Walking After Membrane Sweep

Sandy

Introduction to Membrane Sweep

As your due date approaches and the excitement of meeting your little one grows, it’s common to start wondering about the ways to induce labor. One popular method that obstetricians, midwives, and healthcare providers often suggest is a membrane sweep. But what exactly is a membrane sweep?

A membrane sweep, also known as membrane stripping or cervical sweep, is a procedure used to stimulate the start of labor. The technique involves the healthcare provider gently sweeping their finger around the cervix to separate the amniotic sac – the fluid-filled sac that the baby grows in during pregnancy – from the cervix. This sweeping motion can release hormones called prostaglandins, which can help to kickstart labor.

Typically, this procedure is suggested when pregnant women have passed their due date or are close to it without any signs of labor. Some women also opt for a membrane sweep if they wish to avoid a medical induction or cesarean delivery.

The overall goal of a membrane sweep is to stimulate labor naturally and possibly reduce the need for other more invasive induction methods.

Membrane Sweep Procedure

Understanding the membrane sweep procedure can help reduce any anxiety or stress related to it. So, how is a membrane sweep done, and when is it usually performed?

During a membrane sweep, the healthcare provider or midwife will first explain the process to ensure you are comfortable and give your informed consent. You will then be asked to lie down in a position similar to the one for a cervical examination.

The healthcare provider will insert a gloved finger into the vagina and gently sweep around the inside edge of the cervix. While it may cause some discomfort, the procedure is typically quick and usually completed within a few minutes.

This procedure is generally performed around the 40th week of pregnancy or later, once the cervix is deemed “favorable” or “ripe” for labor. A ripe or favorable cervix is soft, thin, and starting to dilate in preparation for labor. The healthcare provider may also assess the cervix’s position and consistency to predict the success of the membrane sweep.

Below I have put down the step-by-step membrane procedure:

How Is Membrane Sweep Done

The membrane sweep, often referred to as a cervical sweep or membrane stripping, is a relatively simple procedure that is performed by a healthcare provider or midwife. Here is a step-by-step explanation:

Consultation and Informed Consent: Before beginning, your healthcare provider will explain the procedure, its benefits, potential risks, and alternatives to you. After ensuring that you fully understand these elements, they will ask for your consent to proceed.
Positioning: For the procedure, you will be asked to lie down on your back in a position similar to that of a cervical examination. Usually, this involves placing your feet in stirrups and bending your knees.
Examination: The healthcare provider will then put on a glove and insert a lubricated finger into your vagina to locate the cervix. This step may feel a bit uncomfortable but should not be painful.
The Sweep: Once they have located the cervix, they will insert their finger into the cervical opening and make a sweeping motion. This action separates the amniotic sac (the fluid-filled bag that houses the baby during pregnancy) from the cervix. The goal is to stimulate the release of prostaglandins, hormones that can help to initiate labor.
Completion: The procedure is usually completed within a few minutes. You can then resume your normal activities unless instructed otherwise by your healthcare provider.

It’s important to remember that while a membrane sweep can be uncomfortable, it shouldn’t be significantly painful. You might feel some cramping or spotting afterward, which is normal. However, if you notice any heavy bleeding, severe pain, or fluid leakage, you should immediately contact your healthcare provider.

Please note that while a membrane sweep is generally safe, it’s not guaranteed to induce labor, and its success can depend on several factors, including the readiness of your cervix for labor. Always consult with your healthcare provider to discuss the best options for your situation.

When Is The Membrane Sweep Done

A membrane sweep is typically performed near the end of pregnancy when a woman has reached full term but has not yet gone into labor. Full-term is generally defined as 40 weeks of pregnancy.

However, some healthcare providers may consider performing a membrane sweep a bit earlier, around 38 or 39 weeks, especially if there are medical reasons for wanting to encourage labor to start soon.

Moreover, if the membrane sweep does not initiate labor within a certain time frame (usually about 48 hours), the procedure can be repeated. This timeframe can depend on various factors, including the woman’s individual circumstances and the healthcare provider’s recommendations.

It’s important to note that while a membrane sweep can help to stimulate labor, its success can depend on several factors, including the readiness of the cervix for labor. This is why the procedure is often performed when the cervix is deemed “ripe” or “favorable.” This means that the cervix is soft, starting to thin out (efface), and open (dilate), which are all signs that the body is preparing for labor.

As always, the timing and appropriateness of a membrane sweep should be discussed with a healthcare provider, considering the woman’s individual circumstances, overall health, and pregnancy history.

Effectiveness Of Membrane Sweep

General Effectiveness: A membrane sweep has been found to be generally effective at inducing labor, with many women going into spontaneous labor within 48-72 hours of the procedure.
According to some studies, about 40% of women who had a membrane sweep at 41 weeks went into labor within 72 hours of the sweep.
Condition of the Cervix: The condition of the cervix significantly impacts the procedure’s effectiveness. If the cervix is “ripe” (softened, beginning to dilate and efface), a membrane sweep is likely to be more successful. On the contrary, if the cervix is “unripe” or unfavorable, the membrane sweep might be less effective, and the healthcare provider might decide to delay the procedure.
Multiple Sweeps: If labor does not start after the initial sweep, the procedure can be repeated. Some studies suggest that repeated sweeps can increase the success rate of inducing labor. However, the number and frequency of sweeps should be decided in consultation with your healthcare provider.
First-time Mothers vs. Mothers Who Have Given Birth Before The effectiveness of a membrane sweep also tends to vary depending on whether the woman has given birth before. It’s often seen to be more effective in women who have previously given birth vaginally.

While a membrane sweep is a generally safe procedure and can be effective in inducing labor, it’s not guaranteed to work for every woman. Some women might need multiple sweeps, while others might not respond to the procedure.

Also, like any medical procedure, a membrane sweep comes with potential risks and discomforts, such as spotting, cramping, or irregular contractions. Some women may also experience a temporary increase in discomfort during and after the sweep.

For these reasons, it’s crucial to have open discussions with your healthcare provider about the procedure, including its potential benefits, risks, and alternatives, and how it fits into your overall birth plan.

Personal circumstances, overall health, pregnancy history, and readiness for labor should all be considered when deciding whether a membrane sweep is a right option for inducing labor.

Success Rate

As explained earlier the success rate of a membrane sweep varies depending on individual circumstances, including the condition of the cervix and whether the woman has given birth before.

According to research, about 40% of women go into spontaneous labor within 48-72 hours after a membrane sweep at 41 weeks of pregnancy. However, the procedure might be less effective in first-time mothers and in those whose cervix is not yet ripe or favorable for labor.

Factors Influencing the Success Rate

The success rate of a membrane sweep can be influenced by several factors:

Cervical Condition: The state of the cervix plays a crucial role in the success of a membrane sweep. If the cervix is “ripe” or favorable (soft, thinning, or dilated), the procedure is more likely to be effective. Conversely, if the cervix is “unripe” or unfavorable (firm, thick, and closed), the success rate may be lower.
Previous Births: The procedure is often more successful in women who have previously given birth vaginally. This is because their cervix might be more responsive to the procedure.
Timing of the Sweep: The stage of pregnancy at which the sweep is performed can also influence its success. A sweep is generally more successful closer to or beyond the due date, as the body and cervix are naturally preparing for labor.
Multiple Sweeps: Sometimes, one sweep may not be enough to start labor, and multiple sweeps may increase the chances of success. However, the number and timing of sweeps should be discussed with the healthcare provider.
Individual Physiological Factors: Each woman’s body responds differently to procedures such as membrane sweeps. Therefore, individual physiological factors, including the body’s readiness to go into labor, can significantly impact the success rate.
Baby’s Position: The position of the baby within the uterus can also influence the effectiveness of a membrane sweep. A baby that is well-positioned for birth can enhance the likelihood of successful labor induction.

Remember, the decision to have a membrane sweep should be made in consultation with your healthcare provider, who will take all these factors into account and provide advice tailored to your individual circumstances.

Walking After a Membrane Sweep

After a membrane sweep, many healthcare providers recommend walking. You might wonder why something as simple as walking is encouraged following this procedure.

Walking, a low-impact physical activity, promotes the natural downward movement of the baby due to gravity, stimulating labor. This movement helps to position the baby better in the birth canal and can encourage the process of labor. Walking also helps in improving circulation, reducing stress, and keeping the muscles warmed up and ready for the work of labor.

The movement and exercise can lead to increased contractions, especially if the cervix is ripe and labor is imminent. While walking does not guarantee that labor will start, it’s a simple, non-invasive, and healthy way to encourage the process along.

Below I have put down the main reasons why walking is encouraged after a membrane sweep:

Gravity Assistance: Walking allows gravity to assist in moving the baby down into the birth canal, which can put pressure on the cervix, potentially helping it to dilate and efface (thin out) — key steps in preparing for labor.
Promotes Contractions: Physical activity like walking can stimulate uterine contractions, encouraging the body to go into labor.
Helps with Baby’s Positioning: Regular walking can also help the baby to get into a better position for birth, which can facilitate the labor process.
Release of Oxytocin: Exercise such as walking can help to release oxytocin, a hormone that plays a crucial role in starting and progressing labor.
Promotes General Well-being: Walking can help reduce stress, keep your muscles toned, and promote overall well-being, which is beneficial in late pregnancy.

Remember, it’s always essential to listen to your body and not overexert yourself, especially in the late stages of pregnancy. Consult with your healthcare provider to understand what’s best for your specific situation.

Labor Induction after Membrane Sweep

So, what happens if the membrane sweep doesn’t successfully induce labor? Thankfully, there are several other ways to stimulate labor, both medical and natural.

Medical induction usually involves the use of synthetic hormones, such as Pitocin (a synthetic form of oxytocin), to initiate uterine contractions. Other methods include cervical ripening agents that help to soften, thin out, and dilate the cervix, making it more favorable for labor.

On the natural side, there are several ways to stimulate labor. Nipple stimulation, for example, can help induce labor in women who are at term. This method works by releasing oxytocin, a hormone that causes contractions. Another natural method is consuming spicy foods or certain herbs known to stimulate labor. However, these natural methods should only be tried under the guidance of a healthcare provider.

Risk Factors and Potential Complications

Like any medical procedure, a membrane sweep comes with certain risk factors and potential complications. While generally considered safe, some women may experience severe pain, heavy bleeding, or even an accidental rupture of the amniotic sac. It’s also important to note that the procedure could potentially lead to infection, though this risk is relatively low.

Moreover, one of the main downsides of a membrane sweep is that it doesn’t guarantee the onset of labor. Some women may need multiple sweeps before their labor begins, and others might not respond to the procedure at all.

Factors Influencing the Success of a Membrane Sweep

There are several factors that influence the success of a membrane sweep. For instance, the procedure tends to be more effective in women who have had a previous vaginal birth.

The condition of the cervix also plays a significant role in the success of the procedure. If the cervix is “ripe” and the body is ready for labor, a membrane sweep is more likely to work.

Other factors like the gestational age (the number of weeks into the pregnancy) and the baby’s position can also impact the effectiveness of the sweep. Additionally, the mother’s age and overall health can have a significant effect.

The Role of Informed Consent

Informed consent is a critical aspect of any medical procedure, including a membrane sweep. This term refers to the communication process between the healthcare provider and the pregnant woman, which results in the woman’s agreement to undergo a particular medical procedure.

Before a membrane sweep, the healthcare provider should explain the procedure in detail, including the potential benefits, risks, and alternative options. Only after the woman fully understands all these elements should she give her consent for the procedure.

Alternatives to a Membrane Sweep

If the idea of a membrane sweep doesn’t sit well with you, or if you have tried it and found it unsuccessful or uncomfortable, know that there are alternatives available.

These alternatives can range from other medical induction methods, such as the use of synthetic hormones, to natural ways to induce labor, such as nipple stimulation, certain exercises, or even certain foods. However, the effectiveness of these methods varies, and they should always be discussed with a healthcare provider before trying.

Conclusion

As the due date approaches or passes, many women consider a membrane sweep to help kickstart the labor process naturally. Walking after a membrane sweep can further promote the onset of labor. While it’s not a guaranteed method to initiate labor, it’s a less invasive option before moving on to other medical interventions.

Always remember, every pregnancy and every woman’s body is different. It’s vital to discuss any concerns or questions with your healthcare provider and make informed decisions about the birth of your baby.

FAQs

Is a membrane sweep painful?

The level of discomfort during a membrane sweep varies among individuals. Some women might find it uncomfortable but not necessarily painful. In some cases, it might cause cramping similar to menstrual cramps.
Can I choose not to have a membrane sweep?

Yes, it’s your right to refuse any procedure, including a membrane sweep. Make sure to discuss other options and alternatives with your healthcare provider.
What should I expect after a membrane sweep?

After a membrane sweep, you might experience some mild spotting, cramping, or irregular contractions. If you notice any heavy bleeding, severe pain, or fluid leakage, contact your healthcare provider immediately.
How effective is a membrane sweep in inducing labor?

The effectiveness of a membrane sweep varies among individuals. It largely depends on several factors, including the woman’s individual circumstances, the condition of the cervix (whether it’s ‘ripe’ or favorable for labor), and the timing of the procedure.

Research suggests that a membrane sweep can increase the likelihood of labor starting naturally within 48 hours compared to waiting for labor to start on its own. One study found that around 40% of women went into labor within 72 hours after having a membrane sweep at 41 weeks of pregnancy.

However, it’s important to note that while a membrane sweep can help promote labor, it’s not a guaranteed method. Some women might need multiple sweeps before their labor begins, and others may not respond to the procedure at all. Additionally, it’s considered less effective in first-time mothers compared to those who have previously given birth vaginally.

Furthermore, if the cervix is not yet ripe — meaning it has not started to soften, thin out, or dilate — a membrane sweep may be less likely to be successful.

Remember that it’s essential to have open discussions with your healthcare provider about the procedure, its potential benefits, and risks, and how it fits into your overall birth plan.

References

Sandy

This post is written and edited by Sandy who is a clinical pharmacist with over 20 years of experience specializing in pre-natal and post-natal care.