How safe and effective is it to have membranes stripped? Obstetrical Nurse Wanda Steele tells you what this procedure involves and how it might - or might not - get labor going.Your question
How safe and effective is it to have membranes stripped? I'm at 38 weeks. - Christa, Massachusetts
The expert answers
The stripping of the membranes is another one of those debatable issues in obstetrics. This is not a practice advocated by all caregivers.
What we are speaking of here is the physical stripping of the membranes from the uterus just inside the cervix. This is done with the gloved hand of the caregiver, and the cervix must be dilated, the baby's head engaged, and all assurances that there is no placenta surrounding the cervix.
A finger is inserted through the cervix, and works the adhered membranes gently away from the uterus. The thoughts are that this process may allow the membrane to balloon into or through the cervix and put a little extra pressure on it from the inside to cause further dilation.
While this sounds good in theory, actually, what does happen is that any cervical exam causes the release of prostaglandins, which cause contractions, which, in turn, cause changes in the cervix. You may notice contractions after sexual intercourse. This can be caused by the semen being deposited at the cervix, as semen contains prostaglandins. There are many things that can cause contractions - including nipple stimulation, which causes the release of oxytocin - but the contractions have to be effective, strong and regular before any change in the cervix is likely to take place.
Good luck :)