Sex may not work, but sweeping the membranes might

Last week I wrote about a study that suggested sex doesn't get the contractions rolling. This week, however, a study was published that suggests there is something that might work. It's called sweeping or stripping the membranes. To do the procedure, your doctor or midwife will place 1 or 2 fingers through the opening of your cervix and separate the membranes of the amniotic sac from their attachment to the lower part of your uterus. The goal is to trigger a local release of prostaglandins, or the hormones responsible for softening the cervix and stimulating labor. The procedure can be uncomfortable, and often results in period-like cramping, irregular contractions, and sometimes bleeding. (Sex is looking pretty good right now even if it doesn't work, huh?)

In this research, the investigators reviewed 22 studies of nearly 3,000 women and examined labor outcomes. They found that women who had their membranes swept were more likely to give birth before 41 weeks gestation. Further, they found there were no differences in risks of infection for either mother or baby.

The authors concluded that the decision to sweep the membranes needs to be balanced with the discomfort of the procedure. Interestingly, they also suggest that routinely sweeping the membranes does not seem to produce important clinical benefits - although they aren't the ones who've been pregnant for 10 months. Ultimately, this is an important decision to discuss with your health care provider. Meantime, Barry White anyone?

Barry White, pregnancy, and labor

It has been standard practice to tell healthy women who want to get labor going to turn up the volume on Barry White and get busy with their partner. However a study published this month suggests that having sex likely won't pump up the contractions.

Researchers recruited 210 women who were going to be inducted for non-emergency reasons. They assigned each women by chance to one of two groups. The first group was told to have sex to encourage labor. The second group was given no advice about sex before their induction.

They found that women who were told to have sex were more likely to do so - 60.2% compared to 39.6% in the group that was given no advice. However, they also found there were no differences between the two groups in rates of spontaneous labor - or labor starting on its own before the scheduled induction. There also were no differences between the groups in how many women had a C-section or in their babies' birth outcomes.

Bottom line: increasing sexual activity doesn't seem to promote labor. So if your libido is low, don't feel like you have to have sex to get the ball rolling. On the other hand, if sex sounds good, have at it. While an orgasm might not promote labor, it might be your last one for a while - so enjoy!

Even OBs don't always know when they're in labor

My colleague, Dr. Wendy Hansen, is featured on Parents.com this week. She is an OB/GYN and division chief for maternal-fetal medicine at the University of Kentucky. She discusses how when she was pregnant, she wasn't sure whether she was going into labor - despite having delivered over 600 women before she herself gave birth to her first set of twins (she has two sets who are 15 months apart - whew!).

This should make you feel pretty good about calling your doctor or midwife at 2AM when you think you might be having contractions, but you're not sure, and your husband says wait until the morning, but your back is hurting, and it could be back labor, and you are 35+ weeks, and there's definitely something going on in there, but it could just be gas pains....have you called yet?

If this sounds all too familiar, listen to Dr. Hansen and make the call. As she notes in the article, if you were a 50 year old man with chest pains, you'd want to get checked out just in case, right? What you're feeling may be nothing, but it may be labor. Wouldn't you rather know?