“Routine use of sweeping of membranes from 38 weeks of pregnancy onwards does not seem to produce clinically important benefits. The authors of the Cochrane review were concerned about the downsides of this procedure and concluded that, ‘Current international guidelines state that induction of labour, as with any intervention, carries risks and advise it be performed only when there are clear indications that continuing with the pregnancy is of greater risk to the mother or fetus than the risk of induction of labour.” (Finucane et al 2020). Vaginal examination always carries a risk of infection, and many women find such intimate examinations embarrassing and/or uncomfortable.” (Wickham 2018). In some studies, the stretch and sweep intervention only brought the onset of labour forward by about 24 hours. “The risks and downsides of a stretch and sweep include discomfort, light bleeding and irregular contractions, which may interfere with a woman’s ability to rest and sleep in the last few days of pregnancy. Here’s another excerpt from my book on Inducing Labour: Stretching and sweeping isn’t benign, as some people like to suggest. More on that review here.īecause there is so much uncertainty, it’s really hard to know whether, if you go into labour after you’ve had a stretch and sweep, it was because of the stretch and sweep or whether your body was about to go into labour anyway. Questions remain as to whether there is an optimal number of membrane sweeps and timings and gestation of these to facilitate induction of labour.” (Finucane et al 2020). When compared to expectant management, it potentially reduces the incidence of formal induction of labour. “Membrane sweeping may be effective in achieving a spontaneous onset of labour, but the evidence for this was of low certainty. They also note that the evidence isn’t robust and that there are lots of areas that we need to know more about. Note that, in this quote, they can only say that it MAY help. The most recent review shows that it’s still very uncertain whether or not membrane sweeping makes a difference. The Cochrane review that I referred to in there has since been updated, but not much has changed. However, this figure assumes that all women would decide to have induction, which is not the case.” ( Wickham 2018). “The most recent Cochrane review of the research on this topic by Boulvain et al (2005) found that, while these may help bring on labour a bit sooner than otherwise would be the case, eight women need to have a stretch and sweep in order for one woman to go into labour without needing more induction interventions. Here’s what I wrote about the evidence in Inducing Labour: making informed decisions: Many were deemed to be of low quality and, where there is a difference between the women who had a sweep and the women who didn’t, it was a small difference. The results of studies that have looked at this have been very varied. However, you do not have to accept any intervention, including a stretch and sweep. This is understandable, because midwives know that many women do not like induction and it can lead to unwanted consequences. In other areas, midwives offer it because they know that women will be pressured to undergo hospital induction if they do not go into labour by a certain time. Stretch and sweeps are discussed in the NICE guidance in the UK. Some hospitals have guidelines that tell the midwives that work for them to offer a stretch and sweep to all women. In other words, it is a way to try to induce labour. It’s a procedure in which a midwife or doctor will, while doing a vaginal examination, sweep a finger around and/or within the opening of your cervix (the lowest part of your womb).Ī stretch and sweep is offered in the hope that it will stimulate the uterus and bring labour on earlier than it might otherwise have begun. But what is this, why and how is it done, does it work and can you say no? Many women are offered a ‘stretch and sweep’ in late pregnancy, sometimes on more than one occasion.
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