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What is a cervical sweep?
A cervical sweep is when your Midwife performs an internal examination to reach your cervix and ‘strips’ the membranes as far as they can reach with their two fingers in a circular motion. The membranes refer to the bag of waters your baby is in. There are in fact two layers to the bag of waters, that is why they are referred to as the membranes, plural. The intention is not to break the waters, it is just separating the outer layer from the uterine wall. You may also hear it referred to as a stretch and sweep, a membrane sweep or just a sweep. You can have more than one, 48 hours apart, up to three in some cases. It may vary according to local policy.
Why is it done?
The intention is to stimulate the body to go into labour naturally, or as naturally as possible. It will not be offered before 40 weeks and is often not done until a week overdue or more. In certain cases if authorised by an Obstetrician they can be performed between 37 and 40 weeks.
Who performs a sweep?
Your Midwife will perform the sweep or it can be done by your Obstetrician. It can be done in the community in your own home or where you usually see your community Midwife in her clinic, or it can be done when you see the Doctor or Midwife in the hospital clinic or ward if you are an inpatient.
How does a sweep work?
A cervical sweep works by releasing the hormone Prostaglandin, which has a role in starting labour off.
What does a cervical sweep feel like?!
Now not only have I performed hundreds of sweeps on pregnant women, I have also had them done myself for my first and third child, multiple times! So I also know what they feel like myself as well as seeing hundreds of women react. I’d like to be able to reassure you completely because I found them no big deal, but then I know others who’ve found them unpleasant. I can tell you that it isn’t horrendously painful, most women find it completely bearable and at the most it feels like a bad period cramp for 30 seconds. FYI it’s nowhere near as bad as a contraction in established labour.
As mentioned above, the Midwife will need to insert two gloved fingers inside the vagina to locate the cervix. This is often the most uncomfortable part although they will use plenty of lubrication like KY jelly. The cervix can be quite high up and posterior (towards your back) so it means we may need to insert the fingers quite far. A good Midwife will get you in the best position possible which is your legs apart and heels together and tilting your pelvis forward. You can also make fists and put them under your bottom to aid the process. It helps if you are relaxed, which I know is easier said than done. Practice relaxation techniques which are really useful for labour and for things like this.
Image from New health advisor.
Once in position and when the Midwife has located your cervix the sweep part isn’t too bad. It feels like cramping and if you can feel it being done it means they are doing a good job. There’s no point in going through a vaginal exam if the Midwife or Doctor isn’t going to do a thorough sweep of the membranes. So a little bit of discomfort can mean the difference between going into labour naturally or having an induction.
Afterwards, you may have a ‘show’ of blood and mucous or just one or the other. If you have heavy bleeding or you aren’t sure, then contact your care provider. If it’s going to work, it will work with 24-48 hours. Some women have some cramps afterwards which then settle down, others will go into labour.
If your cervix is still long and closed, the sweep will not be possible. This is not uncommon, especially if it is your first baby, and the act of having a vaginal exam may still stimulate the cervix to start becoming more favourable. The closer you are to labour naturally, the more likely it is to work.
Isn’t having a sweep done interfering with nature?
Technically, yes it is. But it’s not using any drugs or interfering with the membranes themselves and shouldn’t introduce any infection if done properly. There is a small risk of an accidental rupture of the membranes (your waters breaking) during having a sweep done, but in all my years practising that never happened to me so it is very rare. If you are heading towards two weeks overdue and you are keen to avoid induction or going too far beyond your due date then I think it’s the smallest of interventions. Remember you don’t have to go through induction if you don’t want to.
Does it actually work?
The success rate is actually not that high. Studies show that only 24% of women will go into labour within 48 hours of having a stretch and sweep. However, there is evidence that women are more likely to go into spontaneous labour if they have a membrane sweep at or after 40 weeks.
You may decide on that basis that it’s not worth it for you, or you may be desperate to go into labour and will try anything! Hopefully, this post together with a discussion with your Midwife will help you decide whether to go for it or not and will arm you with the information you need to feel comfortable.
Not intended to replace medical advice
2 Comments
Brilliant article, I still remember when my partner had one. She’s currently on her journey through uni with a nursing degree and to follow on to do midwifery, this is one thing she said she wasn’t sure if she would manage to do.
July 16, 2020 at 2:43 pmOnce you’ve done most things as a nurse the vaginal exams in midwifery aren’t too bad and once you’ve done one the rest are easy, it just becomes another clinical procedure. Good luck to your wife!
July 17, 2020 at 11:40 am