Chapter 19: Advanced skills for pregnancy and birth
Sew tears as soon as you can after the birth so they will heal well. It is best for
a tear to be sewn within 12 hours.
If you cannot sew within 12 hours, and the woman has a 1st or 2nd degree tear,
do not sew it. Clean the cut well and tell the woman to rest as much as she can for
2 weeks. If she has a 3rd or 4th degree tear, it must be sewn or she can have
permanent damage to her body. She may not be able to control her need to pass
stool. If possible, take the mother to a medical center.
WAR NING! You may not have the skills to sew every tear
yourself. If a tear seems very complicated or deep, if you do
not have sterile tools to sew with, or if you do not have
experience with this kind of tear, get medical help.
Tools for sewing tears
To safely sew a tear, you must have:
chromic gut or
sterile cloth for putting
under the mother
while you sew
a strong light
sterile gauze for
cleaning the tear
while you work
Chromic gut or Vicryl sutures are best because they dissolve and do not have to be
removed. You must use this kind of suture for stitches under the skin.
If there is no chromic gut or Vicryl suture available, you can use plain cotton
thread that has been boiled. But since you will need to take the stitches out later,
make only 1 layer of stitches on the skin.
Use size 000 sutures for inside the vagina, and size 00 for sewing
muscle. If you have only 1 of these sizes, you can use it for all the
It is easiest to sew with a curved needle. Some sutures come with
the needle already attached.
A Book for Midwives (2010)