Did your midwife stitch your tears?

[liberal_chick]

This post will kind of be all over the place, so I'm apologizing in advance.

I had an awesome HBAC 11.5 months ago that resulted in a 2nd degree tear. My midwife said that most tears would heal on their own "if you keep your knees together" and so she didn't stitch it. In fact, she doesn't stitch at all; she would send you to the hospital for anything that needed a stitch.

Well, lo and behold, my tear healed, but it healed apart (like a V) and I had to have it repaired by an OB/GYN at 9 weeks PP. It was worse than the birth; I couldn't sit for at least a week and still have some pain during sex.

Now that I'm pregnant again, I am searching for a HB midwife. I don't really want to use that MW again b/c, in the result of a tear, I don't want to have to go to the hospital to have it stitched up. I am having trouble getting other MWs to call me back b/c I had a c-section for my ds1 and midwives are legally prohibited from attending HBACs in my state (my first midwife was unlicensed).

I can go to a hospital an hour away and birth with a CNM there, but its an hour away! I'm spoiled from being home last time.

So, my question is, did your midwife stitch your tears or did you have to go to a hospital to have it done? And do you think that I'm being silly for discounting my previous midwife for this reason?

[caned & able]

Mine stitched me. I was in New Hampshire at the time.

If you cannot find a midwife in Arkansas, I suggest you cross the border into Texas. Lots of midwives there.

[dachshundqueen]

Yes, 3rd degree tear. Healed fine. In GA.

Can you ask around in your tribal area?

Liz

[violet_]

Mine says she hasn't had a tear bad enough to require stitches in 5 years, but she does stitch them. For smaller tears, she prefers to use superglue (an ER doc turned her onto this).

[liberal_chick]

Originally Posted by dachshundqueen

Yes, 3rd degree tear. Healed fine. In GA.

Can you ask around in your tribal area?

Liz

That is how I found my last MW. She drove from an hour away to see me. There are only 2 other midwives in my area (I'm kind of rural) and one hasn't returned my call and the other works with the one who hasn't returned my call. I think the one that I've contacted feels uncomfortable seeing me "under the table."

[xixstar]

interesting, I didn't tear last time, but I'm pretty sure my mw does suturing because I know she doesn't want you leaving the house after birth at all. She'll do lots to help keep you and baby at home so mom can heal up properly.

I too would want a mw that would deal with any suturing needed.

[laughymama]

My midwife will suture 1st and 2nd degree tears but I'd have to go to the hospital for anything more. She also said she's only had two women have to transfer to the hospital for sutures though.

[MsBlack]

To clarify--all your previous mw said was to keep your knees together? By way of further tear-healing recommendations:

Did she recommend any wound healing potions/regimens to be applied to the tear?

Did she give you a list of things to DO (not just 'keep your knees together') and things to AVOID DOING during the healing time?

I have seen 2nd degree tears heal very well, without sutures. However, there are definitely aids to wound healing that I strongly suggest; some of those are topical (herbs, ice, right on the tear for instance), some internal (oral herbs/supplements), some are things to do, such as keeping your knees together and some are things to AVOID doing (lifting, stair climbing, other).

Also--did your mw look at the tear in the days/weeks following your birth? Part of my policy is to have 3-5pp visits with families in the 6wks following birth. If someone has a tear, then I am definitely going to want to see how it's doing, make new suggestions or at least provide info like 'not healing well, you may have to get this fixed later' (tho actually I've never had to say that to anyone...but it *could* happen).

So--just saying that while you might be more comfy with someone who sutures, there are definitely differences among mws beyond 'Does Suture' and 'Does Not Suture'. Maybe in your search you could make tears and healing a focussed part of the interview--ask in depth questions about how she handles perineal lacerations to find the mw with whom you might feel most comfortable in this respect.

[liberal_chick]

There was literally no instruction beyond "keep your knees together" and no supplements or topical things given or instructed to put on it.

She came at 24-48 hours post birth and looked at it and just said it should heal up fine. She didn't come back again until 6 weeks, and by then it had healed apart.

I'll definately be asking about tear procedure when I interview midwives, if I can get any to call me back. *sigh*

[cheeqz]

My MW sutured - I had a little tearing - only required about 4 stitches.

She gave instructions on preventing pulling the sutures, instructions on keeping things clean, and I was required to visit with her up until 6 weeks after to be sure everything was healing ok.

[sarahr]

My mw (cnm) offered to stitch me, but said it was a perfectly reasonable decision to decline. So I did. I hope it wasn't a mistake.

[katec67]

My midwife stitched my tear and the stitches became infected the following week. The OB I then saw (chose not to see my mw for other reasons) said he could restitch if I wanted it but he preferred not to. He said the vagina is an amazing organ that usually repairs itself beautifully, stitches or not. He told me that if I wasn't happy in 6 weeks with how it had healed, he could do plastic surgery to make it more aesthetically appealing. Turns out it healed just fine and I never bothered with the extra procedure.

It was an upsetting and disturbing occurrence for me, though, so I can see how you might want a midwife who wouldn't just blow off the tear.

[Belle]

My midwife could have sutured up to a 2nd degree tear. I only had a skid mark so didn't need suturing.

[rissierae]

My tear was either 1st or 2nd degree. My midwife said I didn't need stitches, but she did a couple anyway, just to make it heal quicker. I was also instructed to take at least 2 herbal baths a day (with my baby) to help myself heal, and help the baby's chord to dry up.

[claddaghmom]

I know she does b/c she talked about it, but my particular case she said would get the most accuracy at the hospital. It took over an hour for the doc to stitch me.

[Baby_Cakes]

Mine stitched me, and I don't think you're being unreasonable at all to want a midwife who would do the same.

[GoBecGo]

Mine does, but i don't think i would.

After DD i had a 2nd degree which one MW said she'd suture and the other said she wouldn't and i opted not to have it sutured. Did you have a lot of trouble with yours? Did you have it repaired simply because it healed in a V, or for other reasons like pain etc.?

Mine healed open (in a V) too - i expected it to as it was gaping even when i had my knees together - but it is painless, doesn't affect tightness or continence and i am happy with how it healed. I would decline stitches for a 2nd degree tear again, so long as it wasn't through my labia (i've heard it's uncomfortable having tears heal open there as they get pushed about more during sex).

ETA - that seems a long time without PP care. Here i was and will be visited daily for 10 days PP by the MW and then at 2, 4 and 6 weeks by someone (mixture of health visitor, GP and MW)

[IAMommy]

My midwife(CNM) stitched my 2nd degree tear, anything more and she would have sent me to the hospital. It healed beautifully and I never had any discomfort from it, other than the mental discomfort of knowing she was stitching me at the time. I'm needle-phobic.
Is it normal for your midwife to not visit for so long after a birth? Mine was here the next day, and it seemed like they were here pretty frequently, either she or her assistants, for a few weeks.

[MsBlack]

Yeah, that does seem like a long time without pp care. But that's another good question to ask prospective mws--how much pp care do they provide. I see families at 24ish hours, then 72ish, again at 2wks and then 6wks, 'routinely'. However, I do talk with mom by phone daily as long as she seems to need it (up to about a week, less if all is well/no issues). Also, I am on call to them 'whenever' for a few weeks, and if they need me to come over more often than the usual 4 pp visits I do. I can't imagine leaving a significant tear for 6wks without a check-in--at least to instruct the mama to have *someone* look at it each week to make sure it's healing well-and offer advice if not.

Not all mws offer much by way of pp care, though.

There are definitely things to do and to avoid, to help a tear heal together properly. Lesser tears, as one pp points out, may heal apart and make absolutely no functional difference. But some do make a difference--and whatever the case, usually it's better if tear edges heal together properly rather than each edge healing over separately.

[liberal_chick]

The tear healing the way it did didn't cause any problems. I had no pain associated with it or anything. But I had a NP and OB/GYN both tell me, seperately, that prolapse could be a problem one day. I asked when, they said could be when I'm 75, could be when I'm 35. That freaked me out enough to have it repaired. Not to mention it freaked dh out pretty badly (both the way it looked and the posibility of prolapse) and he encouraged me to have it repaired as well.

My MW did call me and check on me periodically and said she would come at the 3 week point if I thought I needed her to. I hadn't looked at the tear at that point but it felt fine so I just assumed that it was healing well.