What happens if you tear and need stitches?

[UmmInayah]

Hi,

Okay, so I don't really know much about homebirth, so if this sounds like a dumb question, it's only because I want to be more informed about homebirth..

So, just curious as to what happens if you have a really bad tear that requires stitches? I know some women only have a doula present when they are having a homebirth, and some have a midwife.. Do either of these give stitches if required? Or do you have to go to the GP/hospital?

Thanks in advance :)

[Fuchsia!]

A doula would not do stitches but a midwife would :)

Depending on how bad the tear is, a middy is qualified to do the repair work :)

[NibbleCurlynBub]

If you have a proper midwife there, then she will have enough tools to administer some local and stitch you up. :yes:

If it is bad and she is not confident in her ability to fix it however, you will most likely have to visit the hospital to have it fixed.

My midwife at the FBC had gas and a little kit of tools which included surgical scissors, dissolvable stitches (a needle too I assume), a local and a shot of pitocin (which she ALMOST gave to me automatically) :rolleyes:

So yeah.. It can be fixed at home.

There are other things that you can do to avoid the risk of tearing though.

[UmmInayah]

There are other things that you can do to avoid the risk of tearing though.

Yeah, I know there are things you can do to try to avoid a tear.. was jsut curious as to what happened if you tore anyway :)

Thanks heaps for the replies :hugs:. Sorry if it was a dumb question, I just wasn't sure!

I figure better to ask then never know :) I'm sure I'll be posting more in here to find out more as the days go along LOL.

Thanks again.

[shed]

My midwife (well, the one I have chosen if I decide to have another baby) does stitches.

I have no intention of finding out how good she is at it of course! But she worked in a hospital for years so she does all the normal things a hospital midwife does.

Only better :laughing:

[~Emmylou~]

A midwife can do it at home, but also bear in mind that your risk of perineal injury is significantly lower in a homebirth situation, especially with a second babe.

Practices that cause or can increase risk of perineal injury:


Supine or reclining pushing positions
Coached pushing (being told when to push instead of being encouraged to follow your own rhythms)
Time limit on second stage
Not being given enough time for natural stretching to occur as baby's head crowns
Episiotomy


None of these practices are likely to be part of a homebirth, so the number of women who have their babies at home and keep their bits intact is very, very high.

:)

[ikis84]

Some tears don't need suturing either. I had a teeny tiny tear (much, much better compared to my first birth... ouchies) and it was better off leaving than putting a stitch or two in it. My midwife could stitch though.

[UmmInayah]

Thanks everyone for the info :)

Labour is pretty much about trusting your gut, hey? I think listening to others really stuffs you around.

I guess I was lucky that my midwife interfered very little and let me take my time with the contractions.. Infact I wasn't sure if I should be pushing or not when I felt like I needed to push.. I just rode it out for a while. So glad I did because when I asked the middie "When I feel like pushing, should I push?" "She said, yeah, just do whatever you feel comfortable doing" and when she checked, DD's head was right there! Pushing stage was very short for me, thankfully. I can only hope for the same with this one, too.

[UmmInayah]

Some tears don't need suturing either. I had a teeny tiny tear (much, much better compared to my first birth... ouchies) and it was better off leaving than putting a stitch or two in it. My midwife could stitch though.

I had a tiny tear too, but my middie also said better not to have stitches :) Guess that's why the topic asked what happens if you tear AND need stitches hehe.

[ikis84]

Smartie ;)

[Tam-I-Am]

Not all middies can stitch. The way mine explained it, they have to do an add-on course to their midwifery course in order to be qualified to stitch. Not all IMs have done that, therefore its a question you need to ask your own IM. Mine couldn't stitch, but the other middie who attended as back up could have. If the 2nd middie hadn't come, then I would have had to have gone to hospital if a tear had required stitching. As it was, my peri was intact, so it was a moot point :)

[lilpearl]

No doula sutures, as doulas are non-clinical helpers for the mother and family.

Most midwives will be able to suture, but not all, as has been pointed out. And then, some are more advanced in what they can repair and what they don't feel comfortable repairing, so it's a matter of asking your I.M. If you have a fantastic I.M who isn't comfortable with fancy needlework, then you may need to travel to the hospital to have the suturing done....although, as has been pointed out, tears are far less common/sever at homebirth.

Depending on the position in which you birth, tears occure in different areas. Reclining positions put morre pressure on the perineum, but forward-facing positions lead to a higher chance of superficial labial tears (that are much more painful, due to all the nerve endings in that area, though they do not have the side-effects that sever perineal tears can have). Squatting positions, while great for opening up the pelvis, put the greatest pressure on the area too, and lead to more tears - so, I think position is really something to think about before the birth, but women most often end up in a position which is instinctual at the time, and this needs to be supported. Waterbirth is far more common at home, too, helping to lessen the change of tears by softening up the tissues.

[AM]

My mw stitched me up last time, she did an awesome job, no pain, and I healed up really fast.

This time I'm praying for no tears :fingerscrossed:

[MelissafromSyd]

A client had her baby at home on Monday night, and I could see that there was a tear that was pretty big so we headed off to the hospital.



It needs to be said that doulas cannot offer clinical care or advice. If they do, they are practicing midwifery / medicine without a license and are open to prosecution.

As has already been posted, midwives can learn to suture by way of an additional course which most IMs do.

[UmmInayah]

Thanks heaps for the info :)

[kymmy]

I didn't tear this time (Wow what a difference!!) but if its minor resting can repair just as well if not better than stitches.

[Freya]

My doula will get the mirror and we will both have a look and assess whether I need stitches or not. She said if it nothing too major she can get a friend of hers (who is a midwife) to come over and do suture me otherwise if they are bad we will go to the hospital.