Chapter 19: Advanced skills for pregnancy and birth
Sewing a tear or an episiotomy
Most tears can be prevented if the mother is in good general health. During
pregnancy she should eat well, get plenty of rest, and do squeezing exercises
regularly (see page 44). It may also help to slow the birth of the baby’s head
during labor (see page 207). But sometimes tears do happen.
Small tears will usually heal on their own.
Ask the woman to rest for a couple of weeks
after the birth. She should keep her legs
together as much as possible, although she
should move them regularly. Others should
do her household work for her and help her
with the new baby.
Other tears and cuts heal better if they are sewn together. It is not hard to sew
them, but it is important to learn how from a skilled teacher.
How to judge if a tear needs to be stitched
Tears are hard to see clearly. A woman’s vagina is usually swollen after the birth,
and blood clots can get in the way. Sometimes there is more than one tear. Take
your time, and use a strong light. Someone may have to hold a flashlight for you.
1. Wash your hands well (see page 53)
and then put on sterile gloves.
2. Judge how long the tear is and
how much of the tissue is torn.
Look at the tear from the outside.
Gently put 1 or 2 fingers into the tear to
feel how deep it is. Carefully stretch the
vagina to see how long the tear is.
3. Decide with the mother if you need to
sew the tear or not. Small tears that stop
bleeding quickly do not need to be
sewn. Deeper tears, or tears that
will not stop bleeding, do.
1st degree tear
This tear is
only in the
1st degree tears do not
need to be sewn.
A Book for Midwives (2010)