Membrane Stripping, Membrane Sweeping–just say NO

I don’t like to put this type of study up on my blog because I think the data is obtained unethically i.e. the women involved are not fully informed that they may get an infection, release the membranes accidentally leading to induction, be subjected to unnecessary pain and suffering, put themselves at risk for a cesarean, have a premature baby, etc. etc etc. I’m posting this because this aggressive procedure is done without hesitation by many practitioners and perhaps some women will read this and warn their friends. Gloria

Just say "no" to stripping membranes.

Just say “no” to stripping membranes.



http://www.jwatch.org/wh200807100000001/2008/07/10/no-need-sweep

No Need to Sweep
Whether or not women underwent membrane sweeping, overall rates of induction, postmaturity, and prelabor membrane rupture were similar.

Membrane sweeping to move the membranes off the lower pole of the uterus, routine in obstetric care, is performed to decrease the likelihood of labor induction or postmature delivery (JW Apr 11 2006). However, concerns about premature rupture of membranes and infection have led to debate about the merits of this practice. Investigators randomized 300 women to undergo membrane sweeping at 38 weeks’ gestation (with subsequent weekly sweeping) or no membrane sweeping. Participants had singleton pregnancies with cephalic presentation and anticipated vaginal delivery; women were excluded if they had indications for labor induction or cesarean delivery or had contraindications for membrane sweeping. Participants and researchers were blinded to group allocation with the understanding that this would not constitute full blinding, as patients probably would become aware of their assigned interventions.

Intention-to-treat analysis showed no significant between-group difference in occurrence of prelabor rupture of membranes (7% of women without sweeping vs. 12% of women with sweeping; P=0.19). Among women with cervical dilation 1 cm, however, 9% in the sweep group had prelabor membrane rupture versus no patients in the no-sweep group (P<0.05). Other obstetric outcomes, including cesarean delivery, spontaneous labor, induction, or postmaturity, occurred at similar rates in the two groups. Comment: These data indicate neither great value nor great risk from membrane sweeping starting at 38 weeks. However, subgroup analysis showed that women with cervical dilation 1 cm during late pregnancy could be at risk for prelabor membrane rupture in association with sweeping, suggesting that such women might be more sensitive to the procedure. This study excluded women with multiple gestations or those with various obstetric indications. Despite these limitations, the data suggest that there is no need to sweep.

– Sandra Ann Carson, MD
Published in Journal Watch Women’s Health July 10, 2008

Related post: http://wisewomanwayofbirth.com/stripping-membranes/

Reference for danger of infection (added May 2015): http://www.sciencebasedbirth.com/ObGynNews%2001a/OBN%20Cx%20manip%20leads%20infection%20Oct01.html

25 thoughts on “Membrane Stripping, Membrane Sweeping–just say NO

  1. How were the participants blinded? I have had my membranes swept once and there was no question about it because it’s pretty dang uncomfortable. And if they recognized it once, they would know which group they fell into.

    • Blinded in the sense that women are not told of the risks involved. Often women are given them without being asked first and the woman just thinks she is being given an internal examination. This happened to me and yes it was very uncomfortable but having never had a VE before I did not know any different.

  2. Given that it is not proved to put women into labour, it is a 50-50 undertaking at best, and a scary, painful interference at worst. Our hospital’s policy is to start offering at 39 weeks but I point-blank refuse to do that. Much better to advise women of what the “due date” really means, and get those babies lined up using Optimal Fetal Positioning. What irritates me the most is the smugness of MWs who do strip-and-stretches and the woman does go into labour, and then the MW takes the credit. For goodness’ sake…do they think the woman will stay pregnant forever?

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  4. I did not agree to a sweep but I agreed to an exam of my cervix.I felt a little pain, she asked me “are you sure you do not want a sweep?”, I replied “no”. But when I went to the toilet I noticed a brown discharge.Is it possible that she did sweep without me agreeing? I was a headache for them because I reached 42+ weeks and they wanted to get rid of me as quickly as possible.

    • Quite possibly, I had one carried out without permission, I had only agreed to checking my dilation…had never had this done before so didn’t know it wasn’t supposed to be so uncomfortable and painful. Then the MW told me afterwards she’d done it. Lets just say my labour pretty much turned sour after that and things all went wrong…

      • Can you tell me about your labor after having this done? We went for my daughter’s checkup this morning and her doctor stripped her membranes while checking for dilation. WITHOUT her permission. They hadn’t even discussed it. It was extremely painful for her and I’m livid. She’ll be 40 weeks day after tomorrow….

  5. No doubt women who were dilated 1 cm or less appeared to be more ‘sensitive’ to the procedure! It involves sticking a finger up through that 1cm (or less?!) gap in an otherwise closed and most likely long, posterior cervix, and mucking around with physiology that is doing a perfectly excellent job of keeping the baby IN – exactly what it is supposed to be doing until labour starts of its own accord.

  6. I have to admit I did a membrane sweep my first babe and it was incredibly painful and uncomfortable. I had zero complications and four and a half hours later I had an AMAZING water birth.
    I am expecting again and knowing now how uncomfortable it is I will NOT be doing a sweep with my second babe!

  7. I’m shocked that ANY practitioner would offer let alone do a s & s at 38 weeks! Given most women statistically don’t birth until around 41 weeks anyway! Dreadful practice!

    I’m from New Zealand and most midwives I know will not even consider offering a sweep until around 41 weeks. Even then, if the cervix is posterior, still really long, thick and hard, then it is a waste of time.

    It’s a crying shame most maternity health professionals around the western world do NOT follow evidence based practice – pretty simple really!

  8. Stripping membranes is an aggressive assault on a pregnant woman and her baby. It does no good and can do great harm. It can cost the woman her birth experience by creating an initial strong birth pattern which peters out before completion. A huge number of the “failure to progress” situations are pre-ordained by membrane stripping to “get things going”.

  9. I don’t agree with a lot of the comments here. The experience for me was slightly uncomfortable, not painful. I was however 38+ weeks and 2cm dialated. Stripping membranes does not cause a complicated labor, woman who experienced this may have been likely to have complications anyway. The first time it did nothing, the second time it worked by the next day. A call out I would caution is to be aware of any amniotic fluid leaking. It may come out in very small amounts at first and if you are not paying attention you may just think it’s leakage from baby on your bladder. My water had broken and I didn’t know for almost 24 hours. Thankfully there was no major infection for me or my baby but if I did it again.. which I would, I would pay more careful attention to that aspect.

    • your water was broken prematurely due to the sweeping, putting your baby and yourself at risk of infection… and you’d do it again.
      oh boy. no words.

  10. I’m having twins. I’m now finishing my 37week and they want to sweep on monday. I’ve been reading since my last appointment, (which was this Tuesday past and all was good). Since day one all as been good. Since the MW didn’t tell me about the risk, i will tell them I’ll wait. Since they say i can still go to 39weeks and such. But here in Switzerland for them twins are always 38weeks (i think most places the same). I want to go all natural as possible. So i will be trying acupuncture on Wednesday. If it works, then i know they were ready to come out. If not, I’m sure they’ll come when they ready. I think any induction shld be done when medically necessary

      • All went well, thank you. I had acupuncture seance onmarch 9th (i do feel like it helped) sunday evening that wknd i did a few bounces on the swiss ball, andstarted having cramps. From 23:00 cramps started and never stopped till they were born at 11:08 on march 14th. I kept my stance with gyno and said if there’s enough room and liquid, i wouldn’t allow anything to start labour. I don’t think here in Switzerland midwives do sweeps without consent (at least i hope). But this country is a stickler for rules.

  11. I declined a sweep at 41 weeks, went into labour naturally at 41 weeks and 3 days. Agreed to an examination of how dilated I was, explicitly told the midwife I declined a sweep and did not want one. First baby and first ever examination, so painful and uncomfortable. At the end she said that she had done a sweep…so mad as I hadn’t consented and really didn’t want one!

    • Did you log a complaint of assault at the hospital? that’s awful! unless the women complain about specific occurances though I can’t see how else to make it stop 🙁 congratulations on your new baby!

  12. At 34 weeks or so my mid-wife suggested that I do a ‘stretch and sweep’. Her explanation was that it would help relax the cervix and enable the cervix to dilate. I hesitated but agreed to the procedure approximately 3 times. I was doing managed expectancy and went into spontaneous labour at 41 and 1/2 weeks gestation. I developed an infection that I found out was group b strep. I had an emergency cesarean, my membranes had ruptured ‘high rupture’ and my son also developed group b strep and spent 8 days in the NICU. my husband and I could not comfirtably enjoy making love as it was so painful I would cry every time. My opinion say NO TO STRETCH AND SWEEP!

  13. I agreed to a sweep with my fourth pregnancy. It was very aggressive and extraordinarily painful. My midwife congratulated herself on her robust technique which she described as more forceful than others. She also described herself as having “piano fingers ” which made these robust sweeps possible. It was terribly painful, and I have given birth naturally. This particular sweep was followed (?causation) by a pre-labor rupture of membranes. In my mind, I know they were related. This, in turn, led to a section. If I can convince one woman to avoid a sweep with the posting of this comment, I would be very happy.

  14. I refused induction at 38weeks due to gestational diabetes so had to ‘bargain’ and agreed to weekly membrane sweeps from 37 weeks. They went like this : 37weeks , membrane sweep- 3cms dilated – nothing happened – not even plug released. 38 weeks – consultant surprised still pregnant. Membrane sweep. 3cms dilated. Nothing again.
    39weeks, consultant amazed membrane sweep hadn’t ‘worked’ membrane sweep, 3cms dilated, waters bulging NOTHING at all.
    40 weeks natural labour began by waters braking of own accord followed 1 hour later by contractions. 2 hrs 20 mins later 10lb 7oz baby born, natural hypnobirth, no pain, no pain relief, no tearing. Beautiful.

  15. I agreed to a sweeping with this 3rd pregnancy, which my first was a unnecessary c-section and my 2nd pregnancy was a successful VBAC. I’ve only agreed bc im past 41 weeks and these doctor’s are so set on with comlications i may not have. Me and baby are healthy and doing fine, However after sweep which was done 24 hours ago, im having more frequent irregular contractions and I lost part of my mucus plug. Hopefully I will go into active labor by Tuesday 7/25 or they scheduled me to be admitted. I’ll say in most cases baby will come on it’s own.

  16. I refused a sweep with my first. Then went into hospital at 41 weeks and 3 days as I’d been having regular painful contractions. Told the midwife I refused a sweep when she asked and then she examined me to see how far dilated I was. First time I had ever been examined in that way and it was incredibly uncomfortable and on the verge of painful. She finished said you are one centimetre and I did a sweep while I was in there. I was so shocked and felt very violated. There was no need as I was in early labour, she didn’t get consent and I had clearly told her I had not wanted one!

  17. Have any of you complained about getting sweeps especially after stating that you specifically did not want one? Im afraid of having an examination now incase they decide to also violate my wishes and give me a sweep.

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