From 40 weeks pregnant, if you are a first time mum and 41 weeks for subsequent pregnancies, at the discretion of your midwife you will be offered a vaginal examination to perform a membrane sweep.
What is a membrane sweep?
Membrane sweeping involves your midwife or doctor placing a finger just inside your cervix (neck of the womb) and making a circular, sweeping movement to separate the membranes from the cervix. This has been shown to increase the chances of labour starting naturally within the next 48 hours and can reduce the need for other methods of induction of labour. It May be carried out at home, during an antenatal appointment at your surgery or in hospital.
The procedure may cause some slight discomfort, slight bleeding or a ‘show’ and/or tightening of the womb. All of these are normal, and will not cause any harm to you or your baby. It will not increase the chance of your baby getting an infection.
Membrane sweeping is not recommended if your waters have broken.
Whether you have decided to have a membrane sweep or not, you will always be offered a date to have your labour induced (started off). We will ensure you are offered an appointment to attend the hospital between 41 and 42 weeks of pregnancy for a review and to commence your induction of labour.
Can I choose not to have a membrane sweep?
If you decide not to have a membrane sweep, this is not a problem as it is your choice. However, if your pregnancy continues beyond the recommended 12 – 14 days past your due date, you will be invited to attend the Quantock Assessment Unit for further review to ensure that both you and your baby remain well whilst awaiting the onset of natural labour.
At this appointment a midwife will talk to you about how you are feeling, and perform a full antenatal check which will include taking your blood pressure, testing your urine and examining your abdomen to assess the growth and position of your baby.
Your baby’s heartbeat will be monitored for a minimum of 20 minutes and you may be offered an ultrasound scan to assess how much water (amniotic fluid) is surrounding your baby where appropriate. This information will help us when discussing the future care of your pregnancy and possible induction of labour with you.
What happens if my waters break?
Sometimes a woman’s waters break before labour starts. This is known as pre-labour rupture of membranes. If you think your waters have broken it is important you discuss this with a midwife.
You may be invited to attend the hospital for an antenatal check to assess both your well-being and that of your baby and to confirm that your waters have broken.
If your waters have broken but you have not gone into labour you will be offered the choice of either:
- A ‘wait and see’ approach to await the onset of natural labour if all remains well. 9 out of 10 women whose waters break before labour starts will go into labour naturally within 24 hours of the waters breaking.
- Induction of labour if there are concerns about either your well-being, or that of your baby.
These options will be discussed with you at the time so that you can make a decision on which you would prefer. One of the functions of the membranes is to provide a sterile environment for your baby. The longer the time interval between your membranes breaking and the birth of your baby, the more likely it is that an infection will develop. Due to this fact, we currently recommend a ‘wait and see’ approach of no more than 24 hours following the breaking of your waters. If labour has not started naturally during this time, induction of labour will be recommended.
It is important that you are happy with the choices you make for your care.
For more information visit www.nhs.uk/conditions/pregnancy-and-baby/pages/induction-labour