Many pregnant women face the question of whether to schedule an induction or wait for labor to begin naturally, often called a “sweep.” Both options aim to stimulate labor, but work in different ways. Choosing between an induction and a sweep depends on your unique pregnancy circumstances. This article examines the key differences between these two labor-starting methods to help you make the best decision for you and your baby.
What is an Induction?
An induction is when your doctor or midwife uses medical methods to stimulate labor. The most common ways to induce labor are:
- Administering synthetic oxytocin (Pitocin) through an IV – This is the most frequently used method. Pitocin stimulates contractions just like your body’s natural oxytocin.
- Inserting a Foley balloon catheter – A narrow tube is inserted into the cervix and inflated, putting pressure on the cervix to help it thin and dilate.
- Breaking your water – Your doctor makes a small hole in the amniotic sac, causing a release of fluid which often triggers labor within hours.
- Applying vaginal prostaglandin gel – This helps ripen and soften the cervix.
These methods artificially jumpstart the labor process. Inductions are usually scheduled in advance, unlike going into labor spontaneously. Your doctor may recommend an induction for various medical reasons like being past your due date, having pregnancy complications like preeclampsia, or having a condition like diabetes or high blood pressure. Some women also electively choose to schedule an induction for convenience or anxiety over a prolonged pregnancy.
What is a Sweep?
A membrane sweep, also called a stretch and sweep, is a procedure where your doctor or midwife massages the cervix during a vaginal exam. The goal is to separate the membranes around the baby from your cervix. This releases hormones like prostaglandins that encourage labor. Having a sweep essentially stimulates your body to go into labor naturally versus using artificial medications.
Sweeps are typically done starting around 38 weeks or later in pregnancy at prenatal visits. Your doctor will likely offer a sweep if you are nearing or past your due date with no signs of labor. Some providers may also suggest a sweep to ripen the cervix before other induction methods.
The procedure only takes about a minute during a standard internal exam. It can cause some cramping or discomfort. The effects are immediate – some women go into labor within hours or days of a sweep. However, it does not induce labor right away like medical induction methods.
Key Differences Between an Induction and Sweep
Here are some of the main differences between having a labor induction versus a membrane sweep:
How labor starts
- Induction – Uses artificial medications and procedures to stimulate uterine contractions and cervical changes.
- Sweep – Releases natural hormones to trigger your body’s own labor process.
Timing
- Induction – Scheduled in advance, typically for medical reasons.
- Sweep – Performed opportunistically at prenatal visits from 38 weeks onward.
Onset of labor
- Induction – Stimulates labor within hours or days.
- Sweep – May trigger labor, but not guaranteed; can take hours to days.
Pain and interventions
- Induction – Often requires more interventions like epidural anesthesia and C-section.
- Sweep – Allows labor to progress naturally, reducing interventions.
Risks
- Induction – Small risks from medications/procedures used.
- Sweep – Very low risks, mainly discomfort during procedure.
Which is Right for You?
Choosing between an induction and sweep depends on your pregnancy circumstances. Here are some factors to consider:
Your due date
- If you are more than 1 week past your due date, an induction may be recommended since the risks of pregnancy complications increase after 42 weeks.
- If you are nearing your due date but not past it, your provider may suggest a sweep to encourage labor naturally before considering an induction.
Bishop score
This estimates how ready your cervix is for labor based on factors like effacement, position, softness and dilation.
- A high Bishop score means your cervix is already ripening, so a sweep can effectively trigger labor.
- A low Bishop score often requires interventions like prostaglandins before an induction.
Medical necessity
- An induction may be needed for medical reasons like preeclampsia or placental problems.
- If you have a normal, low-risk pregnancy, a sweep allows your body to initiate labor itself.
Personal preference
- Many women prefer to avoid medications if possible and let labor begin naturally.
- Others want the scheduled convenience or reassurance of an induction.
Discuss the pros and cons of your options thoroughly with your provider. Make sure you understand any medical indications before deciding on induction or opting to wait for a sweep.
Sweep Success Rates
Sweeps do not guarantee labor will start right away. But studies show they can be effective at stimulating the natural labor process.
Some research on sweep success rates:
- In one study of 357 women at 40 weeks gestation, over half went into labor within 48 hours of a sweep. (Hill et al., 2008)
- A meta-analysis found sweeps reduced the number of pregnancies lasting beyond 41 weeks by 55%. (Boulvain et al., 2005)
- The average time between a sweep and delivery is 1-2 days. (Edwards et al., 2014)
Having more than one sweep can increase the chances of labor starting. The success rate varies based on factors like cervical ripeness. But overall, membrane sweeping is an effective option to encourage natural labor onset before considering a medical induction.
Sweep Success Rates
| Study | Findings on Sweep Success |
|---|---|
| Hill et al., 2008 | Over 50% went into labor within 48 hours |
| Boulvain et al., 2005 | Reduced pregnancies beyond 41 weeks by 55% |
| Edwards et al., 2014 | Average labor onset 1-2 days after sweep |
Risks and Discomforts
Both induction methods and membrane sweeping are generally very safe procedures. But they do have some minor risks and side effects to consider.
Induction Risks
- Uterine hyperstimulation – Too many contractions, risking fetal distress.
- Postpartum hemorrhage – Heavy bleeding after delivery.
- Uterine rupture – Rare tearing of the uterine wall.
- Cord prolapse – Umbilical cord slips into birth canal before baby.
These risks are small, but higher than with spontaneous labor. The induction process can also be physically taxing and may increase chances of needing interventions like an epidural, instruments, or C-section. Discuss your personal risks thoroughly with your provider.
Sweep Discomforts
Membrane sweeping is very safe with few medical risks since it encourages your natural labor process. However, some women experience:
- Mild cramping and spotting after procedure.
- Intense cramps if cervix is very sensitive.
- More frequent Braxton Hicks contractions.
Any discomfort is temporary and lasts hours to days at most. Let your provider know if you have severe pain after a sweep.
How to Decide: Induction vs. Sweep
If you and your doctor decide labor should be stimulated, here are some final tips for deciding between induction and membrane sweeping:
- Try a sweep first if you want to avoid medications and your water hasn’t broken.
- Schedule an induction if you have medical reasons or a strong desire to deliver by a certain date.
- Get a Bishop score to determine if your cervix is favorable for induction or sweeping.
- Ask about multiple sweeps if your first doesn’t induce labor within 2-3 days.
- Consider alternating sweep attempts with induction methods like prostaglandins if needed.
- Discuss a timeline for induction if sweeps don’t work after 1-2 weeks.
Ultimately, choosing induction versus membrane sweeping comes down to your priorities and recommendations from your healthcare provider. Both can effectively stimulate labor, but work in different ways. Understanding the key differences allows you to make the best decision for your pregnancy circumstances.
Conclusion
While an induction and membrane sweeping aim for the same result, starting labor, they work differently to achieve it. Inductions use direct medical methods to stimulate the uterus and cervix. Sweeps encourage your body’s natural labor process through hormonal and physical stimulation.
Sweeps are a lower risk option to try first, especially if your water hasn’t ruptured yet. Multiple sweeps can be done to initiate labor without medications. However, inductions allow for a scheduled delivery and may be recommended for medical reasons like being post-term.
Talk through your options thoroughly with your healthcare provider. Consider your due date, cervix readiness, medical needs, and personal preferences when deciding between induction and sweeping. Either can help successfully stimulate labor when the time is right.
