to stitch or not to stitch, that is the ?

[boobjuice]

afterthough: I am a little curious how many women tear in the upper soft tissues?? I read that the perineum is a big concern for a lot of women. I believe the water softend my perineum which is why it did not tear, on the other hand it also softned the upper tissues which may have led to such a big tear. Also I remeber weeks of itching, discomfort with the stitches, I have already decided to not stitch if my perineum were to tear, has anyone not used stitches with tears in the soft tissues?? Midwifes, your input please??

[beachsea]

I hope someone responds as I spoke with my OB about no stiches, anyone?

[alegna]

I had several odd tears. My perinium was intact though. I refused stitches and healed quickly and nicely. I'd do the same again.

-Angela

[twogreencars]

I tore very badly w/ DS - I pushed all 9 lbs 12 oz of him out in 2 pushes (when midwife asked if I'd like to feel his head crowning in the water, I irrationally thought "if I don't get him out, he'll drown!" so I pushed REALLY HARD and he came out REALLY FAST). The MW asked if I'd like stitches or not and of course, I choose not. It was a real mistake as the tear healed badly and tissue which was supposed to be on the inside (with its nerve endings) ended up on the outside and I had to have an operation 6 months after he was born to remove granulated tissue from my perineum. With DD (nearly 3 years later), I also tore badly and was stitched and it healed up much nicer. It turns out this pregnancy, that my perineum has a hole in it (my MW pointed this out to me) and has a tendency to be sore (even before the birth!) - so who knows what will happen this time! Even tho' I'm not at all into intervention, one thing is for sure - I would asked to be stitched, based on my past exeperiences!

[mamabain]

i had the opposite experience from the previous poster.

with my highly medical hospital birth, i had a 3rd degree tear on the perineum that was stitched. the shot(s?) for numbing hurt LIKE THE DEVIL. worse than crowning or delivery.
it took 7 weeks to attempt sex and hurt for about 3-4 months postpartum.

with my home waterbirth, i had one 1st degree tear on the perineum which i chose not to stitch. a week after birth it was stinging in odd places when peeing so i checked it out and had 2 periurethral tears, (in between the clitoris and the inner labia) about an inch long each. looked like i had been cut with a knife on the outer layer of skin. i didn't have those stitched either. they healed by 2 weeks, very superficial. the inch long perineal tear scared me. i thought it wouldn't heal closed but it did, at 2.5 weeks it was closed together. by 4 weeks we were having sex and it was fine.

[Guest*]

With my first, I had a 1st degree perineal tear. My midwives said I could do without stitches so I didn't get them. I kep my legs together for 2 weeks, rested a lot and didn't overdo it, but it was about 3 months of hell and I finally felt normal again after 8+ months. If I opened my legs even 2 inches, the tear re-tore. By the time I figured out that it wasn't normal, it was too late to do anything about it.

With my second, another tiny perineal tear in the same spot. My midwife said I could do without, but we had talked about my previous experience and I decided that I wanted anything that could be stitched to be stitched. I healed very quickly this last time and am extremely happy that I went through the extra discomfort of having stitches because I'm sure it helped me heal properly and MUCH more quickly. It sucked getting it done, but I'm very happy that I had it this time.

[Roxswood]

I had tears in one side of my labia, which were left unstitched and healed fine. A little differently shaped to the other side but that doesn't matter to me at all. We were able to have sex after only 10 days.

[MacKinnon]

I tore on one side of my labia (really it's a hole, like someone folded paper over and cut it). My m/w didn't notice it, I didn't have it stiched. It wasn't until several weeks later that I realized that the stinging was from a tear in the labia! The hole is still there. I think I would have prefered to have it stiched but it was too late by the time it was found. It doesn't bother me or cause any problems but that first month it was really sore. I wonder if it will rip through with this delivery?

[mwherbs]

this may be TMI for some people just warning ahead of time


well I think an upper tear or a labial tear inner or outer labia all depends on how deep- if you have some good small sutures- 000 suture with a cutting needle- if it is on a very sensitive area like the clitoral hood- there is no way I will stitch that -- but if it is a tear all the way through an outer labia a bit below the clitoral hood then it would be a consideration because - dynamic tension that would be broken up if you don't put it back together-- but not every woman's anatomy is the same so like I said it depends on if it seems like it would change sexual function then I would try to or recommend suturing . on the other hand there are some inner tears that stem from the hymenal ring that you would probably not want all the way back together this is also different in every woman so it is all a judgment call-
some of the upper tears lend themselves to being held together with liquid stitching/ medical superglue.
if we don't stitch we have moms do a postpartum soak/sits baths with comfrey and lavender and yarrow or plantain . If we do stitch then maybe one bath right after but then wait a few days till it is granulated because the comfrey in particular can cause the sutures to dissolve quickly and we dont' want them to come out until the tissue holds it's self together. then we want those sutures to dissapear and the tissue to heal fast.

[pamamidwife]

I rarely suture as it is, but the upper/inner labia tears are the ones you do not usually want to suture. they're painful, but not dangerous in any way.

[mwherbs]

ya pam I agree that it is not dangerous but I was thinking that some women get more stimulation with their labia in tact- I have talked to several clients about this over the years- and it is all in your anatomy... some women loose a bit of stimulation by having a severed labia -- if it looks like the case than suturing is a good idea... of course there are other ways to achieve the same end- you may just have to be more creative in finding them..