When the baby does not seem in a hurry to go out, the midwife or the gynecologist can detach the membranes. This gesture, sometimes painful but without particular risk, can indeed trigger the onset of labor. Explanations.

Detachment of membranes is a medical technique practiced at term and intended to induce contractions in order to induce labor. It is less and less practiced because even if it is without danger, it is reputed to be painful and it has not demonstrated tangible proof of its effectiveness. It is also sometimes known as stripping.

Like all other methods of inducing labor, detachment of membranes should only be considered under certain conditions. First scenario: the term of pregnancy has passed but there is no vital urgency to get the baby out, the latter not showing any sign of fetal suffering. Second scenario: the future mother wishes to give birth on the date of her choice. This triggering said of opportunity or convenience, without medical reason, can then only be done from 39 weeks of amenorrhea. And it can only be considered if the following conditions are met: the uterus must not be scarred, the due date must be precise, the cervix favorable.

The separation of membranes is performed in the office of the midwife or the gynecologist, without specific prior preparation. With the help of his finger, the practitioner loosens the membranes of the amniotic sac from the cervix in a circular motion. This mechanical alteration causes a chain reaction resulting in the production of prostaglandins. These hormones have the particularity of contributing to the onset of labor by promoting the maturation of the cervix and causing contractions. Some light bleeding can occur and in the opinion of many, this gesture is unpleasant, even painful, but it does not involve any particular risk.

Studies concerning the effectiveness of membrane detachment are contradictory. Some show that this gesture would indeed reduce the duration of gestation. Others report that they can cause light bleeding and uterine contractions without actually starting labor within 24 hours. These data explain why the Haute Autorité de Santé recommends the detachment of the membranes at term only when the triggering does not present an urgent medical reason and that the mothers-to-be have been informed of the possible inconveniences associated with this practice.

Detachment of membranes is considered to be a full-fledged technique for inducing labor, even if this gesture, which can be performed in the office of the gynecologist or midwife, is much less medicalized than the other methods (oxytocin infusion, application prostaglandins…). It intervenes in first intention.