A membrane sweep is a procedure that is performed with the aim of inducing labor, to prevent it from going overdue.
Normally, your doctor or midwife will recommend performing a membrane sweep in order to get your labor going, before any other labor induction method can be considered.
The success rates may vary at 37, 38, 39 and 40 weeks. Before choosing thise method, it is important to know the risks involved, and the safety of the entire procedure.
Other than details on those, here’s what a bloody show and cramping after membrane stripping mean.
What is a membrane sweep?
Also known as membrane stripping or a stretch and sweep, this is a procedure performed by a doctor or professional midwife, whose sole purpose is to try and start your labor artificially. Medical experts suggest this method as it is deemed to be more natural, given the fact that it does not require any medication.
- The primary idea behind this labor induction procedure is to help stimulate increased production of the prostaglandin hormone.
- The hormone’s goal is to ensure that your cervix is ready for labor.
- The care provider will insert a finger into your cervix. Once inside, it will be firmly moved in circular motions.
- In the process, amniotic sac membranes will be separated from the cervix.
- Membrane sweeping can be performed anywhere from 37, 38, 39, to 40 weeks of pregnancy.
Membrane sweep at 38 weeks
For a woman expecting to deliver twins, with a vaginal delivery being anticipated, you are likely to have your first sweep at 37 weeks.
After 37 to 38 weeks, your body is likely to become very tired, and it would be ideal to start inducing labor. In the case of twins, the success rate of a membrane sweep improves significantly after thirty-seven weeks.
Some obstetricians and midwives will perform a membrane strip on each prenatal visit starting from thirty-eight weeks of gestation. But, it is imperative to note that the procedure can be quite risky, and is not necessary medically unless there are underlying medical reasons to perform it.
In case you get a sweep at 38 weeks and fail to go into labor, your midwife or doctor could perform an artificial membrane rupture. You will then be started on a Pitocin IV infusion.
At 39 weeks
In many pregnancies related cases, physicians will normally suggest artificially inducing labor, instead of waiting for the normal pain to begin.
In the United States, one out of every five women opt to induce labor artificially [Mayo Clinic]
In such cases, the women opt to have the membrane stripping performed at 39 weeks if they notice that their labor is not coming naturally, or in case they have other medical conditions. But, it is also possible to have your membrane swept earlier, as seen above.
Labor induction can be performed for a number of reasons e.g. if you are suffering from a chronic fitness condition e.g. diabetes or hypertension.
Additionally, failure to increase the fetal body weight is another factor considered when making the decision to induce labor.
After this procedure, many women encounter different experiences, with all expressing varying feelings. But common complaints observed in many membrane sweeping procedures include:
- Light spotting
- Minor uterine contractions
As a result, many pregnant women choose to consult their midwives to gain a better understanding of how they will feel after the sweep, as well as what will be done.
It is important to note that there is no guarantee that the sweep will work in inducing labor. Its success rate is dependent on whether your body is ready to give birth to your child or not.
As your midwife is examining your cervix, they will aim to locate the position of the cervix. In case your cervix has softened and began to efface, the procedure and induction will become much easier.
However, if your cervix is still sitting pretty high, your midwife will ask you to wait a bit longer before a cervical sweep or labor induction can be carried out.
In the event that you do not experience any labor pain after the sweep, alternative artificial labor inducing methods will be performed in a maternity unit.
Bloody show after membrane stripping
Are you noticing a bloody show after a membrane sweep? Is it a good sign? How much longer after the bloody show will I get labor and give birth? Well, there is a possibility that you will experience bleeding after you have had a cervical check or after your membrane has been swept.
- Any time your cervix becomes irritated, even slightly, it could lead to bleeding taking place.
- When the procedure is completed, you are likely going to experience spotting and cramping all day, which may be accompanied by terrible pain or cramping.
- In certain stripping cases, it may take as long as five days before going into labor.
Therefore, the bloody show after sweeping your membrane may be a good indication, but also, it may mean nothing. You, therefore, must be mentally prepared for any eventuality.
How is it done? (Procedure)
Traditionally, membrane sweeping is performed by an obstetrician or a midwife in a community setting, and will not require any special preparations. Therefore, this procedure can be performed at an antenatal clinic led by a midwife or at home.
All that is required is for the environment to be private and safe. Prior to making arrangements to perform this procedure, your midwife will have determined the exact gestation period, by going through your booking scan logs.
The procedure involves the following steps:
- An obstetrician will provide an explanation of what will happen during the procedure, as well as the length of time it will take (it normally takes about ten minutes).
- If you experience any discomfort, you will be encouraged to take shallow, relaxed breaths.
- Prior to the procedure starting, the physician or midwife will ask you to empty your bladder and then get rid of your underwear. A protective sheet will be placed on you to protect your dignity.
- You will then be required to lie on a bed, ensuring that your hands remain at your sides throughout. A tilt may be placed under your cushion as a way of preventing supine hypertension.
- An abdominal palpation will then be performed. Additionally, the professional will also listen to the fetal heart rate, while documenting all the findings.
- Using a gloved, lubricated hand, the professional will proceed to examine your vagina. This is meant to ascertain whether your cervix is in a favorable position for this procedure to be carried out.
- In case the cervix is unfavorable e.g. if it is high or uneffaced, the exercise may have to be pushed to a later date or abandoned altogether.
- In case this exercise is abandoned, your physician will proceed to make other arrangements to have the labor induced using other artificial ways.
- When your cervix is found to be closed, but still soft, a massage is performed around your cervix to allow finger insertion
- In the event that the cervix refuses to open, the effects of the massage could be all that is needed to stimulate prostaglandins release, which would then stimulate your labor.
- When the cervix is determined to be favorable, allowing for labor stimulation, your obstetrician will begin inserting a lone finger into your cervix. The finger that has been inserted is used in separating your amniotic sac from the cervix, and the uterine walls. It is achieved by making circular sweep like motions.
- You will need to use a sanitary pad at the end of this exercise.
- In the case of any painful contractions or discomfort, you will be advised to take a warm bath and some paracetamols.
- Additionally, you and your partner will be advised to visit a maternity unit if you are unable to cope with the resulting pain, there is fresh blood loss, or if the membranes rupture spontaneously.
- To-date, there does not exist any evidence determining the number of times that this exercise may be repeated. However, a sensible suggestion would be to undergo the exercise after every three days.
- If your labor does not take place spontaneously, a formal labor induction exercise will be arranged by your midwife.
Is it safe to do it yourself?
Even though you can attempt to perform a stretch and sweep yourself, this is not recommended. It is advisable to visit a professional midwife and obstetrician, who can then carry out the procedure in an environment that is safe and clean. You should understand that a stretch and sweep comes with risks e.g.
- Irregular contractions
- Experiencing discomfort during this procedure
- Mild bleeding or bloody show after the membrane strip
Therefore, it is best to have a professional perform the procedure. You will then be counseled on what to do, in case any complications arise after the exercise has been completed.
With membrane stripping, it is always best to understand that the procedure is not intended to put you into labor immediately. In some cases, you may not even go into labor. However, there are a few things that you can expect to experience when the sweeping is complete.
For instance, you can expect not only to be uncomfortable, but you could as well begin cramping. After the membrane stripping is complete, you are likely to experience mild contractions or cramps for the next twenty-four hours.
Additionally, you could notice slight spotting, for up to three days after the exercise has been performed.
Bleeding experienced may be brown, reddish, or pink, and it could be combined with cervical mucus. It is normal to experience contractions and spotting after a stripping exercise.
Although rare, there is an off-chance that you may start experiencing severe pain or notice bright red blood running down your legs, or soaking a single pad within a period of sixty minutes. If the latter occurs, you should get in touch with your midwife or health care provider right away.
Risks when inducing labor
Even though this method is recommended for some women during pregnancy, it is not for others. As is the case with most therapeutic procedures, there is always a risk attached to a stripping exercise. In this case, the risks include:
- The cramping you experience within the twenty-four hours after stripping has been completed can make it very difficult for you to rest or get enough sleep. What this means is that you are likely to lose some sleep before you go into the actual labor.
- Some women worry that this kind of exercise can cause the water bag to break or the mother and her child to become ill. However, recent studies have demonstrated that sweeping does not make any of these instances likely to take place.
- Medical experts have advised that it would not be safe for you to deliver your baby normallye. natural birth via the vagina.
- In the course of your pregnancy, you have experienced unexplained vaginal bleeding
- Attending doctors are of the opinion that you should have the baby urgently. Additionally, if the midwife has recommended inducing labor using medication, as opposed to natural methods.
You should try stripping if:
- You are ill, and your midwife or physician thinks that it would be ideal, even safer for you to deliver the baby at that moment.
- The infant is sick, and the medical professionals are of the opinion that this would be the right moment to deliver the baby.
- You have exceeded forty weeks and are around forty-two weeks pregnant.
The following are crucial facts that you should know about this labor inducing method:
Membrane stripping is not natural
Any procedure or method that is intended to kick-start the labor process before it spontaneously begins is not natural.
Even though the method is traditionally touted as being a viable alternative to other labor induction methods, the process is still mechanical in nature, in that it attempts to begin labor before the actual time has arrived.
Whereas labor induction may be necessary for life-saving situations, there are still many babies being born today ahead of time, because of non-medical reasons. Keep in mind that inducing labor comes with many risks, and as such, this process should not be taken lightly.
It can necessitate further interventions
Where an induction is required for medical reasons, the membrane sweep will appear to be a gentler option compared to other known medical methods. But, there exist cases of inductions that are being carried out for non-medical reasons e.g. convenience or when a baby has passed the initially estimated birth date (post dates).
It is always tempting to get a membrane strip in an attempt to get things moving along. However, as much as it may seem harmless compared to having a prostaglandin gel placed on the cervix, this is not always the case.
In the event that the induction does not lead to labor, there is a chance that your attending physician could recommend a medical induction. It occurs in cases where a physician does not support having to wait for labor to begin spontaneously.
Also, if your baby and your body are not ready for labor to start, there are chances that you could end up undergoing more interventions e.g. a C-section, vacuum assisted birth or the use of forceps. There is a probability that the infant may experience breathing related problems, because of being born early.
The procedure can be very painful
Membrane strips can only be performed after it has been established that the cervix is indeed favorable. This implies that your cervix will need to be slightly open (it should be at two centimeters dilated), and begin to soften.
When you are in your late pregnancy phase, the cervix may be slightly angled back towards the tailbone, which will make it a bit difficult to reach. In this type of posterior position, the sweep is likely to be painful, and in some cases even uncomfortable.
In cases when a cervix is closed but has already become soft, the physician can massage or stretch it in a bid to start the dilation process. The cervical stretching process may be very uncomfortable, and there are women who may experience a kind of sharp, shooting pain emanating from this region.
In a case where the induction is deemed necessary for medical reasons during pregnancy, the membrane stripping procedure will not be carried out on its own, as other induction methods will also be utilized.
But, the membrane stripping process can be performed when it is established that the cervix has become favorable. This is done with the aim of preventing further interventions later on.
You should only make the decision to have the sweep done after learning of the benefits and risks that are associated with this process. The choice should be yours, regardless of what your healthcare provider prefers.
- National Institute for Health and Clinical Excellence. (2008). Induction of labor: http://www.nice.org.uk/nicemedia/live/12012/41256/41256.pdf
- National Collaborating Centre for Women’s and Children’s Health. (2014). Care of healthy women and their babies during childbirth: nice.org.uk