Stripping of Membranes in Pregnancy

If you are near or past your due date in pregnancy and eager for labor to begin, your doctor may suggest having your membranes stripped. This simple procedure is usually done during office visits and is performed to help stimulate the start of the labor process.

Function

The amniotic sac, which holds amniotic fluid, is attached to the wall of the uterus with membranes. Stripping the membranes means pulling the amniotic sac away from the wall of the cervix by breaking the bridging molecules that hold the membranes to the cervix. Once broken, these bridging molecules are converted into prostaglandins, which are hormone-like substances that help stimulate labor. Another theory is that the procedure brings on labor because it allows water to collect in front of the baby, putting pressure on the cervix.

Procedure

The process of stripping the membranes is simple and usually quick. Your doctor may perform it while checking your cervix for ripening during a regular pelvic exam. To strip the membranes, your doctor will insert a finger in your uterus and sweep it between the amniotic sac and the uterine wall to loosen the membranes from the wall. Most women report that having their membranes stripped is uncomfortable and some experience bleeding and irregular contractions afterward.

Purpose

It's important to understand that stripping the membranes is not a method of inducing labor but rather a way of possibly stimulating labor. For many women, the hope is that this procedure can help them avoid chemical methods of induction. If it's performed too early it will have no effect so it's not likely to bring on labor before the body is ready; it's simply considered a way to help things move a little faster when your body is prepared.

Safety and Effectiveness

Some experts believe stripping the membranes poses a safety threat by putting the mother and baby at risk for infection. However, an assessment conducted by the Cochrane Group of 22 studies of the procedure revealed no increased rate of infection among women who had their membranes stripped. There is also great deal of debate over whether or not stripping the membranes is actually effective at bringing on labor any faster. The same study that assessed safety was used to determine effectiveness and found that there was no significant difference in how quickly labor came on between the women who had their membranes stripped and the women who did not.

Considerations

If you're considering having your membranes stripped at the end of pregnancy, speak with your doctor about it. She may ask if you'd like it done or you may need to bring it up yourself. Different health professionals have differing views on the matter so it's important to get an opinion from the expert you trust for the health of your pregnancy. If your doctor is willing to strip your membranes she can discuss the pros and cons and possible outcomes of doing so given the current state of your pregnancy.

References

• GynOB
• StorkNet
• The Cochrane Collaboration

Resources

• GynOB.com