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SWEEPS
A sweep or stretch & sweep has become so normalized that it feels like they are routine policy in most hospitals.
They involve a doctor or a midwife inserting a finger in the cervix to separate the membranes of the amniotic sac from your uterus in the hope of encouraging spontaneous labour. Research on the effectiveness is not of great quality but does show that more women on average go into spontaneous labour after a sweep when compared to no sweep. However the important things to know about sweeps are It is a form of induction Some women find them painful and/or distressing especially if they have any previous trauma, injury or womens health issues for example endometriosis. There is a chance of the waters being accidentally released during a sweep. If this happens then you have 24hrs before further induction measures are used. It those fail then you will need a cesarean section. They can cause bleeding and cramps and sometimes a false labour. You may feel like you are in labour for sometime and then it will stop. If this happens and you lose sleep it can leave you exhausted heading into your actual labour. The risks to women who have Group B Strep (GBS) are unknown as there hasn't been any research. But logically if you GBS then anyone moving their fingers up your vaginal towards your uterus and your baby will undoubtedly increase your and your babies infection risk.
A Cochrane review in 2020 also showed that a sweep can increase your chance of going into labour (72% who had sweeps vs 60% who did not) without needing artificial oxytocin to START labour. However it did not mean that these labours CONTINUED to the end without needing artificial oxytocin. They found that the rate of unassisted (without artificial oxytocin) was almost the same in both groups (73% sweep and 71% no sweep). So this begs the question - what is the point of getting a sweep if it doesn't help you avoid artificial oxytocin at all stages of your labour? Use your B.R.A.I.N analysis to determine if you want a sweep or WHEN in your pregnancy you'd consider it. Many women when "overdue" decide the risks of a sweep are outweighed by the fact that they are facing further induction measures in the next few days if they don't go into labour soon. If you don't want a sweep be VERY clear that you don't want one before you consent to a vaginal exam in you last few weeks of pregnancy or when you are overdue. You should always be asked your consent for a sweep ( it's a medical intervention after all) but there are many, many women out there who have been given a sweep when they were neither informed or consented to one beforehand. If in doubt, refuse a vaginal exam altogether.
VAGINAL EXAMS
Vaginal exams or VE are routine policy in most hospitals.
They involve a doctor or a midwife inserting their fingers into your vagina to check the cervix to determine if it is dilating and if so, by how much.
VEs are routine during labour but you may also have them during your pregnancy especially if you go beyond your "due" date.
They can be SOMETIMES useful in determining how much your labour is progressing but remember you are NOT required to have them.
Risks associated with VEs include
Some women find them painful and/or distressing
They may increase your risk of infection if cases where your waters have broken or you have Group B Strep.
Sometimes waters are broken by mistake during a VE. And once they are broken you are on a 24hr clock. If you don't go into labour before then you are going to be inducted or have a cesarean.
Knowing how much you have dilated is not always a good thing. The dilation of the cervix at that moment in time does not indicate how long your labour will be. But if you have been in labour for some time and find out that you are "only 4cm " dilated then it can be very hard not to be disheartened.
And there are other ways (Hobbs line, hot legs) to know how labour is progressing which I cover in my GentleBirth workshops.
So have a think about how a VE might affect you physically and mentally and use your B.R.A.I.N analysis to determine if you want vaginal exams or if you do how often you want them. Just be aware that many hospitals will insist that you consent to one exam to get into the labour ward. But if you do consent to this one it does not mean you have to consent to any more. Or you can decide you want them but at less frequent intervals or when you ask fir rhem. The choice is yours.
And of course remember to include your decision in your birth preferences.
Want to learn more about the latest research on interventions and how to put together your birth preferences? Check out my workshop info at link in bio or www.bewellacupuncture.ie/gentlebirth. And of course email me if you have any questions.