A healthcare provider does a membrane sweep with a gloved finger during labor. They may sweep the membrane that connects the amniotic sac to wall it off from the uterus after the cervix is dilated. This is also called stripping the membranes or sweeping the membranes and may speed up the labor process. It is not possible to do this maneuver when the cervix is closed.
Read on to know more about the membrane sweep, when it is done, and how it speeds up the labor process.
What Is A Membrane Sweep?
Membrane sweeping, also known as cervical sweeping or membrane stripping, manually stimulates the cervix to release the hormone called prostaglandins, for promoting the onset of natural labor (1).
It could be a useful method but might also bring discomfort, irregular contractions, and some bleeding. This technique may also reduce the need for other medical interventions such as prostaglandins and oxytocins for inducing labor or even a C-section for delivering the child (2).
Doctors or midwives may recommend this procedure, but only under certain circumstances.
When Is A Membrane Sweep Done?
A membrane sweep is offered if the pregnancy is prolonged.
- If you are a first-time mom, it might be done during the 40th week of pregnancy.
- If you have given birth before, then it could be done at 41 weeks (3).
A membrane sweep could be one of the safest and non-invasive methods that may not pose any risk. Keep reading to understand how the procedure is done.
How Is It Done?
Membrane sweeping is done for women who are planning a vaginal birth. The procedure is explained below (4):
- The doctor checks the estimated delivery date.
- You may be asked to empty your bladder and lie on the labor table.
- The mattress is tilted towards the left side to avoid supine hypertension.
- The doctor inserts a finger into the vagina to feel the cervix and the position of the baby. They check if the cervix is favorable for carrying out this procedure.
- If yes, a gentle and circular sweep movement is done inside the cervix to separate the amniotic sac from the uterine wall and the cervix. This is likely to promote the release of prostaglandins and facilitate childbirth.
- This might, therefore, improve the chances of onset of labor within 48 hours and delivery within one week.
The condition of the cervix could be a determining factor for the effectiveness of this method.
- If the cervix is unfavorable or uneffaced, then this procedure may not be carried out.
- If the cervix is soft but closed, then a cervical massage is offered until it allows the insertion of a finger, to increase the effectiveness of this procedure.
- If the cervix doesn’t open, massaging around the vaginal fornices may stimulate the release of prostaglandins. If labor pain doesn’t start even after 36 hours, then this process might be repeated.
After the procedure is done, you may have to follow certain instructions given by your doctor.
What To Expect After The Procedure?
Once the procedure is done,
- You may have to wear a sanitary pad and wait for labor.
- The doctor might advise you to take a warm bath and paracetamol in case of painful contractions and discomfort.
- You should seek immediate medical attention in case of blood loss, unbearable pain, or spontaneous rupture of membrane.
The procedure may have to be repeated if the labor doesn’t start within the expected time.
Although this procedure is considered ideal for inducing natural labor, it is not always recommended.
When Should You Not Get A Membrane Sweep Done?
Membrane sweep may not be carried out under the following conditions:
- Rupture of membrane
- Low lying placenta
- Closed cervix
- The baby’s head is not engaged
- When the mother is Rh-negative
- Vaginal infections
Membrane sweeping has its advantages and disadvantages. Let us see what they are.
Advantages And Disadvantages Of Membrane Sweep
Like many other procedures, membrane sweep also has its pros and cons (6):
- Promotes the onset of spontaneous labor.
- Requires no hospital admission as it could be done during a regular pregnancy check-up.
- Considered to be safe and efficient.
- Uncomfortable and slightly painful.
- May not start labor in the first attempt itself.
- Risk of rupturing the amniotic sac.
- Vaginal bleeding, spotting, and irregular contractions might be experienced post-procedure.
This procedure is used to initiate labor naturally, owing to its success rate, albeit low.
What Is The Success Rate Of Membrane Sweep?
According to a review published in the British Journal of Obstetrics & Gynecology, membrane sweeping was found to increase the possibility of labor within 48 hours by 24%. The chances of delivering within a week were about 46 %, and chances of the delivery not being prolonged over two weeks were about 74% (7).
Frequently Asked Questions
1. How do you know if membrane sweep has worked?
The presence of the usual signs of labor such as cramping, regular and stronger uterine contractions, vaginal spotting or bleeding, loss of mucus plug, water break, increased dilation of the cervix, heavy bleeding or severe pain in about 48 hours after membrane sweep may indicate that the procedure worked (8) (9).
2. Does membrane sweep remove mucus plug?
Yes, you may lose your mucus plug if the labor starts after the membrane sweep (8). However, inform your doctor if you notice profuse bleeding along with losing your mucus plug.
3. How do you know if the membrane sweep doesn’t work?
Most women experience symptoms of labor within 48 hours of the procedure. While some may take a little longer, if you do not experience any symptoms at all, even past 48 hours, it may indicate that the procedure did not work. Your Ob/Gyn will help you confirm if the procedure worked or not (8) (9).
4. What makes a membrane sweep successful?
There may be more chances of a membrane sweep being successful if you are past your due date, are already in the early stages of labor, or have a thin, soft, or dilated cervix (8).
5. How far dilated do you have to be for a membrane sweep?
You need to be dilated by about 1-2cm or at least enough for a doctor to pass their finger and perform the sweep (8).
A membrane sweep to induce labor naturally and speed up the process may help you ease your delivery. It is a smooth and easy process that may not cause any concern. However, because it can be a bit unpleasant and has certain risks, you should evaluate the benefits and drawbacks, as well as discuss the details and efficacy of the procedure with your doctor before deciding to go ahead with it.
2. MG Nyamz et al.; Effectiveness of sweeping of membranes in reducing the incidence of elective induction of labor for postdate pregnancies; Archives of Medicine and Surgery
3. Membrane Sweep; North Bristol NHS Trust
4. Membrane sweeping and induction of labour; Maidstone and Tunbridge Wells NHS Trust
5. Sweeping of the Membranes at Term; Midwifery Led Unit – Cavan General Hospital
6. Pregnancy Beyond 41 Weeks; Expert Advisory Group of NSW Ministry of Health (2014)
7. Sweeping The Membranes; Midwifery.org, UK
8. Membrane Sweep; Cleveland Clinic
9. Membrane Sweeping; Wiley Online Library