Tuesday, March 29, 2016

Has your doctor mentioned stripping your membranes? Have you had a cervical exam that ended with your physician telling you he/she stripped your membranes?
Stripping or sweeping the membrane is a form of inducing labor. During a vaginal exam, if a woman is already dilated to one centimeter; your doctor may mention stripping, which involves sliding a finger between the edge of the cervix and the amniotic sac. The Amniotic sac, or membrane, is "stuck like glue" to the cervix and the doctor will use his/her fingers in a sweeping motion in an attempt to separate the membranes from the internal cervix and lower uterus. This will make for a more vigorous vaginal exam, that often results in discomfort, bleeding,cramping, and irregular contractions afterward, which can last up to 24 hours. Some research suggests that it increases the risk of spontaneous rupture of the membranes, as well.
The doctor  puts her or his finger into the cervix—the mouth of the uterus—and uses the finger to separate the bag of water from the side of the uterus near the cervix.
This intervention aims to trigger a release of prostaglandins, the hormones that trigger contractions.
Although this is not a form of induction that uses artificial hormones to stimulate labor, an instead triggers the use of natural hormones....it is still not a "natural process".
Your doctor might encourage you to try this before going the route of a hospital induction using prostglandin gel and/or pitocin. This intervention may shorten pregnancies of women who are at term (41-42 weeks) and may also reduce the need for induction.
Remember, as with any and all procedures, your care provider should obtain consent before performing this or any other procedure.
It is also not ideal for the patient (you) to be asked about this while the physicians hand is in  YOUR vagina.

You should be given time to consider your risks and benefits and prepare for this, if it is something you want to consider.
Stripping of membranes and other mechanical methods of induction may begin labor but may also lead to additional interventions and synthetic forms induction. It is important for care providers to share all information with expectant mothers so that a well-thought out plan can be made.

Reasons You Would Not Want Your Membranes Stripped:
According to the American College of Nurse-Midwives (ACNM) Fact Sheet on Stripping Membranes1, there are five reasons why an expectant mother may not want her membranes stripped.  They include:

  • You have been told that it is not safe to have your infant vaginally.
  • You have had unexplained vaginal bleeding during your pregnancy.
  • You have been told that you need to have your infant urgently and it would be safest to have your labor induced by using medication.
  • You want to let your pregnancy and labor unfold naturally and there is no medical reason to have your labor induced.
  • 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 it is safe if you have GBS so this decision should be made with you and your care-provider making the decision together.