Stripping Your Membranes

Stripping Your Membranes

A few weeks ago, one of my good friends was facing labor induction. She was a week over her due date and her doctor wanted to induce at 10 days past. My friend had tried just about everything to get things moving. I had asked her if her doctor had tried stripping her membranes (also sometimes called “sweeping the membranes”). She said no. Her doctor did not believe in this method of natural induction. I found this response interesting since I had not heard of a doctor not using this method. Which of course led me to exploring this subject even further and writing about it!

What is stripping the membranes?
This is one of several options for those who would like to avoid a medical induction and try some natural methods to kick start labor. While there are many “do it yourself” natural methods for induction, this is not one of them. This procedure needs to be performed by a midwife or doctor. This procedure is done by the doctor or midwife inserting two fingers inside the cervix and separating the amniotic sac from the cervix.

Why it is done?
This procedure is meant to stimulate the production of prostaglandins in the cervix and bring on contractions for at-term women. If one was to undergo a medical induction and the cervix was not yet effaced, cervidil or cytotec would be inserted vaginally to deliver prostaglandin directly onto the cervix to help it soften and prepare for dilation. Stripping the membranes encourages the body’s own natural production of prostaglandin instead of an artificial source.

What to expect from getting your membranes stripped.
Many women say they feel rather crampy afterwards and have a little spotting. However, it should be mild spotting, not a copious amount of blood. I have had some students report back that they have even started to feel full-on contractions afterwards. My own midwife warned me, should we take that route, it it could be rather uncomfortable.

What are the risks?
If you have had a vaginal culture that says you have group B strep (GBS) in your vagina, you may not want to have your membranes stripped; there are no studies that have shown stripping membranes is harmful if you have GBS in your vagina and no studies that have shown it is safe if you have GBS in your vagina, so this is a decision you should make with your provider. (1)

In my research, I have also heard some doctor’s shying away from this procedure in fear that this will cause the amniotic sac to rupture. Although, according to the doctors and midwives I have consulted, they all said that this is very unlikely. The Journal of Midwifery & Women’s Health also noted in an article, Stripping Membranes, “Some people worry that membrane stripping may cause the bag of water to break or cause mothers or babies to become sick. Studies have found that membrane stripping does not make them more likely.” (2)

To rupture the membranes from stripping the membranes, either there needs to be a direct intention to do so or the amniotic sac is very weak to begin with. When an amniotomy (purposeful rupturing of the membranes) is performed, it is done so with a special instrument, such as an amnihook or amnicot, that looks much like a crocheting needle. It is not that easy to rupture the membranes with two finger tips.

What are the benefits?
As mentioned before, stripping the membranes is effective in naturally bringing on labor. According to an article from the Cochrane Library, a well respected source for evidence research, “Sweeping the membranes during a cervical examination is done to bring on labour in women at term. The review of trials found that sweeping brings on labour and is generally safe where there are no other complications. Sweeping reduces the need for other methods of labour induction such as oxytocin or prostaglandins. The review also found that sweeping can cause discomfort during the procedure, some bleeding and irregular contractions.” (3)

For those that have seen their due dates come and go and face medical induction, you now have a new option to discuss with your care provider. For some, this could be an exciting new avenue to explore, and for others just more information to store away. As I always stress, there is no “right way” to give birth, there are endless possibilities!

Sources
1- Journal of Midwifery & Women’s Health
2- Journal of Midwifery & Women’s Health
3- Cochrane Pregnancy and Childbirth Group – Membrane sweeping for induction of labour

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