The NICE GUIDELINES 2021 recommend sweeps for all women from 39 weeks. This guideline is based on no evidence. It's impossible to disprove that women who have had sweeps simply went into spontaneous labour, and the sweep was coincidental.
By 39weeks, remember that only 50.3% of birthing women/people will have gone into spontaneous labour. This is just short of 50% being prevented from initiating their own labour. Stretch & sweeps are routinely offered so please know the facts and do your research before deciding if it is right for you.
A stretch and sweep is a form of induction. As with every procedure in birth, its about understanding your options so you make informed choices.
A sweep involves a midwife inserting a finger into your vagina and past the cervix (the opening of the uterus) and using a sweeping motion to separate the membrane that surrounds baby from the lower part of your uterus. A sweep aims to irritate the cervix and uterus which releases prostaglandins.
Please know, if it is possible to manually irritate labour progression, this may force you and your baby into an experience you are both just not ready for, ultimately resulting in further intervention, making it more likely to remain in a hospital setting.
Research is mixed as to whether a sweep actually works. Evidence suggests if done at 41weeks it may reduce your chances of going over 42weeks. Evidence also suggests it may shorten your pregnancy by an average of 4 days.
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.
As your cervix already needs to be favourable (1cm) and dilated, theres no way of knowing if you'd naturally go into labour on your own without the sweep and when. However, if it does trigger labour, it can help to avoid further forms of induction.
Sweeps are not risk free. They can cause infection and may cause bleeding. Some people find it painful, uncomfortable and triggering. This can impact oxytocin release even if it is harmless, andreneline can override your oxytocin release.
There is a 1 in 10 chance that your membranes can be accidently ruptured and if labour doesn’t start this can lead to further induction procedures due to hospital policies on waters breaking. You can obviously decide on this but imagine the impact on your oxytocin at this point.
Sweeps can induce discomfort, similar to surges - a prolonged early labour can therefore lead to exhaustion and is linked to higher epidural use and further interventions.
Articles to read : https://www.sarawickham.com/articles-2/what-is-a-stretch-and-sweep/ https://www.sarawickham.com/research-updates/the-2021-nice-guideline-on- inducing-labour/ https://www.sarawickham.com/articles-2/ten-things-i-wish-every-woman-knew- about-induction-of-labour-the-article/ https://www.cochrane.org/CD000451/PREG_membrane-sweeping-induction- labour
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