I am slowly....slooooowwwwlllyyyy.....getting more births under my belt. Just had one recently, quite beautiful, eased the head out gently, followed by the body....up on to mom's abdomen. There is just something so magical and beautiful about the moment of birth. It is without a doubt one of the most blessed events I am privileged to witness and be able to share in the family's moment.
I'm oh so very slowly starting to feel a little bit of confidence in my ability to suture lacerations (only the ones that really need sutured, thank you very much!). How to describe the feeling of sewing up a laceration: dive in, anchor the stitch, sometimes rather blindly fumble through some locked or interrupted sutures, tie off, cut. It's not pretty. It's not neat. Blood oozes into your visual field. Where it "feels" like hand sewing or hand quilting to my muscle memory (I am a long time sewer/quilter), it "feels" totally different because it is not neat, measured, precise. Vaginas/labias need held open with the non-dominant hand for better visualization, while you try to find the apex of the laceration in the vaginal wall with your eyes and fingers. Then you have the uterine blood flow/lochia to contend with (yes, the fundus is firm....) dab, dab...don't dab too much or you irritate the tissues more! There is nothing neat or clean about stitching a lacerated vagina. Just get the muscle approximated back together, and it will heal on it's own.
Now, to close the skin on the perineum, that is much neat, clean, and obvious! This is where the stitches are more precise, small, and where my hand quilting experience comes in handy. When the perineal skin comes together --- voila! Beautiful!
Yet, I worry: am I pulling too tightly on the suture? Is it puckering? Will it heal abnormally? What will it look like at the 6 week checkup? I want it all to be "just right" so she does not have any abnormal lumps or bumps of healed tissue later in life.
The stitched vagina: more forgiving with "sloppy stitching". The perineum: not as forgiving, but will tolerate the stitches as long as the muscle and skin is matched up to where it was before the laceration occurred.
I guess this is just one of those things where practice, practice, practice will help improve me hand skills over time.
I'm oh so very slowly starting to feel a little bit of confidence in my ability to suture lacerations (only the ones that really need sutured, thank you very much!). How to describe the feeling of sewing up a laceration: dive in, anchor the stitch, sometimes rather blindly fumble through some locked or interrupted sutures, tie off, cut. It's not pretty. It's not neat. Blood oozes into your visual field. Where it "feels" like hand sewing or hand quilting to my muscle memory (I am a long time sewer/quilter), it "feels" totally different because it is not neat, measured, precise. Vaginas/labias need held open with the non-dominant hand for better visualization, while you try to find the apex of the laceration in the vaginal wall with your eyes and fingers. Then you have the uterine blood flow/lochia to contend with (yes, the fundus is firm....) dab, dab...don't dab too much or you irritate the tissues more! There is nothing neat or clean about stitching a lacerated vagina. Just get the muscle approximated back together, and it will heal on it's own.
Now, to close the skin on the perineum, that is much neat, clean, and obvious! This is where the stitches are more precise, small, and where my hand quilting experience comes in handy. When the perineal skin comes together --- voila! Beautiful!
Yet, I worry: am I pulling too tightly on the suture? Is it puckering? Will it heal abnormally? What will it look like at the 6 week checkup? I want it all to be "just right" so she does not have any abnormal lumps or bumps of healed tissue later in life.
The stitched vagina: more forgiving with "sloppy stitching". The perineum: not as forgiving, but will tolerate the stitches as long as the muscle and skin is matched up to where it was before the laceration occurred.