Monday, 01 December 2008
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Inappropriate Vaginal Repairs
by Nurse Jenna 
I have heard many crass comments in the delivery room, but high on the list of those that bother me the most are comments the new father makes during the repair of an episiotomy, or laceration such as “Make sure you sew her up nice and tight.” While I find these to be beyond inappropriate, crossing into the realm of misogynistic , I have come to learn that there are a lot of disturbing people in the world and while often I get to see the best of people, I am also exposed to the less pleasant side of human nature as well. While I never excuse it, I am no longer shocked by much and have come to accept quite a lot.However, there are still some things I will not accept. Recently, in a delivery, a woman had a completely normal vaginal birth. She had the good fortune of having no tears and had not needed an episiotomy (which most women do not need). Nevertheless, the doctor said (paraphrasing), “You didn’t have any tears, but I can go ahead and put a few stitches in any way to make things tighter so that sex will be better.” The patient, who was paying more attention to her baby than the doctor, said, “Whatever needs to be done; whatever you think is best.” Unbelievable. Needless to say this doctor is being written up and the situation is being addressed.
While one could say there was verbal patient consent, I would definitely argue it was not “informed consent” as to what was really going on given the situation. Regardless, if this “elective” procedure was being done with the patient’s approval, it is not even a “cosmetic” procedure. It is unnecessarily surgically altering this woman for the possibility that it may improve her husband’s sexual satisfaction.
Do you think women who have not torn during delivery should have the option to get a “repair”? Do you think it is malpractice if a doctor places stitches when there was no laceration?
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Comments (69)
I agree, that's bordering misogynistic.
From my understanding, time and exercise will "tighten things up" quite alright. No need to do anything else, in my opinion.
it is malpractice. they always need inform consent from the patient before any procedure is done.
That is absurd. To me it wouldn't be any different then putting a few stitches in my arm for no reason.
No I don't think that unnecessary repairs need to be done. I would like to say I am shocked and quite frankly I do expect more from the doctor but I am losing my shock value the longer that I work in L&D. I am amazed at some of the things I hear in there. My guess is that this is not the first questionable thing he has done. I would like to think as a patient that my warning bells would have gone off long before that point.
Wow! I had never heard of such a thing! I do think the doc needs to have his stethescope readjusted, to put it mildly. And the new fathers who suggest such things... wow. What losers at what would normally be such a precious time.
You should have the choice whether or not you want to have this procedure done. But for the doctor to have made a suggestion at such a time ... he should be written up.
Well from the ethical point of view the patient needs to be informed of the risks of bleeding and infection as well as undesirable result.
Making such a decision during such an emotionally turbulant time is never the right thing to be doing, however, I would argue that perhaps this 'cosmetic' procedure may not necessarily only benefit the male. One might argue that a good sexual relationship would benefit both parties.
Never heard of that before.
That's kinda fucked up.
I can't help but laugh at this blog. I was in the room when my bestfriend had her first baby. After she had him, her husband looked at the doctor and said jokingly, "put an extra stitch in doc." The doctor was a female and said back to him, "if you think YOU'LL need it I can put two in for you." I about died laughing inside. He deserved that. I don't care if he was joking. Here my friend is at 3:30 in the morning just having pushed out a baby that got stuck and broke his shoulder and that's what her husband said!! I think if a woman wants an extra stitch than that's up to her, but it should have definitely been discussed prior to delivery. That was probably really embarrassing for her too. I wouldn't want other people to hear my doc say that.
That is disgusting!!!!
This is not touching on what this whole thing is about, but I need to tell you THANK YOU for letting me know that most women do not need an episiotomy. I am going to be having my baby around Feb. 14 and THAT makes me incredibly nervous. Thanks for making me calm down about one more thing!!!!
My cousin's ex-husband made the same 'highly original' comment. She counts that in the many reasons why he's an ex and I don't blame her.
It's been a while since my last anatomy lesson, but wouldn't the healthier approach to this be kegel exercises? Pleasure for everyone, good for preventing prolapse and incontinence. And without stitches that could become infected and, even if they don't, just...why?? I would have happily done without stitches. They've made a lot of everyday things very..."interesting" in that painful sort of way. Yeah...it seems like malpractice to me. If it's not broken; don't fix it.
Ouch.
Not normally a subject I bring up at the dinner table, but that was one thing my wife and I did not have to think about...
...all four children were born c-section. (First was an emergency c-section, middle two were 'since the first was a c-section, keep it up, and the last was 'we're done, so let's go for the c-section-plus-tubal combo.')
I suppose asking a guy how he'd feel about needles near his parts...cringe.
I find this inappropriate and awful. Seriously.
Less seriously, the way I heard it was the doctor said "I can put two stitches in. I can put two stitches in." She said, "You don't have to say it twice!" and he says, "I didn't. I didn't. I didn't...."
I am ashamed.
i dont understand how stitching where there's no tear would "tighten" her up... anyway, when i had my second child the doctor said i had a tear the size of a "papercut" and there was no need for stitching and six weeks later, sex was greater than it ever was. so yeah that is malpractice.
I think that unnecessary stitches are absolutely insane...but I had the opposite problem, not enough stitches.... I just had my 4th baby in October and I ripped...the doctor completely f*#$ed up my stitches and now I'm going to have to go and be cut and re stitched...that too is unnecessary and I feel that the doctor should most def. get in trouble for it!
Totally agree with you on this one!
That is just silly. I mean, you just pushed a baby's head out of that area and they want to add to the pain and soreness of it all later in the next six weeks. I was one to tear and I got stitches, I do not think I am at all any "tighter" at all -- I have even had this discussion with my husband and he agrees. While I am not like I used to be, everything is fine in the sex department. Ugh. That is just kind of sad.
That is terrible :/ He should definitely have some sort of repercussions for his comments.
@la_vida_linda@xanga - I think people will be surprised to know this was not a "he." This was a woman doctor.
Oh my gosh!!! I can't believe those things come out of people's mouths!!! What are they thinking???
Heck yeah that's malpractice! Borderline sexual harassment too! You don't do that to a new mom who is uninformed and isn't thinking clearly. That's just wrong. That kind of Dr. should have his license suspended. That's just plain awful and rude!!
I am shocked that these things are said in a time when we hear of the horrors of female circumcision - it is really in poor taste for men to make such jokes while their wife has just given birth to their child!
As for the doctor, it is sexual harrassment and if I has heard it I would have changed doctors and considered bringing up a harassment charge - not for the money - but so that others will know what this doctor is truly like. Their name would be mud by the time I was done.
Who would actually want to have that done?! I did not get an episiotomy but tore internal and had to be sutured up.... The doctor gave me the ok and said I looked fine at my 6 week check up, but sex was extremely painful for 5 months afterward. I could "feel" the areas I tore and were stitched and wondered if maybe the doctor had sown me up the wrong way.
More about this topic. Don't some women opt for c-sections because they wan't their "birth canal" to stay the way it was? How often do you see that?
i CANNOT believe the doctor had the nerve to say that. i'd be so offended, even if it WAS a woman doctor. she had no right to make any comments about the patient's sex life
i think it's just plain weird to get a "repair" if there's no laceration....and i doubt it would make a difference anyways because aren't they just stitching up the opening and not the...umm...inside?