Membrane stripping?

SmilingBluEyes · Dec 13, 2006

The doctor/midwife simply does a finger/hand "sweep" of the membranes to remove them from the lower uterine segment. This action can cause the body to release prostaglandins, which can initiate labor contractions, much the same way cervical ripening does. However, this is usually only done when a cervix is "ripe" and ready for labor, in the first place.

It can be quite uncomfortable and crampy and like many things to attempt to initiate labor, it either works, or it does not. It is as unpredictible as that.

Implications are the mom either goes into labor or not. Also, in the action of stripping the membranes, the practioner may actually rupture them in the office, therefore making it necessary if the mom is planning to have the baby in a hospital , to go to the hospital right away, for active labor/and/or induction of labor.

It's a very "low tech" intervention, when compared to labor induction using hormones such as prostaglandins/prostin gel, cytotec, cervidil or pitocin drips.

Another way to initiate labor is via nipple stimulation---this action causes the pituitary to release oxytocin (the natural form of "pitocin") and CAN cause spontaneous labor.

OF course, another way to bring on labor possibly, would be having sexual intercourse, as semen contains prostaglandins in it, and can therefore, act chemically on the cervix to ripen it, or to cause labor contractions.

There is no surefire way, clearly, to start labor. When and if somebody figures that all out, he/she will be one rich person!

HTH.

tvccrn, ASN, RN · Dec 13, 2006

Thank you for the information. I have had three children and never heard of this. now 15 years later, I hear about it a lot and was just wondering if it was the latest fad or what. :lol2:

tvccrn

SmilingBluEyes · Dec 13, 2006

no not new. It's been done a LONG time.

LDRNMOMMY, BSN, RN · Dec 14, 2006

I had it done several times during the last two weeks of my pregnancy. All it ever did was give me painful, regular Braxton Hicks contractions.

wubbakat · Dec 14, 2006

From my experience in labor and delivery, "stripping of the membranes" only works when a person is actually close to being labor ready, otherwise it is just plain uncomfortable if you are pushing the "want to be in labor", and have this done before you are "ready." It should never be done for mom's who are Group B strep positive for sure, and having it done repeatedly, you are only increasing your risk for chorio. It would also be nice if physicians tell the patients what to expect after it has been done, ie the bleeding especially. We get so many people come in after doctors appointments with bleeding, only to find out that they did have an appointment that day, and the doctor did a "real rough lady partsl exam" that day, and to their dismay, they weren't in labor.

BabyRN2Be · Dec 14, 2006

I have heard of physicians doing this either without informing the patient properly, or giving it another name entirely. Sometimes the doctor just does it, saying in the middle, "Oh, I'm going to do a "rough internal exam" today. So if you have any bleeding later, this is what caused it."

My cousin's doctor did this, and when Jen asked her what she was doing, she said, "Oh, I'm just "jiggling things around here in order to get labor started." The doc also gave her a date for induction as she went out. The doc wanted the baby to be here by that Monday. Jen went the whole weekend in pain and bleeding, but no baby before Monday.

I generally do not recommend this to doula clients. I do explain the procedure to them, and if they want it, fine. But I do say that sometimes labor may not start, and if they are uncomfortable to begin with (and who isn't by that point usually), why have one more thing to give them more discomfort?

I do recommend what Deb mentioned, nipple stimulation as well as sex. I've also heard that eating pineapple may help, but I haven't seen any studies on this, but rather anecdotal information.

tvccrn, ASN, RN · Dec 14, 2006

OK, so this isn't something new that the docs are trying out. But, it seems that some of them are doing this without informing the patient. Not good.

Thank all ya'll for the informative replies.

tvccrn

Gompers, BSN, RN · Dec 14, 2006

I do recommend what Deb mentioned, nipple stimulation as well as sex. I've also heard that eating pineapple may help, but I haven't seen any studies on this, but rather anecdotal information.

These three options sound much nicer than membrane stripping, if you ask me! :chuckle

OK, so this isn't something new that the docs are trying out. But, it seems that some of them are doing this without informing the patient. Not good.

Some of my coworkers were talking about this a few weeks ago and had it done when they were pregnant over 20 years go, so definitely not new. I definitely agree that if a doctor is going to do this procedure, they should be telling the patient exactly what is going on! I can't believe some of them aren't educating their patients about this...

Elvish, BSN, DNP, RN, NP · Dec 14, 2006

Blech. Not fun. Had it done before my cervix was actually ready to dilate. So...my water broke and I went 2 hours with nary a ctx. I begged them not to hang pit until I had walked and played with my nipples a little to see if that would help at all -- contracting, anyway. Dilating is a different story. I went from not wanting ANYTHING to having it all -- epi, Pit, IUPC, foley, IVF/abx during labor (from fever, not GBS), and of course the lovely EFM.

Hindsight is always 20/20 so who really knows for sure but I think my son's birth might have been a little lower-tech and cheaper for my insurance had we not stripped and just given things a little more time. (I was 39 weeks.)

Sorry for the rant. This thread brought up more emotion than I thought...