Chapter 19: Advanced skills for pregnancy and birth
Tie your stitches securely
(In these drawings we show one side of the suture
in black and one in white so the parts of the knot
will be easier to see. Real suture can be any color,
but will all be the same color.)
Tie 4-layer knots so they will be secure. Do not use more than 4 layers
or the knot will be too bulky. To tie your stitches with 4-layer knots:
1. Lay the needle end
of the suture over
the other end and
then wrap it under
and pull it through
2. For the second
layer, lay the
needle end back
over the other end,
wrap it under, and
pull it through.
3. Do this 2 more times,
each time laying the
needle end over the
other end, wrapping
it under and pulling
4. Cut the ends about ≤ centimeter long.
This will make a strong knot that will not come untied.
Some people use an extra wrap
on the first layer like this:
Wrap the needle end over, under,
then over and under again.
This can help the first layer stay
tight while you tie the next layer.
A Book for Midwives (2010)