The information below is paraphrased and/or quoted from the listed sources.
*Definition of the procedure
Stripping membranes, sometimes called "sweeping of the membranes" or "membrane
sweeping", is a method used to try to start labor. The health care provider puts
her or his finger into the cervix – the mouth of the uterus – and uses the
finger to separate the bag of waters from the side of the uterus near the
cervix. This releases local prostaglandins/hormones that can trigger
contractions. It can be done in your doctor or midwife's office.
The National Institute for Health
and Clinical Excellence (NICE) notes that for the purpose of it's guideline,
membrane sweeping is regarded as an adjunct to induction of labor rather than
an actual method of induction.
Sweeping (or stripping) the membranes
(sometimes referred to as a 'strip and stretch') is an old method of induction
that was first documented in the year 1810.
The available evidence suggests that
sweeping the membranes promotes the onset of labor. For women thought to
require induction of labor, a reduction in the use of more formal methods of
induction could be expected. For women near term (37 to 40 weeks of gestation)
in an uncomplicated pregnancy there seems to be little justification for
performing routine sweeping of membranes. Sweeping of the membranes is probably
safe, provided that the intervention is avoided in pregnancies complicated by
placenta praevia or when contraindications for labor and/or vaginal delivery
are present. There is no evidence that sweeping the membranes increases the
risk of maternal and neonatal infection, or of premature rupture of the
membranes. However, women’s discomfort during the procedure and other
side-effects must be balanced with the expected benefits before submitting
women to sweeping of the membranes.
According to the American College
of Obstetricians and Gynecologists (ACOG), stripping membranes increases the
likelihood of spontaneous labor within 48 hours and reduces the incidence of
induction with other methods.
- It is a drug free…method of stimulating labor
- It may mean you avoid further intervention
- You can have it performed at home or in your health care
- Spontaneous delivery is more likely
- Has been found to reduce the risk of post term gestation, or
pregnancy continuing past 41 weeks.
In a randomized trial of
274 women, the women who underwent membrane sweeping had:
- Higher spontaneous vaginal delivery rate (69% vs 56%, P=.041)
- Shorter induction-to-delivery interval (mean 14 vs 19 hours,
- Fewer requirements for oxytocin (46% vs 59%, P=.037)
- Shorter duration of oxytocin infuson (mean 2.6 vs 4.3 hours,
- Greater satisfaction with the birth process
- Possible discomfort during procedure
- Possible discomfort after procedure
- Possible abdominal cramping after procedure
- Possible spotting after procedure
- The cramping that may occur in the 24 hours after your
membranes are stripped can make it hard to rest or sleep; this means that you
might lose some sleep before actually going into labor.
- Some people worry that membrane stripping may cause the bag
of water to break or cause mothers or babies to become sick. Studies have found
that membrane stripping does not make them more likely.
- Possible risk of spreading infection for mothers that are
*Links with other options to explore
Was this intervention part of your birth story? What is your insight?
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advice. The reader should always consult her or his healthcare provider to
determine the appropriateness of the information for their own situation. Krystyna and Bruss Bowman and Bowman House,
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the American Academy of Husband-Coached Childbirth®.