I can understand how you might tear along the vaginal walls, but I occassionally see women talk about internal stitches. Do they mean internal as in 'muscle layer' stitches that are done before 'skin layer' ones? Or do they mean higher up in the vagina, say close to the cervix for example? How is it possible for someone to be able to manouver their hands and instruments and be able to see what they are doing inside a vagina? I may have the wrong end of the stick! Anyone know how this works? Any midwives out there?