Episiotomy stitches after giving birth: The 'husband stitch' is not a myth

So you already had your baby out of your lady parts. The worst is over… right?

Unfortunately, some mums still experience painful side effects of giving birth such as a vaginal tear and getting an episiotomy. While having an episiotomy and vaginal stitches should be a medical procedure with limited side effects, it can also go haywire when doctors stitch unknowing mums a certain way.

One of the mums in our online community shared her experience with vaginal stitches gone wrong:

“My baby was eight months old when I was ready to resume my sexual life. After such a long gap, I simply couldn’t wait to feel my husband’s touch again. Even he was quite excited that I was finally up to it.

We both wanted to give each other a super-special experience. But within a few minutes, it turned into a complete nightmare. As my husband tried to enter me, I had excruciating vaginal pain. That’s when we realized that the doctor had given me extra episiotomy stitches. Yes, he had given me the infamous, husband stitch.”

What is the husband stitch? 

“Husband stitches” are, essentially, extra episiotomy stitches. An episiotomy is done when the space between your vagina and anus splits or is cut, during birth.

The extra “husband” stitches are supposed to tighten your vagina for “extra pleasure” for your partner during sex, once recommended. 

The “husband stitch” has more or less remained an urban myth… until now. Many mums are now coming out and sharing the reality of the “husband stitch” or “daddy stitch,” which is usually done without the woman’s consent or knowledge.

The practice is considered highly sexist by many. And while it’s supposed to be done for the male’s pleasure, it results in more pain for the woman.

Episiotomy stitches: Husband stitch is not a myth

There is no study that gives an exact number of how many women have been affected. However, women have started to open up and share their experiences. 

Among many others, Alicia Wanstall Burke recently took to social media and shared that this happened to her. She said: “Hello! Yes, this happened to me! Not sure it was a purposeful thing done by the doctor, but I had to have reconstructive surgery to fix it. Hence, no more vaginal births for me!”

Raquel Rosario Sanchez also shared in a Tweet, “It’s not a myth. I’ve got cousins subjected to this unnecessary pain because a doctor wanted to ‘please’ their husbands.”

Neve said, “The doctor that sewed me up after delivery actually said this to me.”

Venetia Booth said that it happened to her as well. She also stated that the hospital never took her consent and that she had to get it rectified.

What is an episiotomy? 

A perineal episiotomy is a small surgical incision (the muscular area between your vagina and anus). To widen the entrance for your baby’s escape during a vaginal delivery, these cuts are made just before the procedure.

How common are episiotomies?

The rate of the surgery has considerably decreased since the regulation for routine episiotomies changed in 2006. For instance, just 12 per cent of vaginal births in 2012—the most recent year for which data are available—involved an episiotomy, compared to 33 per cent in 2000.

However, as some medical facilities have an episiotomy rate as low as 1% and others have a rate as high as 40 per cent, whether you get this cut or not may depend on where you receive your medical care.

When is it deemed necessary to do an episiotomy?

Although episiotomies are not as frequently advised as they previously were, they are nevertheless appropriate in specific delivery situations:

• Large head
  An episiotomy may be performed in these circumstances because a larger noggin could require a roomier exit.
• Vacuum or forceps delivery
  Additionally, these tools might require extra room to move.
• Complications
  These can include shoulder dystocia, which implies the shoulder is trapped in the delivery canal, or breech presentation (feet or bottom first).
• A preterm child
  In addition, if your child is preterm, an episiotomy may be suggested.
• Stress on the foetus 
  This cut may be done so that your baby can be delivered immediately away if the foetal monitoring of your baby’s heart rate reveals he is in distress and not getting enough oxygen.

Episiotomy vs. tearing: Which is better?

Episiotomies were once carried out to prevent spontaneous perineal tears and lower the possibility of traumatic foetal birth. However, studies have shown that, in general, mums and infants do quite fine without one. In reality, the women who were let to rip spontaneously during delivery as compared to those who did not receive an episiotomy:

• Heal in the same amount of time (or less) and with less discomfort.
• Experience fewer side effects like blood loss, infection, and faecal and urine incontinence
• Have a lower propensity for tears to develop into third- or fourth-degree lacerations, which are more severe.
• Experience quicker healing and less perineal pain

Are episiotomies accompanied by risks?

Yes, there are dangers associated with any form of surgery, including developing a wound that is deeper than a normal tear would be, a chance of infection, and pain, including uncomfortable sex in the weeks following delivery.

A fourth-degree vaginal rip, defined as one that passes close to or into the rectum, may increase the likelihood of a midline episiotomy and occasionally result in faecal incontinence.

How to avoid episiotomy?

Remember that episiotomies may occasionally become required; the choice should be made in the birth room. You might be able to lower your risk, though. What you can do is try:

• Discuss the subject 
  If you want to avoid getting an episiotomy, talk to your doctor about it. She’s likely to agree that it can be avoided unless there’s a valid reason.
• Put it on paper 
  Make a note in your birth plan that you do not want to have an episiotomy.
• Perform Kegels
  These exercises increase circulation and enhance muscle tone.
• Gently massage the perineum
  Six weeks before your due date, get a massage to help stretch this area.
• Apply warmth
  Warm compresses can help your perineum stretch more easily during childbirth by softening the skin there.
• Go slowly
  Bear down slowly and just press for five to seven seconds at a time (instead of pushing hard for 10 seconds while holding your breath).

• Add some resistance
  As the baby’s head begins to emerge, the practitioner can gently push back on your perineum to prevent an unwanted tear from occurring from the baby coming out too rapidly.

What happens during an episiotomy?

During childbirth, there’s a possibility of a natural vaginal tear. Or sometimes, doctors purposefully cut the tender perineum tissues to facilitate a smoother delivery.

If it appears that you may need an episiotomy, a local anaesthetic will be injected to numb the perineal area; however, if you have previously had an epidural, you won’t need this additional dose of medication.

Next, a median (also known as midline) incision—a cut made directly back toward the rectum—or, more frequently in the US, a mediolateral incision—which slants away from the rectum—is performed during the second or pushing stage of labour using either scissors or a scalpel.

After delivery, this tear, whether natural or purposefully done, has to be stitched up. This is when some doctors are said to be adding in that extra stitch for tighter vaginas, keeping in mind the man’s pleasure when they resume sex.

What do experts say about it?

OB-Gynaecologist Jesanna Cooper, MD says that whatever manner the vaginal tear happens, it is not possible to make the vagina tighter with stitching. The vaginal tone should not get impacted by a stitch because it has more to do with pelvic floor strength and not the size of your vagina’s opening. 

Stitching can create a tightness on the perineum and outer vulva. But whether this gives a different sensation to the sexual partner is uncertain.

Vaginal repair is meant to bring the skin back together so that body’s healing process is facilitated, not to tighten the vagina.

Yet at the same time, we cannot ignore these mums who have come forward with their stories of the “husband stitch.” So what do you think? Has it happened to you too? 

Episiotomy scar

The scar tissue that forms around the site of an episiotomy or rip can get quite tight and painful, and it may even start to cling to the surrounding skin layers. It could be uncomfortable or elevated, itchy, or raising during bowel motions, intercourse, or just general activity.

Additionally, perineal massage might aid in scar mobilisation and alleviate uncomfortable sensations.

Episiotomy wound healing time

How long does an episiotomy take to heal?

Every woman who gives birth vaginally (and some mothers who had a C-section) may have some perineal pain after giving birth; regrettably, if the perineum was surgically sliced, the pain is likely to be exacerbated.

The episiotomy site will take time to heal, typically seven to ten days, just like any new incision. A nurse will check your perineum while you’re in the hospital at least once per day to make sure there are no signs of infection or irritation.

Dissolvable sutures, also known as absorbable sutures, are frequently used during an episiotomy.2 The stitches don’t need to be removed by a medical professional; they dissolve on their own in 2 to 4 weeks.

They can be taken out without having to go back to the hospital, and using them almost never results in difficulties.

Stitches from an episiotomy typically begin to fall out within a few days and disappear after a week or two. When you wipe yourself, you could see bits of the sutures (appearing as little black specks left on the toilet paper).

Episiotomy wound care

Remember that your body will absorb the stitches you received, so you won’t need to have them removed. Additionally, you should take it easy for a few weeks while you wait for the okay to resume exercising and having sex.

Your healthcare practitioner will provide you with postpartum perineal hygiene instructions, which include the following:

• Ice packs
  Pain and swelling can be reduced with cold compresses or ice wrapped in a washcloth or plastic bag.
• Sitz baths
  To hasten healing, sit in shallow, warm water a few times each day.

• Pain relief
  Inquire with your doctor about over-the-counter drugs like ibuprofen or numbing creams or sprays.

• Squirt clean
  Spray your perineum with a tiny plastic bottle before and after urinating, and then use a soft cloth or baby wipe to gently pat the region dry.

Episiotomy infection signs

Keep an eye out for any indications that the wound or nearby tissue has contracted an infection, such as:

• Rosy, enlarged skin
• Pus or fluids dripping from the wound
• Enduring pain
• A strange smell

Any potential infection-related symptoms should be reported to a doctor, midwife, or health visitor as soon as possible so that they can ensure you receive any necessary treatment.

When to call the doctor

Call your provider if:

• Your discomfort increases.
• Four or more days pass without you having a bowel movement.
• There’s a blood clot the size of a walnut that you pass.
• You have an odorous discharge.
• The wound appears to open up.

This article was first published in theAsianparent.