Stretch and Sweep: What You Need to Know

Highlights

A ‘stretch and sweep’ is a method to try to start labour by gently moving the membranes around your baby from the wall of your uterus.

• It is a safe procedure that can reduce the risk of going overdue or needing to be induced.
• It can be done during a vaginal examination by your doctor or midwife.
• After the procedure, you may experience cramping pains and see mucus from your vagina.
• This procedure is typically offered when you reach your due date.

In This Article

• What is a Stretch and Sweep?
• Benefits of the Procedure
• When is the Procedure Offered?
• How the Procedure is Performed
• Post-Procedure Expectations
• What Happens if it Doesn’t Work?
• Possible Risks of the Procedure
• Tools and Assistance

What is a Stretch and Sweep?

A ‘stretch and sweep,’ also known as a ‘membrane sweep,’ is a procedure used to try to start labour. It involves gently separating the membranes of the sac surrounding your baby from the wall of your uterus (womb). This action releases hormones called prostaglandins, which help prepare your cervix for labour and birth.

Benefits of the Procedure

A stretch and sweep is considered a safe procedure for low-risk pregnancies. The benefits include:

• Increases the likelihood of labour starting naturally within the next two days.
• Reduces the chance of being overdue and requiring an induced labour.
• Can be performed during a routine appointment.
• No hospital stay required afterwards.
  This procedure can be an effective way to avoid complications related to overdue pregnancies.

When is the Procedure Offered?

Typically, a midwife or doctor may offer a stretch and sweep when you reach your due date. In some cases, it may be offered as early as 39 weeks, depending on the practices of your healthcare provider. If you have a health condition that makes it unsafe to go past your due date, you may be offered a stretch and sweep as early as 38 weeks.

It’s entirely your decision whether or not to have a stretch and sweep. You are not obligated to have one if you do not wish to proceed with the procedure.

How the Procedure is Performed

A stretch and sweep is done as part of an internal vaginal examination by a midwife or doctor. The procedure includes checking if your baby is positioned for birth, lying head-down, and evaluating the state of your cervix. Using gloves and lubricant, the healthcare provider will insert their fingers into your vagina to check whether your cervix is open or closed.

If your cervix is open, the provider will gently stretch the cervix and perform a circular motion with their finger to separate the membranes from the uterine wall.
If your cervix is closed, the provider may massage the outside of the cervix to help encourage labour.

If at any point you find the procedure uncomfortable, you can ask your midwife or doctor to stop.

Post-Procedure Expectations

After the procedure, you might notice a ‘show,’ which is a plug of mucus from your cervix. This may contain some blood, but you should not experience fresh, bright red bleeding. If this occurs, contact your healthcare provider immediately.

You might experience cramps or contractions following the procedure. Taking paracetamol and having a warm bath may help relieve any discomfort. If the pain becomes intense, contact your midwife or doctor.

It is important to monitor your baby’s movements after the procedure. If you notice any changes, inform your healthcare provider right away.

What Happens if it Doesn’t Work?

If you don’t go into labour within the next couple of days, the procedure may be repeated. If labour still doesn’t start, your healthcare provider will discuss other options, including the possibility of an induction.

Possible Risks of the Procedure

For uncomplicated pregnancies, the risks of a stretch and sweep are minimal. However, there are a few potential concerns:

• The procedure may not work and may not trigger labour.
• There is a slight risk of infection, but this is rare, especially if you have had a positive group B streptococcus (GBS) test.
• The procedure may not be suitable if you have certain conditions, such as hepatitis C or HIV.
• If you have a low-lying placenta (placenta praevia), a stretch and sweep is not recommended. The procedure could lead to serious bleeding in such cases. Before performing the procedure, your doctor or midwife will check the position of your placenta.

Always discuss the benefits and risks of a stretch and sweep with your healthcare provider before deciding whether or not to proceed.

Tools and Assistance

If you are considering a stretch and sweep, there are a few resources that can help you navigate the process and provide support:

• Healthcare Provider Consultation: Before undergoing a stretch and sweep, it’s essential to have a detailed conversation with your doctor or midwife. They can explain the procedure, its risks and benefits, and address any concerns you may have. It’s important to feel comfortable and well-informed about the decision.
• Pain Relief Options: Discuss pain relief options with your healthcare provider. While a stretch and sweep is generally a quick procedure, some women may find it uncomfortable. Paracetamol or warm baths may help alleviate discomfort afterward.
• Monitoring Baby’s Movements: After the procedure, it’s crucial to monitor your baby’s movements. If you notice any significant changes or reduced movements, you should contact your healthcare provider immediately for further evaluation.
• Follow-up Appointments: If the procedure does not lead to labour, a follow-up appointment may be scheduled. Your doctor or midwife will discuss other potential steps, including further sweeps or induction, based on your situation.
• Emotional Support: Going through the process of trying to start labour can be an emotional experience. Consider talking to friends, family, or a support group if you need emotional support. It’s normal to feel a mix of emotions as you approach your due date and the birth of your baby.
• Educational Resources: Books, online resources, and antenatal classes can help you learn more about the stages of labour and delivery, including procedures like a stretch and sweep. Educating yourself can empower you to make the best decisions for your health and the well-being of your baby.