This is a question that is asked over and over again. I was offered a sweep, does it work? HOW does it work? Are there any risks? And even more importantly, does it hurt?
You’re around your due date, feel VERY pregnant, heavy and uncomfortable and you feel like you would try anything to have this baby right now. Then your health care provider offers you a membrane sweep, also known as stretch and sweep or stripping the membranes to bring on labour. It seems like a simple way to get things going but there are a few things you should know before making an informed decision. After all, this is a procedure that you have to consent to!
Despite the recommendations of the World Health Organisation and the NICE Guidelines, which do not recommend intervention in a low risk pregnancy until between 41 and 42 weeks, most hospitals have a policy of medical induction around 10 days after the estimated due date (41 + 3). A sweep is generally indicated before using medical induction methods and works by stimulating the production of prostaglandin, the hormone that prepares your cervix for labour. It is performed by inserting a gloved finger into your vagina and into the cervix. First, your cervix is checked to see how effaced (thinned) and dilated it is and then, by using a firm circular motion, the membranes are separated from the cervix.
Is it effective?
Hard to say. Research has shown that approximately one of eight women who had a sweep and were at least 40 weeks went into labour within 48 hours. A sweep can also decrease the length of your pregnancy by between one and four days and some studies show that it can reduce your chances of needing medical induction.
What are the cons?
First of all, a sweep should only ever be performed with your informed consent. Your health care provider should advise you of all the pros and cons associated with the procedure and should give you the opportunity to ask any questions you might have. Should you decide this is NOT for you, you absolutely have the right to politely decline and go your way.
A sweep can’t always be performed. Unless you are at least 1 cm dilated, it can’t be done.
After a sweep you will most likely lose some or all of your mucous plug. It can also cause bleeding and irregular contractions that do not progress into labour.
While most women say that they experienced only slight discomfort during a sweep, others find it quite painful.
In about 10% of all cases, membranes are accidentally ruptured during a sweep. This can lead to longer labours and, in some cases, medical inductions and further interventions. AROM (articifial rupture of membranes) is a method of induction and has its own risks, including the introduction of pathogens into the vagina and the uterus.
So it’s up to you to make a choice! Remember, it is your decision whether you have a sweep. Or not.