What is a Stretch and Sweep?

This week’s blog post is all about what to expect during a membrane sweep, otherwise known as a “stretch and sweep”, a common method used by practitioners to release labour-inducing hormones. 

A stretch and sweep is different from a cervical exam. During a cervical exam, a practitioner will use their fingers to feel the cervix. This may occur before labour, to gather information about the state of cervical softness, thinness, and level of effacement. Cervical exams may also occur during labour, to estimate cervical dilation and assess your baby’s level of descent through the pelvis (also known as pelvic station).  However, during a cervical exam, a practitioner will not manipulate the tissues to induce labour. 

It is important to note that consenting to a cervical exam does not mean automatically consenting to a membrane sweep. You may choose to request a membrane sweep at OB or midwife appointments within your due window (usually 37.5 weeks onward), or it may be important to you to avoid any interventions to a spontaneous onset of labour. It is important to be clear with your provider your wishes for or against a membrane sweep or any other intervention offered. You always have a right to refuse cervical checks and interventions at all times throughout pregnancy and labour.

However if you are wanting to get labour started but are wanting to avoid induction through synthetic oxytocin, a stretch and sweep alongside other less invasive induction techniques may be a wonderful choice for you! 

What a stretch and sweep involves: 
A stretch and sweep involves your provider inserting one to two fingers into the vagina to feel the texture of the cervix. If the cervix is soft and thin, the provider may choose to use a finger to gently “sweep" the amniotic sac away from the uterine wall, in an effort to move membranes away from the wall of the womb. This action helps release hormones called prostaglandins, which, along with oxytocin, stimulate labour.  If the cervix is hard and closed, the provider may use their fingers to massage the tissue in an effort to begin cervical softening.

Is the procedure painful? 
A stretch an sweep can cause discomfort and may feel alarming, especially if the provider performs the procedure without consent. Always ensure your provider is aware of your preferences and knows you require warning should they choose to perform a membrane sweep. Lubricating jelly will help ease some of the discomfort, though you may wish to implement some pain management strategies like deep breathing or visualization during the procedure. 

What happens after a stretch and sweep? 
After a stretch and sweep, it may be common to experience bloody “show”. This show is a clear mucous plug which, when released, may continue to be produced during labour. It is normal for the mucous plug to contain a small amount of blood. You may also begin to feel cramping which comes and goes, which may be a sign of early labour contractions.

What are the benefits of the procedure? 
Studies show that membrane sweeps may improve your chance of having a spontaneous labour. Alongside other non-invasive induction techniques, it can be an effective way to avoid induction through synthetic oxytocin. It is also a zero cost intervention, and relatively non-invasive. It does not come with other interventions and can be repeated if desired. 

Does a stretch and sweep include risks? 
The risks of a stretch and sweep may include a higher chance that the membranes will rupture before labour, especially in the absence of cervical softness (read more here: https://evidencebasedbirth.com/updated-evidence-on-the-pros-and-cons-of-membrane-sweeping/). When membranes rupture before labour, there is a risk of infection to you and/or the baby and medical induction is recommended. 

For more information on membrane sweeps, talk to your provider! The bottom line is, consent for membrane sweeps needs to be verbal and informed. A membrane sweep is not a routine part of a cervical check. A membrane sweep is a relatively non-invasive and low risk intervention that may help your body naturally begin labour. 

Still have questions? Leave a comment on this post with your email, or contact me!