Membrane Sweep at 40 Weeks -- To Do or Not to Do?

[lilly13]

Hi ladies, my doctor is insisting on giving me a membrane sweep at 40 weeks. This is my 1st baby. I don't fully understand what the procedure entails and whether I should go for it. Could you please share your experiences? When were you offered it and why? Did it hurt? Was it effective, eg how quickly you went into labour? Did your waters break as a result of the sweep? Would you recommend it? I have been wanting a natural labour and am really scared about being induced. Many thanks for your replies in advance!

I had 3 with DS (went 16 days over in the end) and so far 2 for DD who is 7 days over, I think in reality only the last one with DS really was a proper s&s because if your cervix isnt soft and short then they cant actually get up in there enough to sweep the membranes anyway. I'd probably suggest waiting til you are 7 days over and then at least you'll know how your cervix is progressing, if it's doing all the right things then it might help but if it's not then an attempted s&s makes no difference IME

Oh and to actually answer your questions lol it's not a fun procedure but not horrid, staying relaxed and deep breathing really helps me. There is no guarantees that anything at all will happen, you may just get twinges / discharge that goes away in 24hrs or if your cervix is ready then it might kick things off!

I had one on wednesday afternoon on my due date (it's my 1st), but no joy yet. MW said that my cervix was softening and that I was 1-2 cm dilated, but I think may have been too far up. Although, she managed to reach it, and I had a bit of a show, I've had nothing since apart from a small bit of bleeding, which I was told to expect.

The procedure itself wasn't as uncomfortable as I was expecting - a bit like a smear test, I thought (in fact not even as uncomfortable as that), but you can always change your mind during the procedure if you don't like it. Only thing I have noticed is that yesterday the baby was much more active than usual - I expect it isn't used to having a gloved hand anywhere near it's head!

thank you so much for your responses! wishing you good rest of pregnancies and labour!

The NICE guidance is leave a woman alone until she's 41 weeks, then OFFER a sweep (note the use of the word OFFER). Is there a good clinical reason your doctor is recommending early induction of labour? Do you WANT your labour started off ? Do you understand the potential risks and benefits of induction of labour?

Your doctor cannot INSIST on doing anything

thanks, snowsquonk! is a sweep considered an induction or is an induction what will be done if the sweep fails to be effective? i read somewhere that with 1st pregnancies, women can be offered a sweep at 40 weeks. i was just told to come in for it. it wasn't really an offer for me to consider. i will question this during the appointment. from what i read so far, it sounds like if my cervix is not ready, they will not be able to do it anyway?

I've had four sweeps so far! The first was at 40+1. I've been 'sweepable'each time, but I'm still only 2cms dilated and not effaced at 41+3.

I was offered it on Weds (at 40 weeks). MW said they offer then at 40 weeks with first baby because they are very rarely effective the first time - however more often are the second time. Its described here:
www.nhs.uk/Planners/pregnancycareplanner/pages/Overdue.aspx

Induction is then done if sweeps are not effective:
www.nhs.uk/Planners/pregnancycareplanner/Pages/Induction.aspx

But, you don't have to do anything you don't want to. I was very clearly offered a sweep, not told I had to have one, she didn't push me into it at all. I didn't want one as I was told they were uncomfortable and didn't know if I would feel happy driving myself home afterwards. I agreed to have one at next appointment, when I will get someone else to take me just in case!

Is there some particular reason they are concerned about you? Why are you under doctors care not midwives? They may be worried about you going much beyond term if you have other health problems.

Hi,
I had a sweep at 40 + 5. I had had a very active baby all the way through pregnancy and then at about 36 weeks she suddenly stopped moving (and I mean I was carefully ticking off my 10 foetal movements by 10.30am one day, and then getting only 4 or 5 foetal movements by 6.30 pm 2 days later - not a gradual slowing as room became tight, or a stretching rather than a kicking. Just lots of movement followed by nothing). I ended up having extra scans to check she was ok (my bump had also stopped growing which caused some concern), and they established that the baby was fine but I was losing fluid. While that wasn't a major issue, it apparently indicated that the placenta was no longer functioning well and I ended up in hospital every 2 days having the baby's heart rate and movement patterns monitored. Not fun when it happens over several weeks. I also got increasingly paranoid, prodding the bump to get a response. When I then went overdue, they asked me at my routine appt if I would like to consider inducing. My reaction was that we knew that the baby at that stage was healthy, if completely inert. I didn't want to risk waiting until she was showing signs of distress before going in to get her out (doctor showed much relief and said that they were hoping I'd say that but didn't want to put any pressure on me). So they started the sweep then and there. Honestly? The worst of all worlds! More uncomfortable than a smear, I thought, verging on painful but not agonisingly so, which means not quite painful enough for you to forget how undignified it all is! And it did nothing for me.

In your situation, I think I'd hold fire on the sweep for a bit because I have yet to hear of anyone who had a result at the end of it, and it's not a brilliant way to spend ten minutes. But, that is all it is, 10 minutes. And it isn't really painful, just uncomfortable, so if there are reasons why they want to get the baby out, as there were with me, then you may as well have it. What have you got to lose (apart from the chance to induce through drugs, which is where I had to go two days later)? But as yet, you are not that far overdue and haven't mentioned any problems, I wouldn't think you need to go there just yet. Start drinking raspberry leaf tea and eating curry and see if that helps instead!
(As for what it entails, you get into a smear test position, and then the doc pops a gloved finger into you and physically pushes around to try and separate the membrane from the cervix. At least, I think that's the aim. Not sure. Just know that it was the first time in the whole birth process that blokes I really didn't know started staring at bits of my previously unseen anatomy!! I drove home afterwards as my DH hadn't come to the appointment. I was fine to drive, just a bit freaked out by the idea of the process that I'd just undergone rather than any physical discomfort.)

A sweep is a form of induction in so far as anything that artificially tricks your body into going into labour is. If there is a reason where waiting for your body and baby to be ready is not advised, then it seems a little premature to be intervening IMO.

As with any induction of labour there are of course risks and consequences that you need to be aware of and then weighed up against whatever reasoning your doctor has for reccommending a sweep so very early.

Your doctor has no right to insist on anything. You and you alone should be in control of what decisions you make re pregnancy, labour and birth, and if you don't feel that you are, then I'd suggest changing gp or healthcare provider.

apologies- I meant

If there is NO reason where waiting for your body and baby to be ready is not advised, then it seems a little premature to be intervening IMO.

Good luck!

My mistake - all first time mothers should be offered a membrane sweep at 40 week appointment according to NICE - note the word OFFER again. They should also have explained to them what it is, and any pros and cons (as opposed to TELLING you they will do one and assuming your compliance!)

There is a lot of argument about what constitutes a prolonged pregnancy and the wisdom of intervening in a healthy pregnancy versus waiting for nature to take it's course.

Some women believe a membrane sweep did start their labour, but the early labour was long, stop-start and uncomfortable. Personally, I'd like my cervix left alone unless there's a damn good reason to go rootling around!

thank you so much for all of your replies! i will press my doctor for answers. it seems that i could probably wait a few days as there was enough amniotic fluid around the baby and he was measuring on the small side, so no need to rush him out... wishing you all great rest of pregnancies!

Hi - I just had attempt at a sweep today (40+6) with first baby. My midwife said it's their policy not to interfere until you're a minimum of 5 days over. In my case, it wasn't successful as cervix was out of reach but in terms of the process it's pretty much as you'll be preparing yourself for! Think smear but with a little bit more "searching"! Not exactly pleasant but if I was told I needed another one tomorrow, it certainly wouldn't cause me to lose any sweep. Good luck whatever you decide!

Lose any sweep sleep. Talk about a Freudian slip!!