The repair
Stitches, anesthesia for them, and what to ask.
Tears needing stitches are repaired shortly after the birth, usually with local anesthetic, or through an existing epidural. A third or fourth-degree tear is repaired differently, usually in an operating room by someone specifically trained, with better lighting and anesthesia.
Two things to say"Please make sure I am properly numb before you start." Being stitched while inadequately anesthetised is a common and entirely avoidable source of trauma, and women frequently do not say anything because they assume it is meant to hurt.
And afterward: "What degree was my tear, and can that be written where I can see it?" You will need that number in your next pregnancy.
And afterward: "What degree was my tear, and can that be written where I can see it?" You will need that number in your next pregnancy.
Where this comes from:
212. Okeahialam NA, Taithongchai A, Thakar R, Sultan AH. The incidence of anal incontinence following obstetric anal sphincter injury graded using the Sultan classification: a network meta-analysis. Am J Obstet Gynecol. 2023;228(6):675-688.e13.
213. Edozien LC, Gurol-Urganci I, Cromwell DA, Adams EJ, Richmond DH, Mahmood TA, et al. Impact of third- and fourth-degree perineal tears at first birth on subsequent pregnancy outcomes: a cohort study. BJOG. 2014;121(13):1695-1703.
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This page is educational. It supports the conversation with your own clinicians. It is not consent to any treatment, and it cannot assess you. If you are worried about a symptom now, see urgent warning signs.