When you’re so pregnant and uncomfortable you can barely roll over in bed, you may not know what to think when your doctor or midwife suggests an even more uncomfortable procedure to hurry up labour: a stretch and sweep. Is it worth the additional pain and discomfort you might endure? Here’s what you need to know about what happens in the procedure, why it’s done and how you’ll feel both during and after. (The great news: It’s not as bad as you might think.)
Also referred to as a membrane sweep, a membrane stripping or simply a sweep, this technique involves gently lifting the amniotic sac—or fetal membrane—from the cervix and lower part of the uterus. Late in pregnancy, a doctor or midwife inserts a gloved finger through the cervical canal and uses a sweeping motion to separate the membrane from the cervix. This “sweep,” releases prostaglandins, which are chemicals that help soften and open the cervix for delivery. “The hope is to accelerate that onset of labour by the increase of prostaglandins,” explains George Carson, a Regina-based obstetrician.
The “stretch,” which refers to gently widening the inner part of the cervix, is meant to further stimulate labour. Alix Bacon, a registered midwife in Ladner, BC, says while one finger is required for a membrane sweep, a stretch needs two fingers to be able to fit through the cervix in order to “literally stretch those fingers apart.” If your cervix isn’t ready to be widened, this part of the procedure won’t be done, she says.
A stretch and sweep is not an induction; rather, it's an equipment-free, drug-free way to coax someone already in late pregnancy into spontaneous labour. The main purpose of a stretch and sweep is to reduce the need for a medical induction after the due date, says Dustin Costescu, an obstetrician in Hamilton, Ont. “Because it causes a natural release of chemicals, it is less risky than medications used for induction such as oxytocin or prostaglandin gels,” he explains. Contescu says some women even request a stretch and sweep to help get labour started, particularly if they have a history of going past their due date. It’s a completely optional procedure—even if your caregiver suggests it.
You may go into active labour within a few hours, a few days, or not at all—it depends on how ready your body is. “One sweep might not do anything, but if you have a sweep at weeks 38, 39 and 40, it’s the cumulative effect of those sweeps,” says Bacon.
It’s a safe procedure, but Costescu says in very rare cases your water will break inadvertently. “While messy, this is not generally harmful,” he says. As with any time in your pregnancy, if you experience leaking fluid or heavy bleeding afterwards, call your healthcare provider.
It’s only offered at 38 weeks or later, and in order to do a sweep, the cervix must already be partially opened, explains Kim Campbell, a registered midwife in Vancouver. If your body isn’t readying itself for labour, the cervix will be out of reach and firmly closed, so the sweep can’t be done. “If this is the case, the care provider normally just massages the cervix and there is no contact possible with the membranes,” she says. The massage will help stimulate the area and hopefully soften the cervix.
Campbell says some of her patients describe a stretch and sweep as uncomfortable, while others call it painful. “Any pain is short-lived, and when the procedure is done, there is no residual pain,” she offers. The whole procedure, which can be done at the doctor’s office, in a midwife’s clinic or at home, is over in about a minute, and you’ll be fine to drive home afterwards if needed. Later that day, you may have period-like cramps along with some light spotting, which is all normal.
In the end, you’re the only person who can decide if it’s the right procedure for you. But if you’re anxious to go into labour, or worried about being induced, it’s a safe, fairly simple step that could have you meeting your little one very soon.