stitches - obtetricrian, midwife or registrar?

[LillianFullStop]

So as a first time mum I've pretty much have to accept that there will be SOME tearing involved during VB.

Who actually does the stitching the midwife or the OB? I've seen some posts where it is the registrar is that like a junior doctor?

I heard thy glaze over these details in antenatal classes and focus more on the birth preparation rather than the post natal care and risks so I thought I'd do some reading. And in some hospitals the midwife do the first degree tears but refer to the OB for 2-4th degree. Who actually decides how bad the tearing is? Does the midwife do the OB referral or will an OB always do a check for hospital births?

I know it's probably rare but I've heard horror stories of post birth stitches not done well, having to be redone, causing on-going problems or longer recovery (some cases longer than CS recovery or requiring further treatment or surgery).

Anyone had any experiences either way of postpartum care for a new mother? eg midwife vs OB skills, lower risk of botched postpartum procedures in private hospitals, etc?

Going back to the 1980s - a midwife sewed me up after an episiotomy. Half way through, she looked up and said "Never let a male doctor do this. They sew you up too tight; they think they're doing you a favour."
I replied that I would always remember her advice. And I have.

Had an episiotomy with DC1, also had a retained placenta so the MW said they would let the surgeons deal with it in theatre. Had been in labour overnight and fell asleep on the operating table

Sections with DC2&3

If you really want the full details, and to k ow how the tears are classified, read section 1.16 of the nice guidelines here www.nice.org.uk/guidance/cg190/chapter/1-recommendations#care-of-the-woman-after-birth

1st and 2nd degree tears - could be midwife or doctor depending on who's available. 3rd or 4th need to be repaired in theatre, so it will be a doctor. Sounds horrible, but I had third degree and the community midwife cheered me up by telling me I'd probably heal quicker than a bad second degree tear given that a mine was repaired in theatre with proper drugs so I didn't move at all and proper lighting to help out. She was probably just trying to make me feel better, but it worked !

A student midwife delivered my baby and assessed my tear, she wasn't sure if it had gone through to my bum even after have a good probe around up there, midwife then came and had a look and feel bit wasn't sure, then a junior Doctor, then finally the consultant who said it was only a second degree tear and said since I didn't need to go to theatre the best person to stitch me up would be the midwife. Baby is 18 days old and my bits feel completely normal. The fact 4 different people had a finger up my bum post birthe whilst I was high as a kite on had and air is my dp favourite part of the childbirth story.

I had a 2nd degree tear with DC1, stitched up by the registrar, but the registrar had already been there for the birth so I guess she did it because she was there as much as anything. No problems afterwards.

I didn't have any tearing with DC2, just a slight graze that healed fine by itself, despite DC2 being about 2lb heavier than DC1.

I had a 3rd degree after a water birth. Midwife said it wasn't that bad, but upon inspection said that it was 'unusual' so brought in a senior midwife, who agreed and called in a snr registrar (who was brutal and rude but that's a different story). She confirmed it was unusual and a 3rd so I had to have it stitched in theatre. Unfortunately I had to wait 3hrs but I want actually in that much pain. I'm sure it is unusual but I had to have corrective surgery 6m later as I didn't heal well. But, am back to normal now. So, in summary, senior and/or theatre doesn't mean the best result necessarily. Good luck with your birth, hope all goes smoothly

Second degree tear with both kids, both stitched up by midwives. I think it was quite a tear with DS2 (10 and a half pounds, went from 6cm to baby in 45 minutes despite amazing midwife slowing him down as much as possible. Impatient little bugger.)

She did the stitches (took longer than I'd been in the room in labour), after getting a registrar to check that the tear hadn't got through internally and was all external. Thank goodness it was just a very messy second degree tear, but they were very thorough about it. And I very much enjoyed tea and biscuits while she put all the bits back together.

I had stitches after DC2 at home by a midwife but DC1, in hospital, after episiotomy, was a registrar. I was off my face on gas and air and had to have two extra injections because she was so fixated on it. Everyone who looked in the following weeks said she did a brilliant job. It took ages and ages, with my poor mum holding baby in the same room while I went on and on about being a German soldier in the Second World War. Naked.

DC1 - quite a few stitches (although I don't recall anyone saying what degree my tear was) by the midwife while I giggled like fuck, off my head on gas and air, and she giggled at my being such a dick .

DC2 - shocked the midwife by not having torn at all - not even a graze - despite having delivered a 9lb baby in just over an hour from start to finish.

Good luck with the birth - and please don't let the stitches freak you out - I honestly couldn't feel a thing when I was stitched after DC1.

I had a big 2nd degree tear. The midwife got a registrar to assess whether it was third degree or not. Warning - this involved a finger up my bum. Registrar established it was a 2nd degree then offered the midwife to stitch it. She suggested he do it as it was a 'bit ooozy' so would be better if he did it. He did a good job - if anything erring on the tight side. No long term issues and the immediate recovery was good. It wasn't particularly sore and there was no sitting on rubber rings for me.

I had an epidural so barely noticed he was doing it once they started. Think it was weirder for DH who was sitting there while a man sewed me up.

thanks so much everyone for sharing their experiences - i've found this thread really reassuring. i get the impression that overwhelmingly there is a high chance everything will be just fine!

i've never had stitches for anything or even been in hospital before - except when very young and i can't remember it - so it is quite daunting for me.

Mine were done by the 'doctor' - I assume an obstetrician, I'm not sure what constitutes a registrar. Took 1.5 hrs - longer than the labour! 3c tear and episiotomy (it was fine!).

Midwife assessed the tear and decided it was a slight third degree tear. I had a lovely doctor come in (a registrar I think, not entirely sure) who agreed with the midwife's assessment. Technically I should have gone to theatre to have it stitched but my midwife was keen to avoid that (I had planned a homebirth but wound up in hospital being induced, in our area you still get your allocated midwife from the homebirth team to look after you throughout labour if you have to go into hospital and my midwife wanted to make my hospital experience as comfortable as she possibly could). The doctor agreed that as it was barely a third degree she could stitch me up in the delivery room. She was lovely and did a great job with my stitches. Apparently all the midwives agree that if they were to have intimate stitches from anyone it would be her!

thank fuck for ELCS - none of this pain and stitches yuk!

I had an epidural and they put a curtain up (therefore I had no idea what was going on) so I didn't even know they had stitched me up until the nurse said that's everything done, placenta stitches the lot. Was quite nice not knowing. I'd have been anxious otherwise.

Don't accept that this will definitely happen, it might not.
Not one tear for all 3 of ours.
What I can tell you is I know I wouldn't have cared if it was a trained monkey if something needed doing.

Sanity: i am really sorry to hear your abdominal wall is still open following your section