Membrane sweep and induction
Sometimes, despite trying all the alleged means of getting labour going naturally, your due date is replaced by an overdue date. Your midwife and the obstetric team may then want to up the ante and try to get labour started with medical interventions, such as a membrane sweep.
What happens during a membrane sweep?
A membrane (cervical) sweep is a vaginal examination during which your midwife will use her finger to sweep the neck of your womb to try to separate the membranes from your cervix (don't try this at home).
This can encourage your body to release hormones called prostaglandins that work to soften and thin the cervix, which might encourage labour to start naturally in the next 48 hours.
It can be uncomfortable and it's quite common to experience a 'bloody show' afterwards. The good news is it doesn't increase the risk of infection to you or your baby, so it may be worth asking for one if you're sitting there clock watching.
Indeed, if it looks like you may have to have your labour induced, you should be offered at least one membrane sweep first as a matter of course.
What Mumsnetters say about membrane sweeps
- I had a sweep at 41 weeks. I felt mild contractions after six hours and my baby was born 12 hours later. I found the sweep painful, but compared to the pain of the actual childbirth it was like stubbing your toe. ChanelNo5
- I had a sweep from a 6' 4" male midwifery student with hands like shovels... very effective. Jemimapants
- I discovered I'm really not fond of pineapple. Curry didn't work and sex was the last thing I felt like. Midwife doing a thorough rummage and 'pulling the cevix round' did the trick. I felt like one of those cows in a veterinary programme but was glad not to have another induced labour. pushchair
Hospitals play it on the safe side, so if you've gone beyond 41 completed weeks and all other attempts to tempt your bun out of the oven have failed, it's likely you'll be advised to have your labour induced artificially during your 42nd week.
How is labour induced?
Typically, you'll be asked to come into hospital where you'll have synthetic prostaglandins - in pessary, tablet or gel form - inserted into your vagina. These are drugs that mimic your body's own 'birthing' hormones that help to soften and shorten your cervix.
As these changes occur, your womb may start to contract; sometimes this is all that's needed to kickstart labour, but all you can do at this point is wait and see (although it helps to remain as mobile as possible).
What does breaking my waters involve?
One thing can tend to lead to another once medical intervention has begun. So, if after at least six hours (24 hours if you've had a pessary) nothing has happened, your midwife or doctor will break your waters, providing your cervix is open enough to get at them (you may need several doses of prostaglandins before this can be done).
The subsequent loss of amniotic fluid often stimulates the womb to start contracting.
What is Syntocinon for?
If there's still no sign of action after several hours, you'll be given Syntocinon – a synthetic version of the hormone oxytocin that causes contractions – by intravenous drip and the dose will be gradually increased until contractions are coming every three minutes.
Are induced labours more painful?
Induced labours are often more painful than spontaneous labours, so it's important you're given adequate information and support about pain relief options. You have a right to whatever pain relief is appropriate to you - in just the same way as if your labour had not been induced.
Remember all labours - even induced ones - are different, so what works for some women might not work for you. You have a right to choose how you are treated, so all these steps should be discussed thoroughly with you so that you can make an informed choice based on the options available to you.
If you don't go into labour after induction, your midwife or obstetrician will discuss this with you, and check on you and your baby thoroughly. Depending on your wishes and circumstances, they may offer you another dose of prostaglandins. In some circumstances, you may be offered a caesarean section.
The most important thing to remember if your baby's running late (and it's a phrase you may well find yourself uttering as a mother) is that it's not a race. (Something it's easy to forget when everyone else in your antenatal group has already popped and every time the phone rings it's Great Aunt Aggie wanting to know if you've 'dropped yet'.)
So relax, put your feet up, watch costume drama box-sets back to back and enjoy your last few days of relative peace: your baby will come - eventually - and then life will never be the same.
What Mumsnetters say about induced labours
- My advice is not to expect it to happen straight away: I thought that full labour would start immediately but this is often not the case. Bring plenty to keep you occupied - music, food etc. Someone I know went round a museum in between pessaries. Pamela1
- I was induced and the downside was going straight into full-on labour pains rather than experiencing a gradual build-up. On the plus side, it was fairly quick and therefore not completely exhausting, plus it all took place during the day and so I had a good night's sleep the night before. Zaria
- I found Syntocinon awful. I was unable to cope very well with the pain; it felt unnatural and I couldn't have an active labour because I was strapped to a monitor. Lizzer
- When I went 14 days past what doctors believed was my due date, they insisted I was induced. They tried twice with prostaglandin pessaries but nothing happened. After that I was scanned and monitored and told to come back to the Foetal Assessment Unit every two days. Eight days later I went into labour naturally and my son was fine. Gillymac
- I remember complaining to my consultant that I was sure I was never going to give birth and he kindly assured me that there was no medical record of anyone ever getting to 10 months pregnant. Somehow my pregnancy addled brain found this comforting. SofiaAmes