Membrane sweeps can be very common in women’s healthcare. So much so that many doctors consider it part of a routine vaginal exam (Just so you know it is a procedure and does require your consent). Let’s look at the research to determine the membrane sweep success rate. Along with the pros and cons to help you determine if this is something you would like to discuss with your provider.
[/et_pb_text][et_pb_text _builder_version=”4.19.2″ _module_preset=”default” custom_margin=”7px||||false|false” global_colors_info=”{}”]What is a Membrane Sweep?
[/et_pb_text][et_pb_text _builder_version=”4.19.2″ _module_preset=”default” custom_margin=”-9px||||false|false” global_colors_info=”{}”]A membrane sweep is a mechanical technique (using manual or instrument) to induce labor. This is where a medical provider will insert 1-2 gloved fingers into the vagina and through the cervix and will use a continuous circular sweeping motion to detach the membrane that connects the bag of water containing the baby and the uterine wall. This is done to encourage effacement and dilation of the uterus. Natural hormones are stimulated to release cause this ripening of the cervix which leads to spontaneous onset of labor.
[/et_pb_text][et_pb_text _builder_version=”4.19.2″ _module_preset=”default” global_colors_info=”{}”]What to Expect With a Membrane Sweep
[/et_pb_text][et_pb_text _builder_version=”4.19.2″ _module_preset=”default” global_colors_info=”{}”]Membrane sweeping can also be referred to as membrane stripping or membrane stretching. This requires no preparation on your part, however, you should be prepared to discuss this with your provider at the beginning of your third trimester. As I said before some providers see this as part of routine vaginal exams in the third trimester. If this is something you don’t want or are not sure about please make this clear to your provider well in advance and prior to every vaginal exam at the end of your pregnancy. Many women report provider performing membrane sweep without giving their consent.
This procedure is not an option for all women. If your cervix is closed your provider may not be able to perform a sweep. There are other options. Your provider may try to manually stimulate the cervix to open it to perform a membrane sweep or they may just massage your cervix which is also effective in helping to initiate the ripening of the cervix.
[/et_pb_text][et_pb_text _builder_version=”4.19.2″ _module_preset=”default” global_colors_info=”{}”]Day Of Exam
[/et_pb_text][et_pb_text _builder_version=”4.19.2″ _module_preset=”default” global_colors_info=”{}”]It is considered safe in uncomplicated low risk pregnancies, but please speak to your provider to weigh risks and benefits based on your specific pregnancy. This is your right and should be done prior to any intervention or procedure. You will arrive to your providers office in an outpatient setting for a regular OB checkup during your third trimester sometime after 38 weeks. During a vaginal exam they will perform a membrane sweep as described above. They may need to stimulate your cervix prior to sweep if it is closed. You should expect to feel some pain and discomfort. You should also expect to see some vaginal bleeding and possibly some irregular cramping.
So how painful is a membrane sweep? In three different studies of 675 pregnant women 31% reported their membrane sweep as not painful, 51% reported it being somewhat painful, and 17% reported it as painful or very painful. Of that same group of women reporting pain 88% said they would still choose a membrane sweep in the future. Everyone’s pain tolerance is different and each providers skill level to perform the procedure will be different. Please keep this in mind as you weigh your options.
[/et_pb_text][et_pb_text _builder_version=”4.19.2″ _module_preset=”default” global_colors_info=”{}”]Pros and Cons of Membrane Sweep
[/et_pb_text][/et_pb_column][/et_pb_row][/et_pb_section][et_pb_section fb_built=”1″ _builder_version=”4.19.2″ _module_preset=”default” custom_margin=”-28px||||false|false” custom_padding=”0px|||||” global_colors_info=”{}”][et_pb_row column_structure=”1_2,1_2″ _builder_version=”4.19.2″ _module_preset=”default” custom_margin=”-4px||||false|false” global_colors_info=”{}”][et_pb_column type=”1_2″ _builder_version=”4.19.2″ _module_preset=”default” global_colors_info=”{}”][et_pb_text _builder_version=”4.19.2″ _module_preset=”default” global_colors_info=”{}”]Pros:
- Improves chances of spontaneous birth
- Decreases risk of Induction
- Simple Procedure
- Low Cost
- Can be done outpatient or at home with a midwife
- Can be used alone or with other inducing methods
- Can be performed multiple times (No evidence yet that this is beneficial)
- No increased risk of any maternal or neonatal risks
Cons:
- Pain/Discomfort
- Increases risk of bleeding after procedure
- Irregular cramping
- Increased risk rupture of membranes (water breaking)
- Can sometimes be performed without consent
Membrane Sweep Success Rate
[/et_pb_text][et_pb_text _builder_version=”4.19.2″ _module_preset=”default” custom_margin=”0px||||false|false” global_colors_info=”{}”]As pregnancies advance risks to both mom and baby increase significantly after 42 weeks. Typically providers will start taking about options to speed up delivery near the end of your pregnancy typically between 38-42 weeks. I am neither for or against a membrane sweep. I am only here to give you the information so you can weigh the risk and benefits to determine what choice you would like to make. So how effective is it? What is the membrane sweep success rate?
Membrane sweep success rates vary slightly. Lets go over two specific studies and a meta review of 22 studies.
One is based out of Saudi Arabia completed in 2011-2012. This study looked at 160 women. Eighty women had a membrane sweep performed at 38 weeks. Of those women 81.3% went into spontaneous labor between 39-40 weeks, 8.75% went into spontaneous labor before 41 weeks, and 10% had an induction performed after 41 weeks. comparitively the control group resulted with 25% of women needing an induction after 41 weeks. The two groups had no significant difference in birth related complications after spontaneous onset of labor.
The second study is based out of Ireland and comprises 199 women. All participants had a membrane sweep prior to delivery. Of these women 79% of women had spontaneous onset of labor and 3 quarters of those women delivered within 7 days of their last membrane sweep. The induction rate was 21%. Things that showed significant positive association of spontaneous delivery within 7 days included: later gestational age, higher Bishop score (13 point scale to determine readiness to labor), and better quality sweeps.
[/et_pb_text][et_pb_text _builder_version=”4.19.2″ _module_preset=”default” global_colors_info=”{}”]In a meta analysis reviewing 22 studies including 2797 women they determined several things:
- Membrane sweeps are effective at promoting spontaneous labor or reducing the need for a formal induction
- There was a 17% reduction in informal induction and no change in mode of delivery or risk of infection
- Routine sweeps at 38 weeks do not appear to be beneficial to induce labor
Conclusion
[/et_pb_text][et_pb_text _builder_version=”4.19.2″ _module_preset=”default” global_colors_info=”{}”]It is clear that membrane sweeps can be successful. The membrane sweep success rate is somewhere between 75-85%. It’s failure rate is around 20-25%. It is not all about if it will work or not but also weighing the side effects of possible pain, bleeding, and cramping. Also keep in mind that premature repture of membrane after membrane sweep occured in about 5% of women, but is 2% in women that have not had a membrane sweep. There are both positives and negatives to getting a membrane sweep and it isn’t right for everyone. Make sure you understand the risks and benefits as you weigh your options and make your choice.
[/et_pb_text][et_pb_cta title=”Next Steps” button_text=”Click Here” _builder_version=”4.19.2″ _module_preset=”default” global_colors_info=”{}”]Share this information with someone you know who is also pregnant so they can be aware of this procedure and have educated discussions with their providers.
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Jess is a registered nurse with over 6+ years of critical care experience for patients young and old and is the mother of two small children. After having her own children she felt inspired to provide mothers with real actionable guidance and education to make informed decisions throughout their pregnancy and postpartum experience.
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