![]() Secondly, I am not challenging this as a tool for expediting labour when there is a medical indication. I fully support an individual’s right and autonomy to choose what is best for them. Let’s begin with some clarity on what I’m challenging.įirst and foremost, I am not challenging the right for a pregnant person to choose a membrane sweep as a means of expediting labour. So what is it about membrane sweeping that is so cherished that challenging it generates death threats? Routines are habits that help organise our days I don’t think there is one other procedure that so callously turns a normally progressing pregnancy into a pathological event than this heinous routine. However, the routine of membrane sweeping for the mere reason that the client is at term is a deeply embedded ritual in obstetrics and mimicked by some midwives. Her birth was hijacked by a damnable routine from someone who should have known better or at least given a damn. The baby spent 3 days in the NICU and she was devastated. She went home bleeding and cramping and within a few days went into labour and birthed a baby that was not ready to breathe. This mother had experienced a non-consenting, unplanned, and unknowing stretch-and-sweep to start labour before she or the baby were ready. The doctor removed her bloodied glove and when this woman asked why she was bleeding, the doctor responded, “That should get things going”. However, rather than a simple vaginal exam, she experienced excruciating pain that had her crawling up the table trying to escape that probing hand. She thought that was an ok idea and stripped accordingly, lay down on the examining table and put her feet in the stirrups. She told me how she went to her usual prenatal visit at 36 weeks and the doctor said it was time for a vaginal check to see how things were coming along. ![]() That particular post was prompted by a brief encounter with a new mother. And horrifically, even more hundreds wrote to share their stories of non-consenting, painful, and violating membrane sweeping when there was no reason for it, aside from the care provider’s decision that they had agency over their patient’s vagina and could do what they wanted when they wanted. I also heard from hundreds of women whose births were ruined by days of painful, non-progressing contractions triggered by a membrane sweep that ended up in a fully medicalised all-the-interventions arrival for their baby that they didn’t want. In general, the sentiment was that I should most definitely be having sexual relations with myself, after which, I should be locked up and forever silenced. The post went viral and I received hate messages and emails from around the world defending this procedure. I talked about its risks and the fact that the clients I worked with called it a sexual assault when done without consent The time interval between the procedure and the onset of labour is usually less than 48hrs.I’ve written about many topics over the years but nothing has ever generated as much discussion, opposition, and vitriol as challenging the cherished routine membrane sweep/stripping, aka stretch-and-sweep.Ī few years ago, I wrote a post about how I’d like to see the routine, prior-to-40-weeks, without-medical-indication membrane sweep banned from obstetrical and midwifery practice. I have had other women with the cervix fully or partly closed and they have laboured soon after. While labour onset is more likely when the cervix is favourable, I have done the procedure on women with a very favourable and open cervix, and they have not gone into labour. The onset of labour after the procedure is unpredictable. Doing so is usually very uncomfortable and some women, though keen, can’t tolerate the discomfort and so the procedure is abandoned. Sometimes when this is the case it is possible to stretch the cervical canal and consequently the internal os is opened and the procedure can be completed. ![]() Sometimes the external os (cervix opening) is open to admit a finger, but the cervix is uneffaced (long) and the internal os is closed. It is not possible to do the procedure if the cervix is closed and does not admit a finger. Labour onset is more likely if, when the procedure is done, the cervix is open, has started to shorten, is in an anterior position and the baby’s head is well applied to the cervix, engaged in the pelvis. Not all women will go into labour after a cervical stretch and membrane sweep. Does a cervical stretch and membrane sweep always work?
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