Stitches
It is possible that you tear during childbirth (rupture) or that we have to make a cut (episiotomy). We can then attach you ourselves, also at home. We have suture instruments and suture material with us. We also have anesthesia (lidocaine) in injection form and in spray form.
There are different types of ruptures:
- 1st degree rupture: This is a tear in the skin.
- 2nd degree rupture: skin, vaginal wall and or muscle layer are torn.
- 3rd degree rupture: the sphincter of the anus is partially or completely affected. This is also called a (sub)total rupture.
- Vaginal wall rupture: The wall of the vagina is torn. This is only stitched if it is bleeding heavily.
- Labial rupture: tear in the labia, usually sutured because urination causes burning.
- Episiotomy: or a cut. This is not actually a tear, but a cut must always be sutured.
How is it bonding?
First you need to see if you need to attach. Then everything is set up for stitching. First we will sedate you; by injection or by spray. The spray is often only used for superficial cracks. Sometimes we use a large tampon that we insert into the vagina to prevent blood loss. This gives us a better overview of the wound during suturing. A wound is usually sutured in layers. First the vaginal wall, then the muscle layer and finally the skin. We tie the internal sutures and the skin is tied or sutured intracutaneously (under the skin).
In the case of a (sub)total rupture, you must be stitched up by the gynecologist in the hospital. This is sometimes stitched under anesthesia in the operating room. After a home birth, you will be transported by ambulance.
Care of the stitches
After giving birth, it is important to take good care of the stitches. It is best to pee in the shower for the first few days, so that you can rinse well. Peeing also stings less. You can also rinse on the toilet with a jug, but usually you don't get close enough to the stitches.
Change your sanitary pads regularly. Occasionally lying with your buttocks exposed (for example while resting) speeds up wound healing.
Removing stitches
We can remove the external stitches on the 6th day after delivery. After 6 days, the sutures no longer have any function and can dissolve on their own within 2 weeks. If the threads don't bother you, we can leave them in place. If it does bother you because the threads get stuck in your bandage, or if it pulls a lot, we can remove these superficial stitches. The underlying sutures take up to 6 weeks to dissolve on their own. Sometimes the subcutaneous suture material does not dissolve properly. Remnants of the sutures will then work their way out on their own. So you can still lose some stitches weeks after giving birth.
