If you see a consultant obstetrician or registrar just prior to or on your due date the chances are you may hear these words: “I’ll just run my finger around the cervix to help get things moving.” Ever wonder what that means? Well, basically, what has become a routine procedure is effectively an intervention that may, as the clinicians say, “get things moving” but it may also cause unwanted side effects that may set off a chain of events you weren’t expecting and it is important to know what this may mean for you.
Evidence suggests that a stretch and sweep (otherwise known as a membrane sweep) is a relatively safe procedure which has some benefits, particularly if a woman and her care providers may be considering an induction of labour. In such cases, a stretch and sweep can kick start labour without the need for a chemical induction of labour, which brings with it a whole new set of potential complications.
However, because a stretch and sweep has become such a common procedure and because the time frame parameters for a normal gestation have narrowed over the years, clinicians sometimes fail to inform their clients of the risks associated with this procedure and some fail to inform their clients that they are doing the procedure at all.
At the very least, you should be asked for your consent before such a procedure is performed. You may need to communicate your need to give informed consent to this procedure prior to any vaginal examinations from 38 weeks onwards.
One of the complications associated with a membrane sweep is that it can nick the bag of waters (amniotic fluid sac that contains and cushions the baby) causing a slow leak or even the sudden breaking of the entire amniotic fluid sac. This can necessitate interventions related to premature rupture of the membranes which may involve induction or augmentation of labour and antibiotic treatment for both mum and baby. The procedure can also cause irregular contractions and prolonged labour. Lastly, a membrane sweep can be an extremely uncomfortable and even painful procedure and result in some bleeding from the cervix.
There is another alternative to induction of labour, acupuncture. Acupuncture has been used to bring on labour and many women find it beneficial. There are no known side effects to this treatment, however, there is little scientific evidence to support its use. That said, many women swear by acupuncture if only for the fact that this treatment is very relaxing.
Most experts agree that minor interventions such as acupuncture and a membrane sweep may not be effective unless a woman’s body is ready to go into labour. Which brings me to the final alternative—waiting for labour to start spontaneously.
These days clinicians are often in a hurry to get labour going prior to week 41 and let’s face it, so are lots of women. However, the potential for complications needs to be weighed carefully on either side and the final decision should be made with clarity and a good evidence-base to back it up.
Further reading:
Boulvain M, Stan CM, Irion O. Membrane sweeping for induction of labour. Cochrane Database of Systematic Reviews 2005, Issue 1. Art. No.: CD000451. DOI: 10.1002/14651858.CD000451.pub2
Smith CA, Crowther CA. Acupuncture for induction of labour. Cochrane Database of Systematic Reviews 2004, Issue 1. Art. No.: CD002962. DOI: 10.1002/14651858.CD002962.pub2
