Dear Anne-Mette,
Indeed primary care midwives in the Netherlands work autonomously and can sweep membranes to stimulate the onset of labour. A randomised controlled trial showed that fewer women need to be induced for postterm labour if midwives do this (de Miranda 2006). What would be the reason to consult an obstetrician? No risks were identified in the trial other than that it can be uncomfortable, there may be a little bit of bleeding and the woman may experience a period of irregular contractions without going into labour. Nevertheless, the large majority of women in the trial said they would have it done again in a subsequent pregnancy.
In fact, another RCT in the Netherlands showed that midwives can also perform ARM to induce labour - this is a bit more controversial although many midwives do this after informing the obstetrician about it.
Even women who have a foley catheter inserted to start labour are sent home in some hospitals and in some countries. I think this can be done in primary care too as it is a bit like a continued sweeping of the membranes and so far, appears to be very safe.
Hartelijke groeten/ Best wishes,
Ank de Jonge, PhD
http://www.emgo.nl/team/961/ankdejonge/personal-information/
Department of Midwifery Science
Tel. +31(0)20 4448196, +31(0)621115591
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Van: A forum for discussion on midwifery and reproductive health research. [[log in to unmask]] namens Nieuwenhuijze M (AV-M) [[log in to unmask]]
Verzonden: dinsdag 29 januari 2019 19:43
Aan: [log in to unmask]
Onderwerp: Re: Autonomy in performing membrane sweeping?
This is a practice done by midwives in the Netherlands, based on their own autonomous judgement, in principal after a process of shared decision-making with the woman.
Met vriendelijke groet | Kind regards,
Marianne Nieuwenhuijze PhD MPH RM
Professor of Midwifery
Research Centre for Midwifery Science
Academie Verloskunde Maastricht
Zuyd University
+31(0)43 388 54 11
[log in to unmask]<mailto:[log in to unmask]>,
www.av-m.nl<http://www.av-m.nl/>
Universiteitssingel 60, 6229 ER Maastricht
[ZUYD]
From: A forum for discussion on midwifery and reproductive health research.
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