Are you creeping up on the end of your pregnancy and hearing your provider mention membrane sweeps? Or maybe you’re doing some late night googling of natural induction methods and have landed here? Whatever brought you here – I’m glad you are! Membrane sweeps are a favorite topic of mine. And I absolutely want you to know all about them so you can make a good choice about whether or not you want to use them to get your labor going.
Who is The Labor Mama and Why Am I Here?
Hey friend! I’m Lo – also known around here and social media as The Labor Mama. I’ve spent my nursing career in labor, delivery, and postpartum, have birthed 3 of my own babies, have labored thousands of mamas at the bedside, have taught hundreds of students online, and have even delivered a few speedy little babies with my bare hands (oops).
Here at TLM, I offer online birth classes to empower you the way everyone should be. The education + support I offer gives you experience, evidence, and empathy; you’re getting all of my years of “clinical” RN knowledge, beautifully combined with my real experiences as a mama and a nurse. These are not your hospital birth classes (those won’t do it, I promise), and honestly, birth doesn’t follow a textbook or protocol anyway – you need to know so much more than that.
If you want to connect with me further, head to Instagram. There are hundreds of thousands of us over there learning together daily.
What is a membrane sweep?
Let’s start with the most basic question: What is a membrane sweep? A membrane sweep is also referred to as a cervical sweep or membrane stripping. A membrane sweeps occurs during a cervical exam. If you are dilated when the provider is assessing your cervix, they can also use a gloved finger to sweep around the thin membranes of the amniotic sac. Basically, they are circling their gloved finger between the sac and the “wall” of the cervix. This sweeping separates the sac from the wall of the cervix and can cause the release of prostaglandins. Sometimes, the release of prostaglandins can then trigger contractions and lead to labor.
Another helpful read: What Acutally Makes Labor Start?
To do a sweep “well,” you do need to be dilated at least 1 cm or so. However, I have also seen providers try to massage a cervix that is closed (0 cm). I’m not sure if cervical massage is tried that commonly, but research shows it may work! So if your cervix is not dilated but a sweep is needed or wanted, it’s worth asking about.
Does a membrane sweep hurt?
It’s basically impossible to answer this question universally. Some mamas will say “yes, it hurt so badly.” Others will tell you “I hardly felt a thing.” Most find that they are more painful when the cervix is “less ripe.” This is especially common if you’re trying a sweep at 37 or 38 weeks. “Less ripe” basically means the cervix is pretty far back in mama’s body, so it’s hard for the provider to get to it and it all just feels super uncomfortable.
Tips for a membrane sweep
The tips for a membrane sweep are basically the same as tips for a cervical exam! Typically, these do not take long. They are a brief “in and out” thing. But, sweeps are “easiest” and quickest when you are relaxed, so really, it’s all about that.
- Empty your bladder. I know, it’s basically always full. But go ahead and pee right before you exam and sweep.
- Feet together, legs fall open, wiggle your toes. Sweeps are almost always done while you are laying on your back. This positioning kind of brings the cervix right to the provider and the wiggly toes can actually help you relax.
- Elevate the hips. If you are comfortable with is, you can fist one hand and place it under your tailbone. You can also roll up a towel and wedge that in there. This can help lift a cervix that is posterior (along mama’s back) towards the provider a little more.
- Deep breathing. Before you provider inserts their gloved hand, inhale deeply. On exhale, let those legs fall open a little more. Try not to hold your breath; inhale and exhale again if you need to!
I deep dive ALL parts of the cervix and membrane sweeps in the Your Body, Your Birth course. I think these topics are so important for labor progress and induction, and I want you to know about them!
Why would someone have their membranes stripped?
So if a sweep might be super uncomfortable, why would someone do one? Basically, it’s for “natural” labor induction and is seen as a gentler (like compared to Pitocin) way to kickstart labor. However, while many lump this induction method into the “natural” induction discussion, it really is a medical induction tool.
Just because it’s a medical tool does not mean you should not have one. But before you say yes to one, I want you to understand that you can choose to have one or not and that it is meant to induce labor! Too often, I hear stories about providers who quickly do a sweep during a prenatal cervical exam without getting their patient’s consent. A sweep and a cervical exam are different and have different purposes, and you are free to say “yes” or “no” to them individually!
Also, real talk? Membrane sweeps do NOT always work. But many mamas would choose to try a membrane sweep before the sign up for a more medical induction, so they’re absolutely important to learn about.
How many weeks do you have to be to get a membrane sweep?
This is really provider dependent! I think it’s most common for a provider to be willing to do one or offer one around 38+ weeks. But like I mentioned above, you have to be dilated to have a sweep, so whether or not you can actually try it does depend on that.
Another thing that may impact your ability to try a sweep is your GBS status. If you are GBS positive, it’s possible your provider won’t want to do a sweep on the off chance that labor begins really quickly. This could mean you aren’t able to receive adequate GBS antibiotics. If you are GBS + and would like to try a sweep, just have a convo about this! I’ve seen different providers feel comfy doing different things in this situation.
What is the membrane sweep success rate?
Most people think that a membrane sweep is successful if it causes labor within 48 hours. However, there isn’t great evidence to support how often that actually happens! A recent Cochrane review (2020) looked at 44 studies related to the use of membrane sweeping for labor induction. It concluded that membrane sweeping may be effective in causing spontaneous labor, especially in the following 7 days. When they compared sweeping to those who had more of a wait and see approach to labor (called expectant management), they also found that it may reduce the need for a more medical induction of labor.
While these numbers aren’t crazy good, I think it’s easy to see why some would definitely choose to try a sweep before jumping to more medical tools and medications.
Pros and cons of membrane sweeps
As with most choices in birth, a membrane sweep does have both pros and cons (or risks and benefits). And like I’ve already said, this is why you should definitely get to give consent before you have one!
Risks of a sweep
Ok, risks or cons. Like I mentioned prior, a membrane sweep is an intervention that some classify as “medical” – and many want to avoid these as much as possible. So if you’re trying to avoid all interventions, this is not your thing!
- Requires a cervical exam: If you are hoping to avoid cervical exams, a membrane sweep is also not an option. Sweeps are doing during an exam, so if you want this done prenatally, you’re signed up for an exam too!
- Break bag of waters: During a membrane sweep, there is also the chance that your provider could break your bag of water. This is a rare, but if it happens, you could end up needing more induction tools because your body wasn’t actually ready for labor.
- Irritable uterus: It is possible that a membrane sweep gives you a very irritable uterus, causing cramping, contractions, and pain, but not actually causing any sort of contractions that lead to cervical change or “real” labor. This can mean an uncomfortable 24-48 hours with no sleep – AND no progress!
- Painful/uncomfortable: Like mentioned prior, some really find these super uncomfortable! I’ve had patients say it was one of the worst parts of their labor. I do think this discomfort is less likely the farther your pregnancy or labor progresses. And for some, it’s no bother at all and exactly what they needed to get going!
Pros of a sweep
Of course, the biggest pro of a sweep is that is starts your labor! Though research doesn’t show super compelling results for sweeps kicking you right into labor, it does show that sweeps can shorten the overall length of pregnancy and reduced the need of needing a scheduled induction. For many, the choice to try a sweep is not only that labor might begins, but that a sweep might allow them to avoid more medical tools like Pitocin.
How to make a membrane sweep successful
There is no perfect trick to making a sweep successful! Honestly, the body will go into labor when it’s ready and wants to. But, if you’re after 37 weeks, you could come home and try the Miles Circuit and focus on other optimal fetal positioning exercises. And if you haven’t begun eating dates yet, the evidence for the way they soften the cervix and get it ready for labor is pretty great! This doesn’t happen overnight, but worth considering!
Ultimately, I’d encourage you to go home and rest, maybe eat a good meal. If the sweep does work, you’re about to labor! And since no one knows how long labor will be, you need strength and energy to do that!
Signs of a successful membrane sweep
Ok, let’s say you went for it. You had your sweep and now your home, wondering what’s next. Of course, some signs are obvious, right? Contractions! If your body starts contracting and that cervix starts dilating, something might’ve worked! Other signs may include losing your mucous plug, bloody show, or your water breaking. If all of these start happening? It’s baby time!
Of note: Light bleeding during the sweep and after is normal. However, if you find that the bleeding increases, clots are present, it doesn’t stop or start to lessen, or coincides with a lot of pain, call your provider right away or head into OB triage to see what is going on.
The take away on membrane sweeps
Membrane sweeps are one of a lot of different things you can try to start to kickstart your labor. They do have pros and cons, so you definitely want to understand those before you choose one! Sweeps also require your consent, so make sure your provider knows whether or not you’d like one if they are doing a cervical exam. There is also a long list of other natural induction tools you can try, so you can do some digging about all of those too!
Did you try a membrane sweep? Will you? Do you think it worked? Let me know in the comments! xx – Lo
More helpful reading:
More resources (and freebies!) for you to take a peek at:
- Comprehensive Birth Plan and Birth Priorities templates
- A complete Third Trimester Checklist
- The RN + mama of 3 Ultimate Packing List
- The Labor Mama online birthing classes for every family
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