Membrane Sweeping

[Mirrormonkey]

Went to my doc today and he said I should consider having my membranes swept at about 38 weeks. Is this normal? Should I say yes? I already feel like this baby will be early, I am 35 weeks now, but I am not sure if it is the right thing to do.

[me&3]

Why on earth would that be suggested at 38 weeks? No, I don't think it's normal or called for.
My first birth - 13 years ago - I was 40 weeks, having contrax, and a bit effaced. The doc decided to sweep the membranes to move things along:
(1) it was *terribly* painful!!!
(2) it kind of "jump started" more active labor - - but it took over 40 hours.

It's best to let baby and nature take their course, if at all possible.

Good luck!

[AnnieNimIty]

Yeah...... I would say no... Then ask why they would suggest that.
I had mine done after 3 days of contractions and 3 centimeters dilated.
HURTS.
It makes no sense if you have no signs of labor. Remember, 38 - 42 weeks is normal gestation. From what I understand, often first time moms do go "overdue".

[Sijae]

There is controversy regarding wether stripping or sweeping the membranes can increase the chance of infection or breaking the water. While it can be a good start to an induction, in addition to being painful and potentially causing cramping and bleeding for several days, sweeping the membranes has not been proven to be clinically useful. "Routine use of sweeping of membranes from 38 weeks of pregnancy onwards does not seem to produce clinically important benefits. When used as a means for induction of labour, the reduction in the use of more formal methods of induction needs to be balanced against women's discomfort and other adverse effects." http://www.ncbi.nlm.nih.gov/pubmed/11405964

It seems that sweeping the membranes at 38 weeks without a medical indiction is nothing but impatience and ignorance or disregard of the health benefits of full-term gestation.

I'd be wary of a Dr. that wanted to move things along at 38 weeks. Remember that pregnancy is considered full-term at 40 weeks. Yes it is usually safe to have a baby at 38 weeks or even before but that doesn't mean it's preferable. Babies should choose their own birth date when they are ready to be born, encouraging them to come out early is playing with fire. Babies born at older gestations have a better suck reflex, more mature lungs and have less problems with jaundice. Giving your baby it's full incubation time in the womb is healthiest for normal pregnancies.

It is normal for some women to have their babies early and some to go significantly beyond 40 weeks. In one study, first-moms *averaged* 8 days over the traditional due date and moms having their second or beyond averaged 5 days over. Doctors have no way to know when a baby is really ready for extrauterine life and unfortunately more and more babies are being born slightly premature and requiring extra care because of early inductions or c-sections before the due date (which may or may not be an accurate estimate of when the baby will be fully mature)

[jecombs]

I got my membranes swept when I was 39 weeks pg with my DD. I was very swollen and BP was rising, plus I was already 3cm dilated. I got swept 3 different times and it did nothing to move labor along. DD came at exactly 41 weeks, about a week after my last sweep so I think the two were not connected at all. It's my understanding that they can't do a sweep unless you're 2-3cm dilated. And even then, it probably won't work unless your body is ready to go into labor anyway.

[loveneverfails]

I would absolutely not consent to a membrane sweep at 38 weeks, because that's a card that you can't really play twice and it begs the question about what you do if the sweep doesn't work. If there is a *reason* why you want/need to be going into labor at that point, then yes... by all means, go for the sweep before you start talking about pit, AROM, etc.

Especially if you're a first time mom, I don't think you've got a great chance of that sweep putting you into labor. And you may not even be dilated enough at 38 weeks to do a sweep! Does your doctor always recommend this stuff?

[Mirrormonkey]

Thanks everyone, I was thinking it would be a premature to sweep my membranes so soon. This is my second baby, and yesterday my doc said the baby felt quite low so maybe he thinks things will go early. I was induced on my due date with my first (long angry story...) and I keep telling this doc that I want to know what it feels like to have things start on their own this time around.

[MiaMama]

The military has a little pregnancy book they pass out, and it has a few pages for each appointment, with a place to write down your BP, FHR, weight, and some little blurbs about what to expect at each appointment.

At the 38 week page, it says "Your provider will check for any cervical opening or thinning and offer to strip membranes if possible." p.63

So, it seems like standard practice in MTF (military treatment facilities). I declined, with no second word about it, but I wonder how many don't even question it.

Interestingly enough, the hospital midwives ended up stripping my membranes when I was in labor to try to encourage the process to move along (I agreed to that one, as it was the least destructive thing they suggested). It was painful and awful.

[AustinMom]

I was 41 weeks pregnant, and I had my membranes swept to avoid going past 42 and having to go to hospital, and I was having VERY mild contractions for about an hr every other week or so, and those got me to 4 cm (first time mom also). After my membranes were swept, and I went into labor, I labored 27 hrs, in ACTIVE, minute-ish long contractions, couple minutes apart and only got to 6cm after 27 hr. I had to have a CS and it turned out he was acynclitic. I am of the belief that when the midwife swept my membranes, she wiggled his head funny, and caused the acynclitism. This time around, I will NOT have it done even if we are 43 weeks!!!

If you feel you are going to be early, great, let the baby come when he/she is ready. The best thing you can do for your baby now is carry him till they tell you they are ready to be born.

[*MamaJen*]

Do you have a birth plan and a doula? If he wants to strip your membranes this early, I think there's a very good chance he'll also try to do a whole lot of unnecessary interventions. Are you trying for a natural birth? Are you pretty well informed on childbirth issues and common interventions in general? This might be a good time to read up on.
The only reason to strip membranes is to induce labor -- and it's really hit or miss anyway -- and barring a medical issue, why in the world would you want to induce labor two weeks early? There are a slew of problems that can arise from inducing labor before the baby is ready, and I would absolutely not consent to it.
The other thing is, did he attempt to give you any reason why he wanted to strip your membranes? I'm really wary of any practitioner who doesn't value informed consent.
Honestly, my real advice is switch to a midwife.

[AnnieNimIty]

I think these other ladies have given you great advice. As for Dr.s' guesses, I was told I would have an over 10lb baby and I would go "early". I had a 7lb 9 oz baby 11 days past my "due date". Sooooo.... Yeah. Take everything they said with a salt lick.

[grcelizabeth]

Basically membrane sweeping can more or less painful for different women, but it should ONLY BE DONE when you are ripe (cervix dilated above 1cm, thin, and soft) and not until full-term. You can choose to have it done and it will aggrivate the cervix yes, maybe causing spotting and cramps, however IT WILL ONLY WORK IF YOU ARE RIPE AND BABY IS READY! This is not just my personal experience, this is from studying it across many women.

Babies come when they're ready and doing a sweep MAY cause baby to come before he/she is ready and therefore lead to complications or interventions.

[Mirrormonkey]

I am telling him no, I want to wait till I am officially overdue before we start trying different things to get labor going.

I don't have a doula or a birth plan, our hospital has a pretty low intervention rate so I am not that worried about that. I do know that I want drugs this time around! Also I don't plan on going in until things are really getting going.

[gardenmommy]

I consented to it with #2, at 16 days post-dates, and it did get my labor started. However, I would not have consented any earlier, and my MW didn't suggest it any earlier. I think it can help you go into labor, but only if you are ready to go into labor anyway. I would def. not allow it at 38 weeks.

To a PP, my last birth #4 was very difficult because the baby was acynclytic. It didn't have anything to do with interventions, it was just the way he was positioned. I did not have a CS, but pushed for almost 5 hours. It was very hard, and I never want to do that again! My ctx were like Pit. ctx., and man! Very tough labor. I'm sorry that you ended up with a CS; I'm sure I would have, too, had I been in the hospital. However, I had a great support system, and birthed at home. My sympathies to you, because I *know* how hard you were working! May your next birth (and mine) be much easier!

[Tenk]

I don't have advice on it's effectiveness or not, but it didn't work for me and it hurt so bad I was crying when she was done. On the other hand I have a friend that had it done with each pregnancy and she delivered with in 5 hours each time, she was however 3+cm dilated each time.

[MegBoz]

I had it done at 41W4D. MW said I was already 3CM, went to 4Cm as she did the stripping, and while she didn't tell me the % effaced I was, she said it was "A perfect cervix."

Sure enough, ctrx started 2 hours later, DS was born about 6 hours after that! So in my case, it was great because I got to labor during the day (spent most of labor floating in our in-ground pool out back!) Otherwise, I'm guessing labor would have started that night.

Personally, I didn't really find that it hurt, just uncomfortable. TMI, but MW had small hands & had to really push to reach up into the cervix and sweep around. But I'd been warned it hurt & it wasn't really that bad. No worse than a pap smear, IMX.

Anyway, I second the others to be cautious of this OB & get a birth plan... I've read way too much to not be wary of American hospitals. not just personal birth stories, both also research from journalist like Jennifer Block in her book "Pushed" & the writings of Dr. Marsden Wagner.