Sweeps

I’ve been talking a lot this week about cervical sweeps with different people and for different reasons.

I’ve been struggling with writing this post and how to angle it as I’m aware it could come across quite negatively yet many women will tell you they’ve had a brilliant experience with sweeps. And yet the evidence around them is insubstantial at best.

Let me tell you about some of the conversations I’ve had recently.

A woman in her first pregnancy had 15 attempted sweeps. That’s not a typo. Understandably she’s traumatised from the experience.

Another woman begging for a sweep from 35 weeks. She got one at 39 weeks. She was left crying, frustrated and defeated because it didn’t work and she’d pinned her hopes on it bringing her baby earthside.

A group of women joking about finding the midwife with the biggest hands to poke their babies out because they’re done with this pregnancy and babies are born before 40 weeks who are fine so why does it matter if theirs comes without waiting for spontaneous labour?

My first baby. Accepted a sweep even though I didn’t want one because I was told it would turn the niggles of early labour into something ‘proper’. The soreness and relinquish of control over what I really wanted set the tone for the rest of my labour and I was left traumatised.

My third baby. Accepted a sweep and on the face of it, it did what it was supposed to do and my baby was born not long after. But I was 42w5 and had been having contractions for weeks – she was coming soon. I accepted as a concession to the SOM who had to pick up the pieces of a registrar telling me my baby would die if she didn’t come out NOW in front of my 2 young children.

( I’ll digress slightly on that note. My baby was transferred from home to nicu shortly after birth to be treated for meningitis and sepsis. The amount of guilt I feel over potentially dismissing the warning signs at monitoring earlier that day will probably stay with me forever. Had the doctor actually listened to me and engaged in a meaningful, transparent conversation with me things may be different. I’ll never know because she didn’t. She will never know the impact she had but I’ll live with it forever.)

Back to sweeps. When did they become so prevalent and synonymous with birth? Why are women being offered – if you’re lucky, the ‘while I’m down here I’ll just give you a sweep’ mentality still exists – without being told they’re the first stage of the induction and intervention process? Why do we not encourage and practice patience when it comes to birthing babies?

They have their place, as all interventions do. But whenever we start interrupting the body’s physiological processes we start introducing risks.

So, let’s talk research.

They can reduce your chance of your pregnancy going over 42 weeks. For some women this is important because that’s the cut off that they’d accept induction of labour. For others who wouldn’t accept induction just for being post term then this isn’t important.

For women between 40-41 weeks of pregnancy there’s a 24% chance of your baby being born within 48 hours of the sweep being done.

They can shorten pregnancy by 1-4 days. Again, these few days might be really important for some women, whereas for others in the scheme of things it doesn’t seem worth it.

70% of women find them painful.

They can cause irritation to the cervix, bleeding and uncertain contractions.

There’s a 9% chance that your waters will break as a result of the sweep. If this happens you’re on infection watch and will be offered further interventions if your body doesn’t spontaneously go into labour within a certain timeframe.

As I said earlier, sweeps have their place. But why are they so commonplace? Why are we encouraging people as a matter of course not to trust their bodies to work as they’ve been designed to, but telling them that they need help? Why are we starting women’s pregnancies, sometimes at booking in appointments, by telling them that they need a medical procedure to go into spontaneous labour? Why is this for the many and not the few whose individual circumstances suggest it might be a good idea?

Image of cervical dilation because I didn’t think you’d want to see a picture of a sweep being carried out 🤷🏼‍♀️