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Sweeps - the risks and benefits


Let’s talk about sweeps! Often called a stretch and sweep, or sweeping the membranes, they’re seen as a “routine” procedure to get things moving as you approach (yes even before you’re due sometimes!) or go past your due date. But are they really necessary and are they risk free?

Now it’s important to note here that there is nothing wrong with consenting to a sweep. As with every procedure in birth, hypnobirthing is not about saying no to everything! It’s about understanding your options so you make informed choices. So let’s look at the facts!


Firstly what IS a sweep?

A sweep, sometimes called a stretch and sweep, or “sweeping the membranes” involves a midwife inserting a finger in to the vagina and past the cervix (the opening of the uterus) and using a sweeping motion to separate the membrane that surrounds baby from the lower part of your uterus. This can only be done if you are already 1cm dilated or more. If your cervix is not “favourable” the procedure cannot be done.

Does it work?

Research is mixed as to whether a sweep actually works to induce labour. There is evidence to show that if done at 41 weeks it may reduce your chances of going over 42 weeks. Evidence also shows it may shorten your pregnancy by an average of 4 days. However, as your cervix needs to already be favourable and dilated, there’s no way of knowing if you’d naturally go in to labour on your own without the sweep and when that could happen. If it does trigger labour, it can mean you avoid further forms of induction such as picotin to induce labour.

Is it risk free?

The simple answer is no. A sweep may introduce infection, and it may cause bleeding. Some people find it painful and uncomfortable, or even triggering. There is a 1 in 10 chance of your membranes being accidentally ruptured. If this happens, and labour doesn’t start, it can lead to further induction procedures. It can also cause irregular contractions and a longer labour.


So should you consent to a sweep?

The key here is for you to assess the pros and cons and make an informed decision. There is no right or wrong answer! If you decide to consent, that’s absolutely fine, as it deciding to decline. It is not compulsory!

Most importantly, is the word consent. A sweep should NEVER be performed without your explicit consent. Agreeing to a vaginal exam and being told “I’ve just given you a quick sweep to get things going while I was down there” is not acceptable or permissable. The consent for a vaginal exam and consent for a sweep are two separate things and require separate expressions of consent. As with anything in birth, you can say no to anything and everything. It’s your body, and in no other situation would it be permissible for you to be touched or have anything done to you without your explicit consent.


If you’d like to do further reading on sweeps, I suggest the following links:


https://www.cochrane.org/CD000451/PREG_membrane-sweeping-induction-labour


https://evidencebasedbirth.com/evidence-on-membrane-sweeping/


https://www.sarawickham.com/articles-2/what-is-a-stretch-and-sweep/


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