With this series (Membrane Stripping), Gina and I both believe that a “natural” induction, is still an induction in a way. You are still using interventions to start labor before you may be ready.
There are risks and benefits to everything we do in life, and for one person it may be worth taking the risk for the benefit while another person it’s not worth it.
We always recommend discussing options with your provider and doing your own research before using any of the induction methods we discuss in this series.
Read our Week 1 Blog: Castor Oil here
Read our Week 2 Blog: Evening Primrose Oil (EPO) here
Read our Week 3 Blog: Acupuncture/Acupressure here
Read our Week 4 Blog: Sex and Orgasm here
What is it?
Membrane Stripping
This is when your provider/nurse separates the membranes of the amniotic sac from your cervix using their fingers during a cervical exam. This stimulates the release of hormones in our body in hope to induce labor, or at least ripen the cervix.
Main Hormones being released are prostaglandins (from the stimulation of the cervix) and oxytocin (stretching of the cervix).
I describe it as a more aggressive cervical exam.
There are a few things needed in order to get one done
- Dilated to 1-2cms at least
- 38/39 weeks gestation depending on the provider
- GBS Negative**
- Some providers will not do this if you are GBS Positive because of the risk that the amniotic sac could rupture during the procedure, but not all providers feel this way!
Will it induce labor based on research?
Based on research, when compared to waiting for labor to happen on its own versus membrane stripping, you are more likely to go into spontaneous labor with a membrane strip. There was no increased risk of c-sectionm intervention, or negative outcomes for baby associated with them. The biggest complaint was pain during procedure.
One study states that those who had their membranes stripped would go into labor 4 days before they normally would have…although no sure how this was determined.
How does it work?
During the membrane stripping, the cervix is stimulated during the sweep to separate the amniotic sac from the cervix. This stimulates the release of prostaglandins. Prostaglandins are largely responsible for ripening and softening of the cervix.
Consent
A common thing we were hearing during our poll we did on 9/28/2022, was that they had a membrane strip down without their consent. After some research, this is more common of a practice in the OB world that I realized.
A membrane stirp is its own intervention and should be treated as such. There is a need for a change in practice but some strategies to protect yourself.
- Before any vaginal exam, explicitly state if you would like a membrane stirp or not during the exam.
- Discuss the intervention at admission to labor and delivery and if you would like it to be done.
- If anything feels off, ask them to stop
- Report any misconduct to the Supervisors
Risks & Benefits
Learn the science of pregnancy and birth to take the mystery of labor away! Understand why you are feeling what you feel, and learn strategies to confidently move through pregnancy and birth!
- 9 hours of on-demand video
- Lifetime Access of E-Course
- Watch on Mobile Device
Benefits
- Could shorter the length of pregnancy by up to 4 days
- Cervical Ripening
- Can be done outpatient, in the providers office
- Can be repeated multiple times
Risks
- Water can break during the procedure
- Risk for infection if water breaks
- Risk for heavy bleeding after the procedure (rare)
- Pain/Discomfort
- May be done without consent!!!
- Irregular contractions that do not lead to labor
Our Professional Opinion
Roxanne: Labor & Delivery Nurse
I have seen the benefits of membrane stripping for labor induction/augmentation, but I know that usually, it is not going to actually induce labor unless the body was truly ready.
I have seen the most benefits when someone was already having some contractions and then received a membrane sweep. This usually kicks labor up a notch and helps them transition from early labor to active labor.
It seems from my experience, if it is going to induce labor, it does so within 24 hours.
I had a membrane sweep done with my first labor after being in early labor for 24 hours. I was only 1cm but 100% effaced. The midwife, who I love dearly, offered to do a membrane sweep. During the sweep, I went from 1cm to 3cm and my contractions definitely picked up a bit! The sweep was done around 3 am, and I had Lily by 11:11 am!
Gina: Birth Doula
In my professional experience, I have found that my clients who are already experiencing cramping or mild contractions have the most success with a membrane sweep progressing into labor. It tends to be more effective in my clients who are over 40 weeks, as well.
In my personal experience, I got a membrane sweep with my first pregnancy after 40 weeks in an attempt to kick start labor but it did not work. I did not have any prior cramping and pretty minimal Braxton hicks when I got the sweep, and my cervix was barely dilated. The sweep was incredibly painful!
For my third pregnancy, I had been experiencing some strong Braxton Hicks and cramping, and opted for a membrane sweep at 41+1, and went into labor the following morning! The sweep was not painful at all, but my cervix was already 3 cm dilated and really stretchy.
I got a second sweep during labor and that helped transition me from early to active labor.
Mamastefit Survey Results
The Results of our Mini Survey we did on 9/28/2022 on Instagram. We asked out followers about Membrane Stripping and their experience.
Did you get a membrane stripping? We had 3141 people answer
- 53% said Yes
- 47% said No
If no, Why not? Most answers were.
- I was GBS +
- Was not dilated enough
- Heard it was uncomfortable
- Wasn’t offered
- Risk of Infection
- Risk of Rupture of Membranes
- Wanted to wait for labor to happen on its own
If yes, Why? Most answers were.
- 41+ weeks
- Pending Induction and wanted to avoid
- Was done without consent (OMG?!? not okay!!
- To try to speed up labor
- Ripen Cervix
- Uncomfortable and desperate to try anything/Impatience to wait for labor
- Was offered and didn’t have a reason against it
- Prodromal labor
- VBAC
How many weeks did you get it done? We had 1849 people respond
- 16% said 38 weeks or less
- 35% said 39 weeks
- 34% said 40 weeks
- 16% said 41+ weeks
How many times did you get stripped? We had 1701 people respond
- 66% said One
- 25% said Two
- 9% said Three
Did you go into labor within 24 hours? We had 1859 people respond
- 42% said yes
- 58% said no
Did you eventually go into spontaneous labor or induced? We had 2279 people respond
- 63% said Spontaneous labor
- 37% said Induction
Did they strip your membranes if you were GBS +? We had 801 people respond
- 43% said Yes
- 57% said No
Did your water break during it? We had 1861 responses
- 6% said Yes
- 94% said No
Did you get it done while in early labor? We had 1726 reponses
- 17% said yes
- 71% said no
- 12% said I don’t know
If you did get it done during labor, did it speed things up? We had 863 people respond
- 29% said yes
- 32% said no
- 39% said I don’t know
Did you have any heavy bleeding after the stripping? We had 1681 people respond
- 13% said yes
- 87% said no
If you went into labor after the strip, how many weeks were you? We had 867 people respond
- 10% said 38 weeks
- 27% said 39 weeks
- 38% said 40 weeks
- 25% said 41 weeks