Lets talk Stretch & Sweeps

Lets talk Stretch & Sweeps…

Many pregnant folk are offered a ‘stretch and sweep’ towards the end of their pregnancy, and it may be mentioned earlier that that. Or you may never have heard of one. So here's some info about what it is, why it may be helpful for you (or not), how is it done, if it works and your choice to have one or not.

So firstly- what is a Stretch & Sweep?

It's procedure in which a midwife (usually) or doctor will sweep a (gloved) finger around and/or within the opening of your cervix whilst doing a vaginal examination. It's also know as a 'sweep' or 'membrane sweeping'.

Why is a Stretch & Sweep offered? (note the language offered)

It's offered in the hope that it will stimulate the uterus and bring labour on earlier than it might otherwise have begun. Basically a Stretch & Sweep is a type of induction (don't let anyone try to tell you otherwise).

Some trusts have guidelines that tell the midwives that work for them to offer a stretch and sweep to all women, at a certain number of weeks gestation. In other areas midwives offer Stretch & Sweeps because they know that women will be pressured to undergo further induction procedures if they don't go into spontaneous labour by a certain time. Midwives know that many women don't like induction, and it can lead to unwanted consequences and a cascade of interventions (more about that in future posts).

BUT, you do not have to accept any intervention offered to you - including a Stretch & Sweep. It is an offer, and it carries potential risks and benefits. You decide if it's right for you.

Do Stretch & Sweeps work?

Well we don’t actually know (sorry). The results of research studies that have looked at this have been very varied, and many were deemed to be of low quality. Where there is a difference between the people who had a Stretch & Sweep and those who didn’t, the difference was small.

According to researcher Dr Sara Wickham:
“The most recent Cochrane review of the research on this topic by Boulvain et al (2005) found that, while these may help bring on labour a bit sooner than otherwise would be the case, eight women need to have a stretch and sweep in order for one woman to go into labour without needing more induction interventions. However, this figure assumes that all women would decide to have induction, which is not the case.” (Wickham 2018).

Dr Wickham goes on to say that "The most recent review shows that it’s still very uncertain whether or not membrane sweeping makes a difference. Note that, in this quote, they can only say that it MAY help. They also note that the evidence isn’t robust and that there are lots of areas that we need to know more about."

“Membrane sweeping may be effective in achieving a spontaneous onset of labour, but the evidence for this was of low certainty. When compared to expectant management (ie lets just wait and see), it potentially reduces the incidence of formal induction of labour. Questions remain as to whether there is an optimal number of membrane sweeps and timings and gestation of these to facilitate induction of labour.” (Finucane et al 2020).

Hmmmm, there is so much uncertainty about Stretch & Sweeps then. It's really hard to know whether if you do go into labour after you’ve had a Stretch & Sweep, it was because of the procedure, or that your body just went into labour anyway because it was ready. In some studies the intervention of a Stretch & Sweep only brought the onset of labour forward by about 24 hours.

What about risks?

Yes there are risks. A Stretch & Sweeping isn’t benign, as some people like to make them out to be.

~ They can be uncomfortable or painful.

~ There can be some light bleeding.

~ Your waters might break - so creating an infection risk to baby

~ They can cause irregular surges (contractions) which may interfere with a woman or birthing persons ability to rest and sleep in the last few days of pregnancy and so exhaust them before labour begins (not helpful).
~ Any vaginal examination carries a risk of infection

~ Many people find such intimate examinations embarrassing and/or uncomfortable and put them into a stress response (not good when you're trying to get labour started!). They can be traumatic for people who have experienced previous sexual trauma.

The Cochrane review concluded that, ‘Current international guidelines state that induction of labour, as with any intervention, carries risks and advise it be performed only when there are clear indications that continuing with the pregnancy is of greater risk to the mother or fetus than the risk of induction of labour.” (Finucane et al 2020).


“Routine use of sweeping of membranes from 38 weeks of pregnancy onwards does not seem to produce clinically important benefits. When used as a means for induction of labour, the reduction in the use of more formal methods of induction needs to be balanced against women’s discomfort and other adverse effects’ (Boulvain et al 2005: 2).”

Making YOUR choice

As with any procedure that is offered to you in pregnancy, labour or postnatally, it can be helpful to ask your care provider about both the benefits and risks. You may also wish to ask about alternatives and about what your options are if you decide to do nothing. ie use your BRAIN analysis, I teach more about this on my Hypnobirthing & Antenatal Courses. Because knowing you have a choice, and doing what is right for you as an individual is really important. There is no 'one size fits all'. And it MUST be done with your informed consent, and after all your questions have been answered (keep asking questions until you feel you have enough information to be able to make the decision that’s right for you).

Know that you can no to a Stretch & Sweep (just like you can with any vaginal examination)

So in summary

~ A Stretch & Sweep isn’t as effective as some people would like you to think.

~ It will only work for a few people and, if it does work, it doesn’t bring labour forward by much anyway.
~ This is a form of induction (not an alternative to it, which is sometimes how it's presented to women), and may lead to other forms of induction and a cascade of interventions

~ Stretch & Sweeps have potential downsides as well as potential benefits.

~ You can say no, and you do not have to justify why.
~ You don’t have to be induced at all, if it’s not right for you and your baby.

~ But you may find it is just the thing for you - remember it is your choice

I hope that is helpful in providing some information o to help you make a decision that is right for you. Because that is what I am passionate about - choices.

You can find more on my Hypnobirthing & Complete Antenatal Courses here

Susan x