A sweep is a form of induction as it aims to encourage the body to go into labour before it would have happened on it’s own. However, people are not encouraged to be in hospital or anything after having one so if labour begins after that you would go on to labour in your chosen birthplace etc.They are often offered routinely at the end of pregnancy, the gestation that this would happen will vary based on area.

Process

Via a vaginal exam the midwife or doctor will insert a finger into the cervical opening, if possible, and try to run a finger around the inside to separate the membranes (the sac containing your baby) from the wall of the uterus. If the cervix is not open they can sweep the outside.A sweep aims to irritate the cervix and uterus which releases prostaglandins. Usually a certain amount of discomfort is experienced during a sweep as it is not a gentle procedure.

Evidence

It’s impossible to get accurate evidence on sweeps as if someone goes into labour the day after a sweep, it is impossible to know if they would have gone into labour then anyway, since sweeps are only given at the end of pregnancy when labour is likely to happen. The evidence from a Cochrane review that brought lots of studies together showed that the use of sweeps in first time parents did ‘not seem to produce clinically important benefits’ when used to prevent the need for further induction interventions. However many birthers would like to try it as a first step to see if they can avoid induction. Sometimes this can have positive mental benefits as it can make you feel like you’ve tried all you can.

It is worth remembering at this point that the cervix can change quickly so if you attempt a sweep and find that your cervix doesn’t seem to be gearing up for labour then don’t be disheartened as you could still go into labour any minute! Get that oxytocin flowing!

Side effects

-Sweeps can induce discomfort similar to surges/prolonged early labour which can lead to exhaustion and is linked to higher epidural use and further interventions.

-They can cause bleeding and discomfort to the cervix which can impact oxytocin even if it turns out to be harmless.

-In some cases the membranes (your waters) can be broken and this would then begin the clock on your local policy of how long to leave labour to begin before stepping in to induce or offer caesarean. It is always up to you how long you would like to leave it or if you are happy to go with the recommendation but it can be more decisions to make and can impact oxytocin.

Resources

What is a stretch and sweep? Sara Wickham

What is a stretch and sweep?

EBB Podcast- Episode 6- Pros and cons of membrane sweeping

https://evidencebasedbirth.com/updated-evidence-on-the-pros-and-cons-of-membrane-sweeping/