiday. I know it can be difficult for you if you have to work to pay your bills. But at some point, if you are tired of the constant hustle and bustle of life, you should try to plan a little vacation. We all need a break sometimes, that's okay. Consider asking your boss about having a mental health day If you're married, talk to your spouse about traveling together or on your own. This might be the breath of fresh air you need. nine0008 Call grandparents
If your parents live nearby or can afford to visit you, invite them. Most parents would like to be able to visit and see their grandchildren if they could. Even if it's a short trip, they can give you the break you need. Having your parents as support for you and your family can take a huge burden off your shoulders. This can make you feel refreshed and regain focus and energy. nine0008 Check your diet
Our diet plays a big role in why we feel what we do.
When we eat donut instead of mashed potatoes in the morning instead of breakfast, it will eventually catch up with us. Our body needs proper nutrients to give us the energy to get through our day. When we don't drink enough water, eat mostly fast food, sweets and starchy foods, then our body can start to feel a bit sluggish. Our bodies can be depleted faster than usual. nine0008 Take some time to think about what you have been eating for the past week or two. This may be the reason why you feel more tired than usual.
Include fun things in your day
Without fun, our days can feel flat, leaving us with nothing to look forward to. Feel fair and worry a little about your day. If you like to read, take this novel. If you're more adventurous, take a short excursion after work on a Friday afternoon. Plan a mid-week movie night with family and popcorn. Whatever you do, make sure it's something you expect and enjoy. nine0008 Talk to the professionals
-
The Lancet says stents are safe and effective in India
If you've tried everything and nothing works, you may want to see a therapist.
They are trained professionals and can help if you think you have a really serious problem. It's scary to talk to a complete stranger who says he can help you. But if you have exhausted all your options, then it may be time to turn to a professional. nine0003
If you or someone you know is struggling with depression, know that you are not alone. There are treatment options, community support, and resources available to you or your loved one.
If you or someone you know is in an immediate crisis, seek help by calling the National Human Rescue Service at 1-800-273-TALK (1-800-273-8255) or visit the International Association for Suicide Prevention to be associated with a trained counselor at a crisis center nearby. nine0033
As your due date approaches, your anxiety and anxiety increase.
You can expect your difficult pain at any time. As a rule, after 40 weeks of pregnancy, labor pains occur in pregnant women. But in some cases, contractions are not observed even after the date of birth. In such scenarios, a manual procedure is performed to trigger the contractions. Membrane reaming is the first and most basic procedure performed by doctors, nurses, or midwives to induce labor. nine0003
What is the membrane cycle?
Membrane reaming or cervical stripping is a manual process used to stimulate the cervix. The doctor or midwife will insert a gloved finger, feel the neck of a full-term pregnant woman, and gently but firmly run the finger. This sweeping up of the thin membranes of the amniotic sac is also called membrane stripping. Sweeping the membrane separates the sac from the cervix and helps release prostaglandins (hormones that can cause labor pains). Membrane stripping is also referred to as the "stretch and ream" process because, if no sweeping is required, cervical stretching is performed to manually stimulate the cervix.
nine0003
How is it done?
The pregnant woman is asked to lie down with her legs together and her knees on either side (lithotomy position). When the woman is comfortable, the doctor inserts a (gloved) finger into the vagina. Feeling the cervix, the doctor gently sweeps the cervical region. As discussed earlier, this process of unfolding and stretching separates the amniotic sac from the cervix and promotes the release of prostaglandin hormones. The release of these hormones causes pain and leads to labor and delivery. The membrane stripping procedure is the main and widely used method because it does not involve any medication. nine0003
Is membrane stripping safe?
Studies show that membrane removal does not carry any major risks and is considered safe. According to a study published in the Journal of Clinical Gynecology and Obstetrics:
- There were no negative side effects due to membrane stripping.
- Women who have had their membranes removed are unlikely to experience complications during childbirth.
Is membrane sweeping effective? nine0089
Research experts find it difficult to conclude whether membrane sweeping is effective Various studies have been conducted to analyze the effectiveness of membrane sweeping. One such review concluded that effectiveness depends on the period of pregnancy when the procedure is performed, as well as whether women have used other methods to induce labor.
For pregnant women who are about to give birth, this procedure can be very effective. It was also found that women who underwent the procedure continued to experience labor pains and were born soon after. However, it is important to note that membrane sweeping may not be as effective as other methods or procedures that use drugs. Thus, the removal of membranes can be considered as an effective option in cases where there is no urgent medical reason to induce labor pains with drugs. nine0003
When is it offered?
Prolongation of pregnancy may affect the health of the baby and mother.
After forty-two weeks, your placenta may not be able to provide your baby with enough oxygen and food, which can compromise or affect growth. Therefore, your doctor may suggest removal of the membrane in the following cases:
- You have crossed the deadline and still have not experienced difficult pain. Ideally, this will be after the completion of 40-th th week of pregnancy.
- As a rule, for new mothers, if labor does not begin at 41- and weeks, membrane stripping is necessary.
- For women who have already given birth before, doctors advise a membrane insertion if labor pain persists even after 42 weeks.
- There is an emergency and the baby must be delivered as soon as possible.
When should I avoid it? nine0089
Doctors avoid sweeping the membrane in the following cases:
- If the pregnant woman bleeds.
- If a woman has a B-streptococcus infection, removing the membranes may make the situation worse.
- If a woman cannot have a vaginal delivery due to complications from the doctor.
Membrane stripping risks
Membrane detachment has some risks such as rupture of the amniotic sac, leaving the baby exposed to possible infections. You may also experience cramps 24 hours after stripping, which can disrupt your sleep before labor begins. nine0003
Pros
Below are some of the benefits of membrane removal:
- This is a natural procedure and does not require any medication.
- It reduces the chances of a caesarean section by causing labor.
- The procedure is quite simple and can be done by a midwife too.
- As a rule, little intervention is required after the membrane reaming procedure.
Cons
Below are some of the disadvantages of membrane stripping:
- This is not always effective and may take several times to induce labor.
- This should not be done unless a doctor advises vaginal delivery.
- This is inconvenient because the cervix may be located deep inside and may not be accessible.
- It is possible that the water bag may break during the procedure, exposing the child to infections.
Does it hurt?
Sweeping the membrane is not painful, but definitely uncomfortable. The procedure lasts only 5 to 10 minutes and can be made easier with relaxation techniques and breathing exercises. If you are not completely sure about the procedure, you can choose other methods to induce labor pain. nine0003
What happens after a cervical smear?
Cervical reaming or cervical smear is not very pleasant and may be uncomfortable. There are many blood vessels in the cervix, so you may feel pain or bleed after the procedure. In case of heavy bleeding, see your doctor and make sure you go to the hospital right away.
Some Important Facts About Diaphragm Purge
Here are some important facts about membrane removal:
- restlessness
Removal of the membrane may cause anxiety in some women.
It is recommended that you rest a lot after removing the membrane, as you might be worried about delay.
- awkwardness
Some discomfort may be felt after the removal of the membrane, as it is difficult to reach the cervix in a full-term pregnancy. It can also be painful in some cases. You can do some basic breathing exercises to help you relax during the procedure. Some women experience light spots and irregular contractions after the procedure. nine0003
- Passing your due date
It is quite unusual for women to go through the last 42 weeks of pregnancy. Usually 41 weeks is the maximum for a normal delivery, but 3 out of every 100 women go through after 41 weeks. In this case, the doctor will try to strip the membrane to naturally induce labor.
In many cases, labor pains occur on or before the due date. However, in cases where this is delayed and doctors believe that labor must be induced, then the most common procedure is membrane sweeping.
