Wondering what a membrane sweep is, and whether it will hurt? We've got all your questions answered in this ultimate guide with expert insights.
A membrane sweep, also referred to as pregnancy sweep or cervical sweep, is a relatively low-intervention way to help bring on labour (opens in new tab). Membrane sweeps are not compulsory, and you should only have one if you feel comfortable doing so.
Some medical professionals will explain the pros and cons, and others might just presume you want one or - in the worst cases - conduct one without your permission. You should research your options, understand the process, and make an informed decision about what's best for you and your baby.
- What is a membrane sweep?
- What are positive signs after a membrane sweep
- When would I need a membrane sweep?
- Are membrane sweeps compulsory?
- What is membrane sweep success rate?
- Are membrane sweeps painful?
- What happens after a membrane sweep?
- How long after a membrane sweep does labour start?
- Does membrane sweep causes mucus plug loss?
- What are the risks of having a membrane sweep?
- What happens if I don’t have a membrane sweep?
- The pros and cons of a membrane sweep
What is a membrane sweep?
A membrane sweep involves a midwife or doctor using their finger to separate the membranes of the amniotic sac surrounding the baby from your cervix and release hormones that will hopefully kick-start your labour (opens in new tab). Your midwife or doctor will ask you to lie down with your feet together and your knees to each side. They then insert a finger and pass it around your cervix opening.
Sometimes your midwife or doctor will suggest a 'Stretch and Sweep'. This means you're not quite ready for a membrane sweep so the midwife will stretch and massage your cervix. This may begin to 'ripen' your cervix before a full sweep at your next appointment. If you're going for a sweep, wear a pantyliner or maternity towel in case of any spotting afterwards.
Anthonissa Moger, Founder of The Hypnobirthing Midwife (opens in new tab) and author of Holistic Hypnobirthing (opens in new tab), says that the body must be ready for a successful sweep: "A sweep is the least medical of the induction pathway. It may be worth trying in order to avoid induction, but you can decline if it doesn’t feel right for you. A sweep will only work if your cervix has already started to soften, open, and come forward because your body is getting ready to go into labour. If your body hasn’t started to change the midwife may not be be able to reach your cervix at all."
What are positive signs after a membrane sweep
Positive signs after a membrane sweep would demonstrate that your body has responded well and that labour is progressing. These are similar positive signs to any other labour, and include contractions becoming stronger and more regular, losing your mucus plug, your waters breaking, or your cervix becoming more dilated. Find out more about the most common signs of labour starting so you know if you're about to give birth.
When would I need a membrane sweep?
Your midwife may suggest a membrane sweep once you're more than 40 weeks pregnant (opens in new tab). If you're a first-time mum you may discuss a sweep at your 38-week, 40-week, and 41-week antenatal appointment.
If you're not a first-time mum, you'll be offered a sweep at 41 weeks. Sweeps are one option before the midwife discusses inducing your labour through hormonal medication such as pitocin or prostaglandin. However it's important to remember that any such medication is also optional. Induced labour can be more painful than a labour that begins of its own accord, because the body receives a relatively swift dose of hormones rather than a gradual increase naturally. Some mums find induction labours are more intense and painful. You may also receive two or three sweeps before labour starts or a hormonal induction is suggested.
Remember, you can ask for a sweep, but you can also say no if you'd rather wait. If you do decide to wait, the midwives may want to keep an eye on your progress and the baby's health - but your main priority should be relaxing and not worrying about the fallacy of due dates (opens in new tab).
Are membrane sweeps compulsory?
No, membrane sweeps are not compulsory and they do not form part of a routine examination. Medical staff should always ask your permission before conducting a sweep. They should also explain the process and implications to you. A midwife or doctor should never pressurise you into having a sweep.
"It’s absolutely your choice," says Milli Hill founder of the Positive Birth Movement (opens in new tab) and author of the bestselling Positive Birth Book (opens in new tab). "You don’t have to feel any pressure to have a sweep if you don’t want one. But if you are happy to have one, then that’s also up to you."
What is membrane sweep success rate?
There is no reliable evidence that a membrane sweep will bring on labour. Once a woman has had a sweep, there's no way of knowing what would have happened otherwise.
"It’s one of those areas of women’s healthcare, of which there are far too many, where the answer is: ‘we don’t have enough evidence’" says Milli Hill. "A Cochrane review (opens in new tab) (which is a very reliable source) suggests that sweeps ‘might' reduce the likelihood of formal induction, but that more research is needed into whether sweeps are effective in starting labour. And if so, when is the best timing for them to be most effective. We just don’t know, basically."
Rebecca Dekker, the founder of Evidence Based Birth (opens in new tab) says that membrane sweeps potentially reduce the length of your labour, but only by four days: "If your membranes are swept at 41 weeks, this can lower your chance of having to go past 42 weeks and needing an induction at 42 weeks. It decreases your chances of going to 42 weeks from 41 percent down to 23 percent.
"It can also decrease the length of your pregnancy by one to four days. Most studies found four days on average. That doesn’t mean that you’ll go into labour within four days. What it means is, say, your body was naturally going to go into spontaneous labour at 41 weeks. Then, instead, if your membranes were stripped, it would shorten your pregnancy by about four days. Maybe you would go into labour at 40 weeks and three days instead of 41 weeks." This suggests that whilst sweeps might reduce the length of a pregnancy, it's only in relation to what was going to happen anyway.
Are membrane sweeps painful?
Unfortunately, yes. Membrane sweeps can be painful. One medical study (opens in new tab) found that 70 percent of women found that membrane sweeps were associated with significant discomfort, and one third of women complained of significant pain. Membrane sweeping can also cause slight bleeding and make your uterus irritable and with irregular contractions. Women have described the discomfort as something similar to a painful smear or period pains, to stronger cramping sensations.
Sam Nightingale, clinical academic midwife at University Hospitals Coventry and Warwickshire NHS Trust and researcher at women’s health research charity, Wellbeing of Women (opens in new tab), warns that sweeps can sometimes trigger trauma too: "Some women find sweeps very uncomfortable and distressing. This is more likely if the neck of the womb is still quite far back, or also if a woman has experienced sexual trauma or previous birth trauma." If you are concerned about birth trauma, you can contact The Birth Trauma Association (opens in new tab).
What happens after a membrane sweep?
After a membrane sweep you may begin to feel the first positive signs of labour. This can include contractions, losing your mucus plug, or your waters breaking.
"We tell women to carry on as normal after their sweep but they must keep an eye out for any changes. There can be a little blood, it can also bring on the 'show' and, of course, it will hopefully make labour happen," says Janet Fyle midwife advisor for the Royal College of Midwives (opens in new tab).
Midwife and Wellbeing of Women researcher Sam Nightingale warns against significant blood loss, however. "Fresh blood loss after a sweep is never normal and should be reported to your maternity unit. Women may also experience period-type tightening pains."
How long after a membrane sweep does labour start?
"How long labour may take after a sweep is impossible to be exact about," says Sam Nightingale. "It varies depending on how ready the neck of the womb is to be fully thinned out, central, soft and starting to open. These are all physiological processes that happen prior to labour and this is what the sweep aims to encourage."
You would expect positive signs of labour within 12 to 48 hours of having a membrane sweep, however. If it takes longer than this, it means the membrane sweep hasn't worked and your body is not yet in labour.
Does membrane sweep causes mucus plug loss?
Yes, a successful membrane sweep can lead to a 'show' or losing your mucus plug. The mucus plug is a sticky, cervical mucus that blocks the cervix during pregnancy to prevent infection. Once the cervix softens and opens, the plug becomes loose and you may see a white or pale pinkish discharge. If you see a lot of blood or a brown or green discharge, you should contact your midwife as this could be a sign of complications in the pregnancy.
What are the risks of having a membrane sweep?
There is considerable professional debate about the pros and cons of membrane sweeps, and whether they help induce labour. You may experience some discomfort during the procedure. Additionally, you may have to repeat it several times if it's not successful. According to a 2020 study in Midwifery (opens in new tab) journal, inducing labour can also lead to more complications, including: "Longer, more painful labour, increased risk of postpartum haemorrhage and reduced satisfaction with birth experience compared to women who experience spontaneous labour onset... Epidural, assisted vaginal birth and episiotomy are also more common with induction of labour."
Position of the cervix
Because the cervix has to be slightly dilated to conduct a membrane sweep, the body is already in the process of initiating labour. There are therefore some schools of thought that a membrane sweep is not a necessary intervention. There is a 1 in 10 chance that a membrane sweeps can inadvertently break your waters. This could lead to longer labour, and if you don't then go into labour spontaneously within an allotted time you might potentially need a medical induction or epidural. So whilst some midwives argue that sweeps help avoid induction, it can also lead to a medical induction and unnecessary stress.
You should always feel fully informed and supported about your decision to have a membrane sweep or not as part of your birth plan (opens in new tab). It's important to understand the implications for having a caesarean (opens in new tab) too.
What happens if I don't have a membrane sweep?
If you have a healthy pregnancy it's OK to not have a sweep and wait until you go into labour. If your baby is breech or there are other complications, then you should speak to your doctor or midwife. You might want to try one of these 20 ways to have an easier labour (opens in new tab) too.
The pros and cons of a membrane sweep
Lesley Gilchrist, Registered Midwife and Founder of My Expert Midwife (opens in new tab), advises that there are pros and cons to having a membrane sweep: "The advantage is it may start labour off and reduce the need for any further intervention for induction of labour. But this is more likely if your body was already preparing to labour naturally. The disadvantages are: it may not work; some women find this procedure very uncomfortable; you may have sporadic contractions but not go into active labour and this can be tiring. More uncommonly, your waters may break during the examination."
A successful membrane sweep may help initiate the birthing process and enable things to proceed. Technically a membrane sweep is not a form of medical intervention as it doesn't require medication. It is also a drug-free way to induce labour, which many women prefer.
Still unsure? Watch this video to understand the pros and cons of a membrane sweep:
What other mums told us:
'I was dubious over whether a sweep would work or not. But I went in for the procedure and a few hours later I was in labour. It was a quick one, and in less than 24 hours I had my baby girl.'
'I had two or three sweeps with my first baby and it was useless. A very unpleasant experience too. Some say it works but you never know if the baby was just ready.'
'I considered having a sweep for my first pregnancy, but I waited a little bit longer. Our gorgeous baby boy was born of his own accord just a few days later.'
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