RE: [ozmidwifery] Tears and repairs

[Tania Smallwood]

Personally, I don’t suture, not for lack of wanting to, but I haven’t really had the opportunity to do it other than a workshop here and there, and no practical experience whilst doing my midwifery education.  The midwife I work with would suture up to a straightforward, ‘everything lining up well’ second degree tear, and when I’ve managed to see her do another, I’ll probably be able to do one under supervision myself, with the woman’s permission of course J.   The thing is, anything other than a first degree tear is very rare in our, and I presume other IPM’s practice, although that doesn’t mean it doesn’t happen.  If the woman sustained a complicated second degree tear, or 3r or 4th, then absolutely we would transfer into the hospital for expert suturing.  We believe it’s important for the woman to be sutured by someone who does it all the time, and who is an expert in doing it well, particularly when there is deep muscle involvement.   It’s just another example of appropriate transfer for medical assistance in my eyes, and we would transfer in with the woman, and baby, and stay with her while the suturing is done, and then take her home again, all other things being well.    Just my take on things   Tania   From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Honey Acharya Sent: Wednesday, 21 September 2005 7:59 AM To: ozmidwifery@acegraphics.com.au Subject: [ozmidwifery] Tears and repairs   I am curious about something (and I know it is fairly rare with homebirth) but for experienced midwives I assume you would stitch tears yourself even if they were 3rd or 4th degree, but I don't want to make assumptions so is that the case? Or would you transfer to hospital to have a doc stitch it,  or for  the extra pain relief so you could stitch it yourself? At what point?   Thanks Honey