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Pros and Cons of Membrane Sweeping

hi my name is Rebecca Decker and I'm the

founder of evidence-based birth today

we're going to talk about the evidence

for membrane stripping or membrane

sleeping

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so today let's talk about the evidence

for membrane stripping or membrane

sweeping this is often done at the end

of pregnancy when your care provider is

doing a vaginal exam they may go ahead

and do something that what we call

membrane stripping and this is where

they insert their finger up your vagina

towards your cervix I must say this is

the opening of your cervix if it is open

at all

and they take their finger and they kind

of sweep around to separate the membrane

that surrounds your baby from the lower

part of your uterus down here by your

cervix they can only do this if your

cervix is dilated at least a little bit

sometimes this is done routinely without

even talking to the woman about what's

about to be done and you may just notice

that the vaginal exam is very painful

other times you may have an actual

informed consent discussion where your

care provider explains the pros and cons

but for those of you whose care provider

doesn't explain the pros and cons to you

what are they

well membrane stripping or membrane

sweeping is seen by many as a form of

induction although it's not necessarily

always a very successful form of

induction and so it really does warrant

a discussion about pros and cons now

there have been a lot of randomised

trials on membrane sweepings and what

they show are the benefits are if your

membranes are stripped or sleeped

at 41 weeks so one week after your

estimated due date this can lower your

chance of having to go past 42 weeks and

needing an induction at 42 weeks it

decreases your chances of going to 42

weeks from 41 percent down to 23%

so it pretty much cuts your chance in

half of having what we call a post term

pregnancy or a pregnancy that goes past

42 weeks it can also decrease the length

of your pregnancy by one to four days

most study some four days on average so

that doesn't mean that you'll go into

labor within four days what it means is

say your body was not naturally going to

go and

spontaneous flavor at 41 weeks then

instead if your membranes were stripped

it would shorten your pregnancy by about

four days so maybe you would go into

labor at 40 weeks and three days instead

of 41 weeks membrane stripping has also

been shown in research studies lower

your chances of meeting a formal

induction if your pregnancy goes on too

long and you and your care provider

decide that you want a formal induction

so membrane sweeping can help prevent

needing medications for an induction so

what are the cons of membranes sleeping

well one of the cons is you can't have

your membranes swept if your cervix is

closed your cervix needs to be at least

one centimeter dilated in order for this

procedure to occur another con is that

most women report that the procedure is

either somewhat or very painful and in

fact one study found that 70 percent of

women reported that the procedure was

significantly painful with an average

pain score rating of seven on a scale of

one to ten with ten being the worst pain

possible membrane sleeping can also

cause bleeding after the procedure it

can also cause your uterus to become

really irritable and contract

irregularly so you may lose some sleep

and worry a lot because you're having

lots of weird irregular contractions

that are not labor but they just really

bother you or it could be start the

start of labor so you may be unsure as

to what's going on because it just leads

to that uterus irritability when women

are the studies are randomly assigned to

have their membranes swept and their

membranes are actually slept they

actually receive the procedure about 9%

of them experience their water breaking

as a side effect of the procedure so you

have about a one in ten chance of your

water breaking if you have your

membranes swept this can lead to longer

Labor's and it can also lead to the

chance that you might need a formal

medical induction if your water broke

and you didn't go into labor on your own

finally one of the cons of membranes

sleeping is when it's done without

informed consent so

so I hear reports of women all over the

world who tell me that their membranes

restrict or sweat without their consent

and although there has never been a

research study done on this phenomenon

it is anecdotally something that does

happen to some women so that's just

something to be aware of when you're

going into those appointments and we

have a Q&A video all about routine

vaginal exams at the end of pregnancy so

it might just be something you want to

talk with about your provider do they

consider the membrane stripping to be

part of a vaginal exam because

technically they are separate and

technically that you should be giving

informed consent or refusal for membrane

stripping so it's just good to know

ahead of time if that's something that

your provider does before they're doing

their cervical or vaginal exams so I

hope this video was helpful and I hope

you can join me in another Q&A video

feel free to browse our resources at

evidence-based birth thanks and bye

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