Can we talk about Membrane Sweeps?

[laughymama]

I am currently 41 weeks 4 days.

Last week my midwife asked if I wanted to be checked at all (she doesn't do internals unless the client wants her to.) or if I wanted her to strip my membranes. We talked about it a bit and she didn't have any feelings on it either way, left it entirely up to me. The baby was sounded great, my BP and everything else is great. I decided to let it be and declined the internal and the sweep.

I have another prenatal tomorrow morning and I'm wondering if I should ask her to do a sweep this time. I've been reading up on it though and it seems like a toss up of "It worked for me!" and "Didn't do a darn thing". I am also not sure if I know all of the risks associated with it or not though I will definitely discuss them with her tomorrow morning. I thought maybe I'd get some perspective from some ladies on here.

Has anyone who has had it done feel strongly one way or another about it? Would you have it done? Also, how uncomfortable was it? Internals are not necessarily "painful" for me but I'm not throwing a party about having one when I do. Is the sweep a fair amount more uncomfortable?

I will be 42 weeks on Thursday. I've been losing a LOT of thick whitish mucus all week long and today there was also a bit of brownish color in there with it. I've had mild cramping here and there for about a week or so as well. So my body is definitely doing SOMETHING.

My dates are not exactly accurate but they aren't crazy off. If they're off at all then it's only by a week maybe. I measured right at 40 weeks last week.

My homebirth is not under any threat as I am in Missouri and there really aren't any regulations here legally on homebirth when it comes to "risking out".
I'm a bit concerned about being "late". Is there a higher risk of complications or special concerns? What are they?

Like I said, I'll discuss this with my midwife in the morning before anything but I thought maybe I could get some good info tonight to kind of think on. Thanks Mamas!

[homemademom]

I've had it done with two of my pregnancies. The first time it seemed to worked (meaning, I started having stronger more regular contractions within 24 hours) and the second time it didn't. I actually had it done twice and the baby still came a few days later.

To me, it's one of those "why the heck not?!" sort of things, when you get a to your edd. I've heard a very few negative stories where the mom thought it put her into labor too soon, but mostly, it's like you say: yes it worked, or no it didn't, but it didn't do any harm.

At 41 wks 4 days, I'd be all over it personally Good luck with whatever you choose. . . and with that impending delivery!

[etsdtm99]

my midwife offered to check and strip/sweep if i wanted to .. i had it done with both of my other kids, with my DS it didn't work (was eventually induced), with my DD my water broke a week later which may/may not have been related..

i had it done with DD at 1cm and my midwife checked me last week iw as 2CM and she said it would hurt too much to do it.. it hurt REALLY bad with my DD and i bled a lot after.. my midwife acted like my OB was crazy for doing ti at 1cm and she usually only does it at 3-4 cm ..

so.. i think at 42 weeks i'd do it either way.. but my midwife isn't comfortable with just waiting it out at that point..

oh, and my main 'concern' would be that it can break your water and have labor not start.. don't really want that..

[*MamaJen*]

Hearing stories about routine membrane sweeps at 38 weeks drives me absolutely crazy. But getting on to 42 weeks, especially if I was already starting to dilate, I might think about doing a gentle sweep.
The way I understand it, if you're getting close, a sweep might nudge you over the edge.

[Earthylady]

I think the greater risk, and the reason why many refuse internals all together are because of risk of infection, and also risk of breaking your water.

[Sfcmama]

I had mine swept at 41 weeks because my birth center didn't allow deliveries past 42. Because I was already dilated 3ish cm, it was umcomfortable but not worse than an gruff pap. (and NOTHING compared to the intensity of labor ;0)

I bled slightly and felt minor contractions but didn't go into labor for another 3 days, which confirmed my feeling that sweeping could be the tipping point but can't force what's not ready.

I was aware of running the risk of infection and waters breaking (neither of which happened) but I was REALLY worried I wouldn't be able to deliver at the birth center. The irony of it all was that I ended up transfering anyway due to meconium... one of MANY lessons that we can't control/predict everything ;0)

Best of luck, mama!!!

[MegBoz]

Originally Posted by laughymama

it seems like a toss up of "It worked for me!" and "Didn't do a darn thing".

I've actually found the research shows the same thing! There are studies showing no effect & other studies showing - particularly if sweeps were done repeatedly in late pregnancy, women did deliver sooner than without sweeps.

Here's my experience:
Had it done on 41W4D. (Planning hospital birth, their "policy" was routine induction if I hit 42W, although at least one of the MWs flat out told me she didn't agree with this, so I would have declined, but obviously would rather not have to face it anyway.)
MW said I was about 3cm, went to 4 as she went around to do the sweeping.
She said it was "a perfect cervix. I really think this is going to work." She didn't name the percentage effaced I was, although I didn't care much about the # since I know those stats are meaningless without labor. She just said "perfect cervix again." (I had asked about coming back to have it done like 10-12 hours later if nothing happened.)
I had previously not even had ANY BH ctrx & was starting to feel paranoid my uterus didn't even work!
Ctrx started 2 hours later. DS was born about 6 hours after that!

I had had the sweep done at 10:30 AM, so I was very fortunate to labor during the day - & since it was July & we had a big in-ground pool, I spent most of labor floating in the pool, which ROCKED!

My belief is that I would have gone into labor that night if I hadn't had the sweep (pretty sure I've read it's more likely to go into labor at night since oxytocin levels are naturally higher.) But as I said, laboring in the day was a huge advantage since I got in the pool outside! I also figured it was nice that I was well-rested instead of waking up at 2 AM with ctrx.

The sweep actually didn't hurt. It wasn't exactly 'comfortable' but it wasn't painful. One of my friends said it hurt her. BUT - this particularly MW has really tiny hands! she just did a pelvic exam on me a couple months ago & it was by far the most comfortable I've ever had - so I'm thinking it's likely her small hands helped the sweep to not be painful. (Hm, although reading a PP, maybe it was the fact that I was 3cm & stretchy?)

It also took maybe 2 seconds if that, she literally just ran her finger in a circular motion just inside the cervix. I really don't think it was more than 2 seconds.

The only risks I saw were introduction of bacteria- more of a concern if you're GBS +. I also worried about breaking the water, but my doula said, "Oh, they know what they're doing, they won't break the water." Not sure how often it happens that water breaks.

Another 'risk' I've read about is people having ctrx that start after a sweep & then never really go anywhere! So you're coping with the discomfort of ctrx, maybe not able to sleep, but not actually put into labor. Seems that would be a bit hassle... i.e. if I'm not going to actually be in labor then I don't want to be dealing with semi-regular ctrx!

Based on my personal experience, I'd probably have it done again - in the morning - but only if I hit 41W or beyond again. I agree that it's sort of a "why not" thing - the risks are so low. AND - I really think it's like other natural 'induction' methods such as nipple stimulation & sex - it can help get things moving if you are ready anyway, but it won't necessarily put you into labor if your body & baby are NOT yet ready. Although, ha, that's not evidence-based! Just an opinion I have based on reading about it for years.

As for risks of going post-dates, actually, yes, the risk of stillbirth does go up after 41W & again after 42W - BUT, it is still a very low risk overall and I don't think it goes up substantially. There's also a risk that the placenta will begin to degrade, and therefore not adequately supply the baby with oxygen, but I really don't know how often that happens & a woman does NOT go into labor.

[VeggieLovinMama]

I had a sweep done with my last baby. I didn't ask for it, the doctor just did it because she could tell I was getting anxious/tired I guess. It was a couple of days before my due date. I went into labour the next afternoon and DS was born 3 hrs later. The sweep didn't hurt and I didn't really know it was happening. I hadn't had any BH or cramping or anything prior to the sweep.

This pregnancy (I was due 4 days ago) I really want to get a sweep again. I've had so many BH and cramping and thick white discharge. I'm not sleeping well, I feel drained because I'm such an anxious person at the end of my pregnancies. I really want to meet this baby and have my DH start his paternity leave (I look after 2 toddlers and homeschool a very active 7 year old) so I have some extra help. I'm going to ask for the sweep tomorrow since I've tried everything else (aromatherapy, nipple stim, sex, castor oil, acupressure, labour tincture...)

I think it's a personal decision and depends on your health, support, and due date. I'm also GBS negative which I think helps make my decision since I was going to refuse the antibiotics.

[wami]

I had a sweep done on my due date with my DD. I was 1 cm dilated and 90 percent effaced and had been since 36 weeks. I decided to do it because the last month of my pregnancy was miserable -- DD had dropped and was so low I had severe rectal pressure for several weeks. I was working and didn't want to waste any sick time before my mostly unpaid maternity leave.

It wasn't comfortable, but it was all pretty minor compared to the pain of labor! I immediately had cramping, went home and walked and walked and walked to keep the contractions going and had my DD just after midnight the next day. My sense is I probably would have gone into labor on my own in a day or two anyway. I lost my mucus plug the day before my sweep.

I'm due this week with our second and I'm not planning to have a sweep -- but if I end up being more than a week past due, I'll consider it.

[Eresh]

I actually had my membranes swept during labor -- sort of. I'd had 3+ days of off and on contractions. They would get regular 5-6 minutes apart for 10-12 hours then peter out. The membrane sweep worked in that I immediately went into hard labor and had DS 8 hrs later. I was over 4cm dilated at the time and it was the most painful experience of my entire labor.

Btw, since I think you also asked about post-dates, the main risk associated with going past 42 weeks is increased risk of stillbirth. While there is a large increase in the risk percentage, the absolute risk is still extremely low.

ETA: Oh, and if you're having a lot of brown-tinged mucusy discharge, your cervix is definitely doing something so I would think a membrane sweep would be more likely to be productive than otherwise.