Quality standard

Quality statement 4: Membrane sweeping for prolonged pregnancy

Quality statement 4: Membrane sweeping for prolonged pregnancy

Quality statement

Pregnant women discuss the option of vaginal examination for membrane sweeping at their antenatal appointments after 39 weeks of pregnancy.

Rationale

A membrane sweep after 39 weeks of pregnancy might make it more likely that labour will start naturally, without the need for pharmacological or mechanical methods of induction. It is important to discuss the procedure with women and to obtain their consent.

Quality measures

The following measures can be used to assess the quality of care or service provision specified in the statement. They are examples of how the statement can be measured, and can be adapted and used flexibly.

Structure

Evidence of local arrangements to ensure that pregnant women discuss the option of vaginal examination for membrane sweeping at their antenatal appointments after 39 weeks of pregnancy.

Data source: Data can be collected from information recorded locally by healthcare professionals and provider organisations, for example, from service protocols.

Process

Proportion of pregnant women attending an antenatal appointment after 39 weeks of pregnancy who discuss the option of vaginal examination for membrane sweeping.

Numerator – the number in the denominator who discuss the option of vaginal examination for membrane sweeping.

Denominator – the number of pregnant women attending an antenatal appointment after 39 weeks of pregnancy.

Data source: Data can be collected from information recorded locally by healthcare professionals and provider organisations, for example, from patient records.

Outcome

a) Rates of induction of labour for women with prolonged pregnancy.

Data source: The NHS Digital Maternity Services Dataset collects data on the medical induction of labour, the method for delivering baby and neonatal death.

b) Mode of delivery for women with prolonged pregnancy including:

  • spontaneous vaginal birth

  • instrumental vaginal birth

  • elective or emergency caesarean section.

Data source: The NHS Digital Maternity Services Data Set collects data on the medical induction of labour, the method for delivering baby and neonatal death.

c) Rates of stillbirth beyond 40 weeks of pregnancy (where there is no underlying medical cause).

Data source: The NHS Digital Maternity Services Data Set collects data on the medical induction of labour, the method for delivering baby and neonatal death.

What the quality statement means for different audiences

Service providers ensure that processes are in place to discuss the option of vaginal examination for membrane sweeping with pregnant women at antenatal appointments after 39 weeks of pregnancy. Service providers ensure that systems are in place to obtain the woman's consent before carrying out membrane sweeping.

Healthcare professionals discuss the option of vaginal examination for membrane sweeping with pregnant women at their antenatal appointments after 39 weeks of pregnancy and obtain their consent before carrying out membrane sweeping.

Commissioners ensure they commission services that discuss the option of vaginal examination for membrane sweeping with pregnant women at their antenatal appointments after 39 weeks of pregnancy and obtain their consent before carrying out membrane sweeping.

Pregnant women discuss the option of a vaginal examination to carry out a membrane sweep, in which a healthcare professional moves a finger around the cervix or massages the cervix, to help start labour, at their antenatal appointments after 39 weeks of pregnancy. Pregnant women are asked to give their consent before they have a membrane sweep.

Source guidance

Inducing labour. NICE guideline NG207 (2021), recommendation 1.3.2