Membrane sweeps, yes or no?

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momW's picture
Joined: 09/29/09
Posts: 5634
Membrane sweeps, yes or no?

My OB told me that he routinely offers membrane sweeps starting at 38 weeks. He also said that since I am a VBA2C hopeful growing a large baby (history of large babies and GD) that he would offer it to me at 37 weeks. While my first instinct is to decline the offer (he won't push it) I thought I would ask what your girls think.

My thoughts are that it doesn't work anyway unless your body is on it's way in the direction of labor so what's the point. I'm also inclined to decline cervical checks because there is a risk of introducing bacteria and along with that there must be a risk of infection, no matter how small it just doesn't seem worth it. So, with the sweep there must also be an infection risk. I don't know if this is a risk as I really haven't researched membrane sweeps, but being that close to the bag of waters, what if they accidentally break it?

I might change my mind as my 42 weeks deadline approaches, but I really don't think it's something I'm interested in early on.

Give me your opinions girls! Any links are welcomed as well!

jooniper's picture
Joined: 08/27/07
Posts: 780

I'm not completely against them, but 37 weeks seems a bit early. Heck, I'd say 39 weeks seems early:)
It seems a little invasive (and painful) to have as a routine procedure.

TiggersMommy's picture
Joined: 02/14/10
Posts: 6043

I won't be getting cervical checks until I'm 40 weeks + 5 (40 according to my MWs). That's pretty routine with my MWs. I'll consider a membrane sweep if I'm showing signs of progress just for the chance that it'll help me stay at the birth center. My biggest concern is rupturing my water. I want to avoid that clock. In your situation I don't know what I'd do. 37 weeks sounds really early to me.

SaucyVidel's picture
Joined: 07/20/06
Posts: 634

Do NOT take it that early. It is a tool, and a very useful one, but it only works once. The closer you are to going on your own, the more likely it is to help you go into labor. If you use it before your body is ready to initiate the cascade of hormones that creates labor, you have lost a very useful tool in avoiding a medical induction a few weeks later.

I have no problem with membrane sweeps, I had them with both my girls, but they are better used at 40-41.5 weeks, not before, unless you are facing induction for another reason and this is an option to exhaust before being brought in for it.

They did the membrane sweep with my VBAC at right around 39.5 weeks because I was facing a transfer of care and the OB was not skilled in placing the foley catheter. Getting a sweep with the catheter was a good option, and since I was less able to do chemical inductions and my chances of successful VBAC lowered after 41 weeks, they wanted to start priming my body for labor sooner than later. But that was an unusual VBAC situation, had I not been facing a transfer of care I wouldn't have done it before 40 weeks without a more compelling health reason.

My midwives used it with my first to try and get me into labor at 41 weeks, if I recall, and it didn't work. Lots of contracting, but malposition to contend with. It probably would have worked if my fetal positioning had been better.

Long story short, it is a really useful thing to try, but it won't work if your body isn't ready. And your body is a whole lot more likely to be ready the closer to your due date or further postdates you are.

SaucyVidel's picture
Joined: 07/20/06
Posts: 634

As for breaking your water, about 1 in 200 women experience a rupture of membranes during a sweep, if I recall. They cannot tell if this is because the woman was ready, per se, or the sweep itself caused it. As for infections, I haven't heard of any appreciable infection rate that differs from normal infection rates with sex, cervical checks, swabbing, etc etc. All of those carry about the same level of risk (extremely low) when done properly.

Of all the things I am concerned about, infections with an intact bag of water from a cervical check or sweep is very, very low. But there is no point in doing either, really, before due dates.

Amber_daisy's picture
Joined: 10/17/06
Posts: 567

Ow, ow, ow!!!! I had one at 41.5weeks and 42weeks with Jesse and dear God it hurt like hell! There are risks (rupturing your membranes, which could land you with another c/s if you don't start labour then on your own) and infection. The likelihood of it putting you into labour at 37 weeks are pretty low.

If it were me, I'd definitely turn it down. Like anything, there's a time and a place, but this isn't it, in my opinion.

jolly11sd's picture
Joined: 02/02/05
Posts: 3327

I had it done at 38 weeks by my MW without much knowledge about it and had SROM 4 days later. I don't plan on doing it again this time. At least not consider it until after my 40-41st week. This MW is very different and doesn't do any internal exams until I ask for one. Also I don't have to worry about transfer of care too much since she will work will us past 42 weeks.

Joined: 03/16/15
Posts: 53852

I agree with Taryl in all she wrote. I also think that there is benefit for having more than one sweep if you are postdates. A good sweep can help create forewaters to put pressure on the cervix...especially if you are a multip and not getting the benefit of the baby's head putting pressure on the cervix.

I had my first sweep yesterday at 40+5 because I had an otherwise favourable cervix and don't want to wait for induction. I know that my babies grow big, and that they tend to be on the slightly more 'done' side when they are born, so I'm OK with helping it along a bit once I'm past my EDD.

cactuswren's picture
Joined: 10/19/09
Posts: 4658

I did it postdates, but I definitely would not do it that early. Your instincts are right on, IMO! It didn't actually do all that much for me anyway, but I did try it after 40 weeks. It's pretty uncomfortable--I had to use non-focused awareness (pain relief technique I looooooooove) to get through it--and if you're not "late" yet, I wouldn't say it's a worthwhile bargain to introduce even the small risks or the pain. In fact, I wouldn't have done it until 42 weeks if I hadn't been trying to make my birth center's risk out date.

Illiana's picture
Joined: 09/29/05
Posts: 338

I'm with Taryl and Emily.. I'm fine with them but I don't think they should be done before 40+ weeks and only if favorable. I was told by my MW with DD that they don't do them more than once because it unlikely to work a second time around but thats just their experience. i was 40w4d when i had mine and went into labor that night. This time i'll hold off until i'm facing induction issues again which hopefully won't be til closer to 42 weeks.

Joined: 06/05/06
Posts: 61

Ditto.

BTW, I just had one at 41+4 and it didn't hurt one bit. It wasn't even uncomfortable for me...and she got in there pretty good. So I think that just has to do with your body. The sweep did work - I went into labor about 7 hours later. But I don't think there's any benefit in doing it before term.

If anyone's interested - here's a Cochrane Review on "Membrane sweeping for induction of labor." http://www2.cochrane.org/reviews/en/ab000451.html

Joined: 05/24/05
Posts: 944

In your situation, I would decline the sweep and also decline any checks before 40 weeks. If the doc doesn't know anything about your cervix then they can't say little things like, "the baby's really high, I'm not sure this is going to happen soon", or "still no progress." These things can be really discouraging despite the fact that they are normal.

Keep the sweep in your bag of tricks for when and if you go significantly post dates.

Allie01979's picture
Joined: 10/10/07
Posts: 4706

My OB did a S&S at 39 weeks, I had Aidan at 39+3, I hear if it's going to work it works in 24 hours, but that's from a friend source so I'm not banking on it lol. It didn't hurt me, it defintiely wasn't a party in my pants lol. I probably won't opt for one this time unless I go over.

ETA: my waters didn't break though. The delivering OB broke them when I was 10cms and ready to push (I don't know why though)

Joined: 03/16/15
Posts: 53852

"Allie01979" wrote:

My OB did a S&S at 39 weeks, I had Aidan at 39+3, I hear if it's going to work it works in 24 hours, but that's from a friend source so I'm not banking on it lol. It didn't hurt me, it defintiely wasn't a party in my pants lol. I probably won't opt for one this time unless I go over.

ETA: my waters didn't break though. The delivering OB broke them when I was 10cms and ready to push (I don't know why though)

Typically the waters will burst forth in an explosive splash during pushing if they are still intact. He was probably trying to avoid a shower.

Allie01979's picture
Joined: 10/10/07
Posts: 4706

"Emilys3Guppies" wrote:

Typically the waters will burst forth in an explosive splash during pushing if they are still intact. He was probably trying to avoid a shower.

HA that would have been a fun show. Lol

Amber_daisy's picture
Joined: 10/17/06
Posts: 567

"Allie01979" wrote:

My OB did a S&S at 39 weeks, I had Aidan at 39+3, I hear if it's going to work it works in 24 hours, but that's from a friend source so I'm not banking on it lol. It didn't hurt me, it defintiely wasn't a party in my pants lol. I probably won't opt for one this time unless I go over.

ETA: my waters didn't break though. The delivering OB broke them when I was 10cms and ready to push (I don't know why though)

Sad I hate hearing things like that. It sounds like the intact membranes weren't hindering you at all....why fix what ain't broken? Birth is messy, they should expect the occasional "shower." Lol

One of the OBs here is famous for leaving membranes intact if the mom gets to pushing and they aren't broken yet. She loves "caul babies" (she's kinda superstitious)

Jesse was a caul baby.... sort of. The membranes were completely covering his head when he was born. They had ruptured up high though, and amniotic fluid squirted out with each push.

Allie01979's picture
Joined: 10/10/07
Posts: 4706

"Amber_daisy" wrote:

Sad I hate hearing things like that. It sounds like the intact membranes weren't hindering you at all....why fix what ain't broken? Birth is messy, they should expect the occasional "shower." Lol

One of the OBs here is famous for leaving membranes intact if the mom gets to pushing and they aren't broken yet. She loves "caul babies" (she's kinda superstitious)

Jesse was a caul baby.... sort of. The membranes were completely covering his head when he was born. They had ruptured up high though, and amniotic fluid squirted out with each push.

Actually Em and I were perusing a website that had pics of natural births, one of the babies was born en caul too, it was pretty cool, I wouldn't argue a caul birth.

Amber_daisy's picture
Joined: 10/17/06
Posts: 567

maybe you'll get a second chance! Biggrin

Spacers's picture
Joined: 12/29/03
Posts: 4103

I had to look back at my birth lodge to see what I did when I was getting toward the end of Weston's pregnancy. Funny how I can remember Tiven's pregnancy 6+ years ago so vividly but can't remember what happened last year. Here's what I wrote at 38+6:
[INDENT]I asked [my OB] if she would check my cervix and do a membrane sweep if I was dilated enough, and her eyes lit up and she said, "I'd be delighted!" I think I just made up for breaking her heart when I refused a cervical check at 36 weeks, LOL. SmileIf I wasn't a VBAC, I wouldn't even be thinking about dilation yet, but I'm almost 39 weeks and time is not really on my side this time. Unfortunately, my cervix wasn't cooperative, only fingertip dilated but very soft and about halfway to anterior. With Tiven, my cervix was like that at 41+6, so at least I'm making some progress! Yahoo She did get her finger all the way in and moved it around some, but she couldn't make the bend necessary for a sweep, but I've been pretty crampy since then so she definitely stirred things up! I'm planning to get out my breast pump tomorrow and see what that might bring.
[/INDENT]I started taking EPO capsules orally & inserting them vaginally every night starting at 38 weeks. I also started taking homeopathics at 38 weeks, Caullophyllum one day and Cimicifuga the next, three times a day for one week and then six times a day starting at 39 weeks. Had a not-so-good sweep by my midwife on my due date, and a pretty decent one by my OB the next day. On Sunday, 40+5, my midwife & I decided to try stepping things up so I increased the homeopathics to a dose every hour, alternating Caullophyllum & Cimicifuga, and I also took 2 ounces of castor oil that night. Woke up on Monday morning with strong regular waves 30-45 seconds long every 4-5 minutes. That early labor lasted all day Monday; Monday evening I was finally dilated enough for her to do a really good sweep, which kicked me into active labor within a few hours.

Warning: Caullophyllum has the potential to increase baby's heartrate and lower your blood pressure. The homeopathic version is much safer than the herbal blue cohosh, because the dosage & amount of active ingredient in each dose are controlled, but it's important to be monitored (or carefully monitor yourself) when you start it and whenever you bump up the dosage.