August 04, 2022
A stretch and sweep (also know as "membrane sweeping" or just as a "sweep") is one of the most widespread interventions in pregnancy and labour. Many women have sweeps in late pregnancy and it is something that has become pretty routine. But what are they? And what are the benefits and the risks of having one?
A sweep is carried out by your midwife by manually inserting a (gloved) finger into your vagina and sweeping around your cervix (the lowest part of your womb) and if possible, inside the opening of your cervix. Your midwife will try to separate the membranes from your cervix. The extent to which this can be carried out will, in part, depend upon how far your cervix has progressed and how much your cervix has dilated (opened) in preparation for birth. If your body is not about to go into labour, a sweep may not be possible.
People usually opt for a sweep as a way of encouraging labour to start or progress more quickly. A sweep is often suggested as an alternative to inducing labour – but given that a sweep is done purely to encourage labour before it has naturally started, it is of course a means of induction! If you’re being told that it’s not a way of inducing labour…. why then would you do it? Surely that’s the only reason you’d accept a sweep? To bring on labour earlier than it would’ve otherwise happened?!
Some midwives encourage women to have a sweep on the basis that they know that as their pregnancy progresses they will come under pressure to have a hospital induction, and so they are trying to avoid that for them. But one form of intervention is not the only alternative to another form of intervention – there is a third option which is declining both!
When we are considering bringing labour on early, we always want to do as little as possible to kick-start things. My advice to clients is therefore always the same: Think about why you are wanting to end your pregnancy early. If you decide that the benefits of induction outweigh the risks of ending your pregnancy early, then a sweep is a great place to start! But it is a method of induction and it is a decision to give careful thought to.
We don’t have much evidence on them and the evidence that we have is of poor quality. A sweep is thought to increase the likelihood of you going into labour sooner than if you did not have one, however the evidence on this is mixed. It suggests that 1 in 8 women go into labour within the 48 hour period after the sweep – however given that sweeps are usually performed within the estimated ‘due period’, we don’t really know how many of these labours would have started at that point anyway!
It varies – depending on how relaxed you are and who is performing the sweep (as techniques will vary). It is common for it to feel uncomfortable.
Focusing on your breathing and relaxing as much as possible will help. If at any point you want to stop, tell your midwife and she must stop immediately.
Whenever you have any kind of vaginal examination there is a risk of infection – particularly after your waters have released. There is also a risk of light bleeding afterwards.
Sweeps are an invasive procedure and of course can feel uncomfortable or painful and so the body’s response to that will be to produce adrenaline. Adrenaline is unhelpful for labour because the body receives the message that there’s something causing you to feel stressed / anxious / unsafe etc – and so the body’s response will often be “Must not labour now! Must wait until it's safe to be in labour and for this baby to be born!”
Occasionally midwives and doctors accidentally break the amniotic sac when performing a sweep, causing your waters to release. This is not thought to be very common, but if it does happen it will mean that the pressure to have a hospital induction will be increased as your risk of infection then rises. This can feel ironic when the thing you were doing to try and avoid a hospital induction has just made it a lot more likely!
Sweeps may also result in irregular contractions which fail to progress to active labour. This can mean that by the time you do eventually go into labour you are exhausted after days of discomfort - not a great start to your labour.
Possibly…possibly not! We simply cannot predict whether it will have any impact – the only true decider will be whether your baby and your body were ready for labour.
One way of not being induced however is….to decline! It’s always your option whether to have a sweep or a hospital induction, they are not alternatives to one another! You may opt for one, for both or for neither! And saying ‘no’ to a sweep does not mean that you won’t go into labour unless you are induced. The rate of induction has shot up in recent years – does that mean that all those inductions were necessary? Absolutely not. Does that mean that you too have to be induced? Also no. Its 100% your choice.
So again, come back to that point that I made earlier: If you decide that the benefits of induction outweigh the risks of ending your pregnancy early, a sweep is a great place to start as part of that induction!
Its very easy to get into the mindset of thinking that you’ll need a sweep to get labour started – particularly if your pregnancy goes beyond its due date (which, statistically, it will!) I know of women who have had 3 or 4 sweeps. That can start to feel very stressful and stress is never going to help labour to start (see above re adrenaline!) Sweeps are now being discussed at 39 week antenatal appointments - so before you have even reached your due date! This is inevitably going to have an impact on how you feel about your labour starting - and whether you expect to be able to go into labour naturally!
So work on trusting your body and listening to it. It grew a baby – it knows how to labour and birth a baby too! A sweep is always an option and never something that you have to have.
Sweeps are just one tiny subject that we cover on my hypnobirthing & antenatal course Bump to Birth to Breast. If you'd like to know all your options and feel super confident in making those choices, come and join us!
Don't have time to book a full course? Book in for a 1:1 Power Hour instead.
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