If you’ve been on your VBAC journey for any amount of time, you’ve likely heard of a membrane sweep. Take a scroll through our social media communities, and you’ll most definitely see all kinds of chatter surrounding membrane sweeps.
While this isn’t something unique only to VBAC moms, a membrane sweep is definitely common in the VBAC birthing space for a few different reasons. And being a VBAC mom who has had several of them myself, I want to shed a little light on the facts + my own personal experience.
Here we go!
What is it?
A membrane sweep (or membrane strip) is a mechanical form of induction, meaning it’s performed without the use of any medication or drugs. Your provider performs a membrane sweep by inserting a gloved finger through the vagina, into the cervix and uses a sweeping / stripping motion to separate the amniotic sac (bag of waters) from the uterus.
Why would I need one?
It’s not uncommon for a VBAC pregnancy to go beyond 40 weeks (read more on due dates here). And we all know what typically starts happening even before that at 37, 38 and 39 weeks… your provider starts asking to perform cervical checks to find out if you’re dilated yet. They begin discussing induction methods and requesting or even demanding that you schedule a c-section date. All things that can feel overwhelming and disheartening.
A membrane sweep is an option for those close to or past their due date who are ready to start the labor progression. However, your provider may not even attempt a membrane sweep if your cervix isn’t “ready” for one, meaning there is little to no softening, thinning or dilation. Typically, providers need your cervix to be dilated to at least one centimeter to perform this. It’s also important to note that a membrane sweep may or may not be effective.
Who is it right for?
A membrane sweep is an option for those close to their due date who are ready to start the labor progression. However, your provider may not even attempt a membrane sweep if your cervix isn’t “ready” for one, meaning there is little to no softening, thinning or dilation. Typically, providers need your cervix to be dilated to at least one centimeter to perform this. It’s also important to note that a membrane sweep may or may not be effective.
Oh, and don’t miss this — if you’re feeling ready for labor, you consent to a cervical check and find out you’re not dilated at all, don’t fret! There is no time stamp on dilation and labor progress. You could still walk out of your appointment, dilate over night and have a baby the next day. A membrane sweep isn’t the only way you’re going to start or progress labor!
Is it safe for VBAC?
Research classifies a membrane sweep as a simple procedure that may help avoid more formal induction methods like Cytotec (which FYI is not okay for VBAC), Cervidil or breaking the amniotic sac (Finucane, 2020). While a membrane sweep is a type of intervention, it’s not medically changing the course of your labor and seen more as a way to ripen or prepare your cervix. You should always discuss the safety & effectiveness of a membrane sweep (and all other procedures) with your provider before making a decision.
What does it feel like?
While not typically painful, a membrane sweep is usually classified as uncomfortable. I think many women would say it feels like a routine cervical check, maybe a little more pressure.
What can I expect to happen after having one?
If a membrane sweep is going to “work,” meaning it kickstarts labor, it will typically happen within 24-48 hours. Some providers may suggest another sweep at your next appointment if nothing happened after the first one. From immediately following the sweep to anywhere within that 24-48 hour time period, you could experience some discomfort, spotting, loss of mucus plug, irregular or regular contraction patterns.
Some suggest that a membrane sweep is only effective at stimulating labor if your body was already headed that way.
What are the advantages?
Well, a membrane sweep could be effective at promoting the onset of labor without the use of medicines or drugs, which is a good option to have as a VBAC mom. The procedure can be performed at a regular prenatal appointment by your provider and is very quick. It can be combined with other natural induction methods like curb walking, having sex or nipple stimulation, and it can be performed more than once.
What are the disadvantages?
Like already mentioned, a membrane sweep can be uncomfortable and possibly cause some spotting or irregular contraction patterns. It’s also important to note that a membrane sweep could increase the risk of water breaking before labor begins.
Lastly and very importantly, a membrane sweep is a procedure that requires informed consent. This is never a routine procedure that should be done without your provider asking you, providing the facts and answering all of your questions. If you are adamant about not having a sweep, you can always deny any and all cervical checks.
So, to wrap all of that up, here’s what we know – a membrane sweep is a fairly common, non-medical form of induction or cervical ripening. It can be uncomfortable but is typically not very painful. A sweep may kickstart labor within 48 hours, or it may not do anything at all.
And at the end of the day, as with every other decision throughout your VBAC journey, you get to decide what’s right for you because you are in charge of your birth experience.
We’re so grateful to be on this journey with you!
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Sources
“EBB 151 – Updated Evidence on the Pros and Cons of Membrane Sweeping,” Rebecca Dekker, Oct 2020, https://evidencebasedbirth.com/updated-evidence-on-the-pros-and-cons-of-membrane-sweeping/
Finucane EM, Murphy DJ, Biesty LM, Gyte GML, Cotter AM, Ryan EM, Boulvain M, Devane D. Membrane sweeping for induction of labour. Cochrane Database of Systematic Reviews 2020, Issue 2. Art. No.: CD000451. DOI: 10.1002/14651858.CD000451.pub3
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