Chapter 19: Advanced skills for pregnancy and birth
Numb the torn area
If you sew a tear immediately after birth, the woman’s genitals may still be numb,
and you may not have to use an anesthetic. But if possible, you should numb the
cut before you sew it.
Before you give the anesthetic, ask the mother if she has ever had this medicine.
Do not give the medicine if she has ever had any reaction to an anesthetic
(like itching, rashes, or trouble breathing).
To numb the genitals before sewing
• inject up to 10 ml of 1% lidocaine without epinephrine in the torn tissue
• inject up to 20 ml of 0.5% lidocaine without epinephrine in the torn tissue
• spray topical lidocaine onto the skin and into the torn tissue
Lidocaine is a common local anesthetic. It is sometimes called lignocain. There may
be other local anesthetics in your area. Be sure these do not contain epinephrine.
Before you inject an anesthetic, look carefully at the shape of the tear. Think
about what pieces of tissue must be sewn together. This is important because the
tear will swell and change shape after you inject the medicine.
1. Slide the needle under the skin, just inside one side of the tear.
2. Pull the plunger back just a little. If any blood comes into the
syringe, pull it out and try inserting it again.
3. Slowly inject medicine and at the
same time, slowly pull the needle out.
This will inject a line of medicine under
the skin instead of injecting it all in one
place. The tissue will swell a little.
Inject medicine on the other side in the
Inject about 4 ml into each
side of the tear. Do not inject
more than 10 ml all together.
A Book for Midwives (2010)