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Membrane Sweep and Induction
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Induction of labour
If you go overdue in pregnancy you will be offered an induction of labour to try and start your labour off. This is normally offered when you are 40 weeks +10 days however the World Health Organisation says that the normal gestation for a human infant is 37 - 42 weeks.
The decision to have induction should be made in partnership between you and the Midwife or Dr who is caring for you; however it is ultimately down to you.
If you have any problems in your pregnancy where you or your baby are put at risk an induction may be recommended.
For Example:
- Prolonged Rupture of membranes (If your waters have been gone for sometime and labour has not started)
- Pre-Eclampsia
- Gestational Diabetes / Diabetes
- Obstetric Cholestasis
- Symphysis Pubis Disorder
- IUGR (Intrauterine Growth Restriction) - If they are worried about your babies growth
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Membrane Sweep
So what if you go over due? The first suggestion your midwife may make will probably be a membrane sweep. A ‘Sweep' has found to increase the chance of you going into labour naturally within 48 hours if successful, therefore you may not need any further intervention to bring on your labour.
If you do consent to have a sweep they are normally conducted around 41 weeks. Some midwives may do them earlier, however it is not recommended that they are done before 37 weeks.
They can be carried out in clinic or in your home and can be quite uncomfortable, more so if you are tense, which of course is understandable. If you can try and relax it will be easier. Your midwife will try and find your cervix by doing an internal examination. She will then try and put a finger inside the cervix and then will carry out circular ‘sweeping' movements to separate the membranes surrounding your baby from the cervix. This should stimulate the release of the hormone prostaglandin which is needed to start your labour off.
After this you may feel some discomfort and abdominal pain and you may have a bloodstained loss. A membrane sweep should not cause infection or harm your baby. If your membranes have already ruptured (waters broken) a membrane sweep may not be recommended.
Prostaglandins
If your labour does not start naturally then, depending on how ‘favourable' your cervix is, prostaglandins may be used to soften your cervix and induce your labour. The most commonly used prostaglandins being Prostin tablets or Prostin Gel.
Before you are given the prostin your midwife will first carry out a monitoring of your babies heartbeat just to make sure your baby is happy prior to induction.
The tablet or gel will then be placed into your vagina and you will need to stay laid down for around 20-30 minutes (make sure you have a wee first).
You are then likely to be left to go into labour. If this fails to start your labour then you may need another dose around 6-8 hours after the first.
Oxytocin
If your cervix has already started to ‘ripen' and become ‘favourable' then the midwife might recommend that your waters are broken to induce labour followed by an Intravenous infusion of Oxytocin.
If your membranes have already been ruptured then you will be recommended an Oxytocin infusion to start your labour off.
This will be given via an Intravenous ‘Drip' into a vein in your hand or arm. The infusion will be increased gradually until your contractions are regular, strong and your baby has been born. Your baby will be monitored using a CTG whilst this infusion is in progress to ensure that he or she remains happy. If your baby's heartbeat causes any concern then you may be asked to change position. Babies seem to be happier if you are laid on your left hand side. If the midwife or DR are worried about the heartbeat then the drip may be turned off.
You are more likely to need an epidural anesthesia if you have an Oxytocin drip as the contractions can become more intense.
