How to stretch your cervix
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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Stretch and Sweep: Is It Safe?
Stretch and Sweep: Is It Safe?Medically reviewed by Debra Sullivan, Ph.D., MSN, R.N., CNE, COI — By Rachel Nall, MSN, CRNA on April 6, 2016
You’ve reached your due date or have gone past it, but still haven’t gone into labor. At this point, your doctor may offer you additional options to welcome your baby into the world.
One option is inducing labor with medicine that stimulates contractions. Another option is called a “stretch and sweep.” Stretch and sweep is also known as membrane sweeping, or stripping of membranes. This option is thought to stimulate labor without administering medications or performing a cesarean delivery.
Here’s what to expect during and after membrane sweeping.
Your membranes are another name for the amniotic sac. This is where your baby grows and develops for nine months. Doctors may perform a membrane sweep in a doctor’s office, at home, or at a hospital. The process typically takes less than 10 minutes. Your doctor will first apply sterile gloves.
Your doctor will then perform a cervical examination to determine if your cervix is open. If the cervix is open, they will insert a finger into your cervix and perform a sweeping motion. This will separate your membranes from your cervix. If the cervix isn’t open, a stretch and sweep can’t be performed.
A membrane sweep is intended to stimulate the release of hormones known as prostaglandins.
Prostaglandins are hormones that are associated with labor because they cause smooth muscle contractions. This includes contractions of the uterus that can lead to labor. The contractions are thought to “ripen” the cervix, or cause the cervix to soften so that a baby can more easily pass through the birth canal.
Doctors intend for a stretch and sweep to stimulate labor within 48 hours. But if a stretch and sweep doesn’t prove successful, a doctor may make further recommendations for inducing labor, depending on how far along you are and the health of you and your baby.
Some women shouldn’t have a stretch and sweep.
Doctors won’t usually perform a stretch and sweep if:
- baby’s head isn’t pointing downward
- you aren’t 40 weeks pregnant or more
- you have a vaginal infection
- your membranes have already ruptured (your water has broken)
- your placenta is low-lying
There isn’t any data to indicate that stretch and sweep increases the risk of infection to mother and baby when it’s properly performed.
According to a review of study data published in The Cochrane Review, stretch and sweep performed at term labor was associated with reduced labor duration and pregnancy duration. The review examined 22 studies that included nearly 3,000 women. However, the study did find that women who underwent stretch and sweep reported symptoms such as bleeding, irregular contractions, and discomfort during vaginal examination.
Stretch and sweep can cause side effects, including:
- bloody show or mild bleeding (may appear brown with time)
- cramping that can feel like menstrual cramping
- discomfort during the procedure
- irregular contractions
There’s also a risk that a stretch and sweep could break the amniotic sac. This is sometimes known as your water breaking. Some women can have irregular contractions, and they may not necessarily lead to labor.
If you experience side effects like bleeding bright red blood, your water breaking, or intense pain that doesn’t decrease with time, call your doctor.
You shouldn’t attempt to perform a stretch and sweep on yourself. Only a licensed professional should do it.
Stretch and sweep is a process thought to increase a woman’s likelihood for going into labor spontaneously, without the interventions of medications and/or surgery. Women who wish to go into labor naturally may prefer this option when compared to medical induction. If the stretch and sweep isn’t effective the first time, a doctor may repeat it at a later time, usually a week later. They usually won’t perform the procedure two days apart or less.
If your body doesn’t respond to this, medical induction or a cesarean delivery may be necessary. This is because there are risks if your pregnancy goes past 42 weeks. For example, the placenta may not be able to provide enough oxygen to your baby at 42 weeks. Talk to your doctor about options to stimulate labor, and the risks and benefits.
A:
Answers represent the opinions of our medical experts.
All content is strictly informational and should not be considered medical advice.
Last medically reviewed on April 6, 2016
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How we reviewed this article:
Healthline has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. We avoid using tertiary references. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.
- How to perform a stretch and sweep. (2012, January 19)
- Inducing labor. (2015, December 2)
nhs.uk/conditions/pregnancy-and-baby/pages/induction-labour.aspx - Membrane sweep in pregnancy. (2016, January)
- Membrane sweeping for induction of labour. (2009, July 31)
- Stretch and sweep. (2015, May)
pregnancybirthbaby.
org.au/stretch-and-sweep - Stripping membranes. (2009). Journal of Midwifery & Women’s Health, 53(3), 259-260
medscape.com/viewarticle/703499
Our experts continually monitor the health and wellness space, and we update our articles when new information becomes available.
Current Version
Apr 6, 2016
Written By
Rachel Nall, MSN, CRNA
Edited By
Nizam Khan (TechSpace)
Medically Reviewed By
Debra Sullivan, PhD, MSN, RN, CNE, COI
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Medically reviewed by Debra Sullivan, Ph.D., MSN, R.N., CNE, COI — By Rachel Nall, MSN, CRNA on April 6, 2016
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Preparing the cervix for childbirth
Now your nine months of waiting are coming to an end, soon you will see your long-awaited miracle. And at this stage, the question arises of preparing the cervix for childbirth.
The readiness of the pregnant woman's body for childbirth, the condition of the cervix largely determine the course and outcome of childbirth. The most important hormones that determine the course of labor are estrogens, oxytocin, corticosteroids and prostaglandins. The concentration of estrogens and prostaglandins increases towards the end of pregnancy, and the concentration of progesterone begins to decrease, starting from the 36th week of pregnancy, which leads to the preparation of the cervix, its softening and shortening.
Assessing the readiness of the cervix for childbirth
Timely and correct assessment of the state of readiness ("maturity") of the cervix for childbirth is of great importance in determining the prognosis of the course of the upcoming birth. In the perinatal center "Maternity Hospital on Furshtatskaya", the assessment of the readiness of the cervix for childbirth is carried out by an individual obstetrician-gynecologist, who subsequently conducts your birth.
At 39 weeks, your individual doctor will conduct an internal obstetric examination and make a conclusion about the readiness of the cervix for childbirth. To assess readiness, the Bishop scale is most widely used, which takes into account such signs as: the consistency of the cervix, its length, location in relation to the wire axis of the pelvis, the patency of the cervical canal and the location of the presenting part of the fetus. Each feature is scored from 0 to 2 points. With a score of 0-4 points, the cervix is \u200b\u200bconsidered immature, 5 points - insufficiently mature, more than 5 - mature.
In the department of pathology of pregnant women of the perinatal center "Maternity hospital on Furshtatskaya", our highly qualified specialists will help assess the readiness of the cervix for childbirth using the modern rapid test Actim™Partus, the principle of which is to determine a specific protein (a phosphorylated form of protein-1 that binds insulin-like growth factor) in the mucus of the cervical canal, which is released shortly before the onset of childbirth.
Non-pharmacological methods of preparation of the cervix.
From 36 weeks, after consultation with your individual doctor and there are no contraindications, you can start preparing the cervix for childbirth on your own. Non-drug methods of preparing the cervix for childbirth after 36 weeks include regular sex life without a condom. Since the male seed contains natural prostaglandins that soften the cervix. Moderate physical activity (hiking, swimming, yoga for pregnant women) also contributes to the formation of a favorable hormonal and emotional background to prepare for childbirth. In the last weeks of pregnancy, the diet should increase the amount of fish, vegetable oils (olive, linseed), lactic acid products, reduce the amount of animal proteins and fats.
Medicamentous and mixed methods of preparation of the cervix
After 39 weeks of pregnancy, with insufficiently “mature” cervix, its preparation begins with various methods.
In outpatient practice, antispasmodics are widely used, which lower the tone of the smooth muscles of the internal organs and reduce their contractile activity.
They also use instrumental methods for preparing the soft birth canal (methods of acupuncture, massage, intranasal electrical stimulation, acupuncture).
In the conditions of the department of pathology of pregnant women of our medical perinatal center, preparation of the cervix is carried out after a complete clinical and laboratory examination of the mother and assessment of the condition of the fetus (fetodoplerometry and cardiotocography). Preparation is carried out by introducing kelp, prostaglandins and the use of synthetic antigestagens.
Natural and artificial kelp are used in obstetrics. Natural kelp is a seaweed that is found in the northern and Far Eastern seas, two types of kelp are used: Laminaria digitata (finger-dissected) and Laminaria japonica (Japanese). Sticks 6-7 cm long and 2-3 mm in diameter are made from specially processed kelp. A strong silk thread is passed through the stick, for which the used dilator is removed. Due to its hygroscopicity, already 3-4 hours after entering the liquid, kelp swells in diameter, reaching a maximum expansion of 3-5 times after 24 hours, and its consistency from dense turns into much softer and resembles rubber.
An important positive feature is that, by expanding the cervical canal up to 9-12 mm, kelp after swelling remains unchanged in length.
Prostaglandins are a highly effective means of preparing the cervix. The introduction of prostaglandin E2 leads both to the "ripening" of the cervix, and causes contractions of the myometrium as a starting point for the onset of labor. Currently, intracervical administration of Prepedil gel and intravaginal administration of Cervidil gel are used. Mifepristone is a synthetic antigestagen that competes with progesterone at the level of its receptors and removes its inhibitory effect. The use of mifepristone provides a "soft" process of "ripening" of the cervix, does not cause hyperstimulation of the contractile activity of the uterus and does not adversely affect the condition of the fetus and newborn, in most cases leads to complete "ripening" of the cervix, which is the key to spontaneous childbirth with a favorable outcome .
The author of the article is Chorba Elena Mikhailovna, personal doctor for childbirth, obstetrician-gynecologist of the Center for the Correction of Pathology of Pregnancy of the Family Clinic "Maternity on Furshtatskaya"
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What will help in childbirth - articles from the specialists of the clinic "Mother and Child"
Vovk Lyudmila Anatolyevna
Reproductologist, Obstetrician-gynecologist
Lapino-1 Clinical Hospital "Mother and Child"
We walk and dance
If earlier in the maternity hospital with the onset of labor a woman was put to bed, now obstetricians, on the contrary, recommend that the expectant mother move . For example, you can just walk: the rhythm of steps soothes, and gravity helps the neck to open faster. You need to walk as fast as it is convenient, without sprinting up the stairs, it’s better to just “cut circles” along the corridor or ward, from time to time (during the aggravation of the fight) resting on something. The gait does not matter - you can roll over like a duck, rotate your hips, walk with your legs wide apart. It is worth trying and dancing, even if you think that you do not know how. For example, you can swing your hips back and forth, describe circles and figure eights with your fifth point, sway in a knee-elbow position.
The main thing is to move smoothly and slowly, without sudden movements.
Showering and bathing
For many people, water is a great way to relieve fatigue and tension, and it also helps with painful contractions. You can just stand in the shower, or you can lie down in the bath. Warm water will warm the muscles of the back and abdomen, they will relax, and the birth canal will relax - as a result, the pain may decrease. Well, if it does not decrease, then in any case, the water will relieve stress and at least for a while distract from the pain. So if there is a shower or jacuzzi bath in the delivery room, do not be shy and try this method of pain relief for contractions. The only thing is that the water should not be too hot, even if it seems that heat helps to better endure contractions.
Swinging on the ball
Until recently, fitball (rubber inflatable ball) in the rodblock was something outlandish, and today is found in many maternity hospitals.
And if you find a fitball in your rodblock, be sure to use it. You can sit on the ball astride and swing, rotate the pelvis, spring, roll from side to side. You can also kneel down, lean on the ball with your hands and chest and sway back and forth. All these movements on the ball will relax the muscles, increase the mobility of the pelvic bones, improve the opening of the neck, and reduce the pain of contractions. And while the woman is sitting on the ball, her partner (usually her husband) can massage her neck area for additional relaxation.
To be more comfortable, the ball should be soft, slightly deflated, and large, with a diameter of at least 75 cm.
We hang on a rope or wall bars
When the contractions become very strong and painful, you can take poses in which the stomach is in a “suspended” state. Some advanced maternity hospitals have wall bars and ropes attached to the ceiling for this. During contraction, you can hang on them, as a result, the weight of the uterus will put less pressure on large blood vessels, and this will improve uteroplacental blood flow.
In addition, in the “suspended” position, the load from the spine will be removed, which will also reduce pain.
Do not hang on a rope or a wall only if there is a desire to push, and the cervix has not yet opened and the efforts must be restrained.
Lying comfortably
If during childbirth a woman wants not to move, but, on the contrary, to lie down, then, of course, she can lie down. In modern maternity hospitals, instead of traditional ones, there are transforming beds: you can change their height, lower or raise the headboard or foot end, adjust the tilt level, push or push some part of the bed. There are also handrails in transforming beds (to use them to rest or even hang on them), and leg supports, and retractable pillows, and special backs - in general, everything in order to fit the bed under you and take it with it comfortable position. Moreover, this can be done without any physical effort - using the remote control.
We use everything we have
In any roadblock, even if it is minimally equipped, you can still find something useful.
For example, if during a fight you want to take a position with a support, you can lean forward and rest against something that turns up under your arm - a table, a headboard, a window sill. The main thing is that the support must be very stable. You can also get on all fours in the “cat pose” and focus on your hands, and to make it more convenient, put a pillow and a folded blanket under your chest. If you want to hang on something (and there is no rope or wall) and your husband will be nearby, you can use postures that allow you to transfer body weight to him: for example, hang on your husband’s neck. In general, it is worth showing imagination and adapting any item in the rodblock to your needs.
And don't be afraid to look stupid during childbirth. No one in the delivery room cares about how you move or lie down as long as it helps you get through your contractions, so calmly find your comfortable position.
Giving birth in an uncomfortable position is both difficult and inefficient.
