No, your doctor doesn't want or need to "throw in an extra one."

By Korin Miller
September 25, 2020
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A growing number of medical professionals have been using TikTok, and it’s a great way to get a little snapshot of what’s on the minds of doctors and nurses, regarding both new and old trends in the medical community. The most recent one that seems to have hit a nerve among ob-gyns in particular—and with good reason—is something called the "husband stitch."

The most recent doctor to call this out is Danielle Jones, MD, an ob-gyn ("TikTok's 1st Gynecologist," she says in her profile) who goes by @MamaDoctorJones on the app. In the video, Dr. Jones breaks down her thoughts on the husband stitch by acting out a scene in which she pretends to talk to a woman who just gave birth and her male partner.

“Great job mom! You have a teeny tiny little tear down there,” Dr. Jones says in the scene, playing herself. “We call it a first-degree laceration. It should only take a couple of stitches to make it stop bleeding. You won’t feel a thing because your epidural is working great. So, you just hold that baby and I’ll be done in just a second.”

Dr. Jones then pretends to be the new mom’s male significant other, asking her to "throw an extra one in for me," referring to the stitches needed for the vaginal tear.

That's when Dr. Jones gives her opinion on the matter. At first, she says what she wants to say to the man in a sarcastic tone: "Sure, how small do you need it, sir?” But follows up with what she actually says in situations like this one: “I need to make it very clear that my job as an ob/gyn at the time of delivery is to reapproximate any tissue that was disrupted by the birth of a child," she says. "I would never, and no one ever should, alter the size of the vaginal opening at the time of a laceration repair. And that’s on ethics.” Dr. Jones also wrote in the comments that this isn’t a joke—she’s really had male partners ask this after delivery.

Dr. Jones also isn't the only TikTok ob-gyn to speak out on this issue: TikTok user Dr. Jennifer Lincoln (@drjenniferlincoln) also shared a post talking about the "husband stitch" as did a labor and delivery nurse who goes by @averynrainyy on the app.

It's cringeworthy, to say the least, but instances like this regarding the "husband stitch" do seem to happen. Here's what you need to know, and what other ob-gyns think about this problematic procedure.

Why would someone need stitches after a vaginal birth?

If you have a vaginal delivery, it’s really common to experience what’s known as an obstetric laceration or tear per the American College of Obstetricians and Gynecologists (ACOG). This can happen on your cervix, vagina, vulva, labia, perineum (the area between your vaginal opening and anus), and pretty much any other place your baby comes into contact with when it’s working its way out.

Most of these don’t end up being a huge deal, ACOG says, but in some cases, severe tears on your perineum can cause pelvic floor injury, incontinence issues, pain, and sexual dysfunction.

Still, it’s common to need a stitch or two after a vaginal delivery to repair an obstetric laceration, Christine Greves, MD, a board-certified ob-gyn at the Winnie Palmer Hospital for Women and Babies, tells Health. “Sometimes the tissue tears and needs to be reapproximated,” she says.

Does a ‘husband stitch’ actually do anything—and does the procedure really happen?

The idea behind the “husband stitch” is to add an extra stitch in repairing the woman's vaginal laceration to try to make the vagina tighter and—read between the lines here—cause more pleasure for the partner during sex, Dr. Greves says.

“There is a notion that the delivery leaves the vagina stretched out and not able to have the capacity for sexual pleasure,” Jessica Shepherd, MD, an ob/gyn in Dallas, Texas, tells Health. “And also that it cannot return to the size it was prior to pregnancy. This is not true.”

It should be known that "this is not routinely done," Dr. Lincoln said in her TikTok explanation. Why? First, because she says "that's gross," and that "consent matters," but also because the procedure isn't something doctors are trained to do. While she says that she can't speak for all doctors out there, any doctor out there who does perform a "husband stitch"—either at the request of a woman or her partner, or on their own—is the exception, not the norm.

Still, despite the "husband stitch" being rare, there are some patients and partners who inquire about it. “I have heard this over my years of practice from both men and women, surprisingly,” Dr. Shepherd says.

Mary Jane Minkin, MD, a clinical professor of obstetrics and gynecologist and reproductive sciences at Yale Medical School, has heard it too. In Dr. Minkin's case, she instead recommends women do Kegel exercises instead. "I'd much rather that women do Kegels to keep up the pelvic floor, not putting in 'husband stitches,'" she tells Health. Lauren Streicher, MD, a clinical professor of obstetrics and gynecology at Northwestern University who has also gotten the request, usually takes another approach to answering the question: “I would always say, ‘Just how small do you need it?’” she tells Health.

If, in some situations, a woman does receive an extra stitch down there, it can cause more harm than good. “Sometimes if it is too tight, it can result in pain for the patient with intercourse when resuming that,” Dr. Greves says.

Women’s health expert Jennifer Wider, MD, agrees. “It can do harm,” she tells Health. “If a doctor adds unnecessary closure and tightening of the vaginal opening, it can cause serious pain for the woman.”

Dr. Shepherd stresses that the whole point of getting sutures or stitches after childbirth is to “repair tears and lacerations—not to bring the vagina down in size.” A “husband stitch” is not needed, even if you are worried about your vagina stretching out, she says. “The vaginal tissue has physiologic recoil and elasticity and is able to go back to size,” Dr. Shepherd says.

Just a little something to consider going over with your partner before you hit the delivery room.

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