Having sex was incredibly painful and she couldn’t use tampons anymore, but Robyn* thought that any woman who had been stitched after giving birth was probably experiencing the same.
When she went for a smear test though, a year after having her first child, the nurse found it difficult to perform the exam; that’s when she started realising something was wrong. “[The nurse] was the one that said to me: ‘It looks like you’ve been stitched too tight, I thought they had stopped doing that’,” Robyn recalls.
This was 16 years ago, and the practice of giving new mothers one or more unnecessary stitches under the illusion that it would tighten their vagina and enhance a man’s sexual pleasure during intercourse – the so-called ‘husband stitch’ or ‘daddy’s knot’ – was already considered an urban legend.
“I was in nursing college at the time and we all did placements on maternity,” says the 42-year-old mother from Buckinghamshire. “They talked quite freely about there having been a practice, in the past, of stitching women very tightly and I honestly thought it was a myth.”
The nurse at the smear appointment could not think of any medical reason to justify Robyn’s excessive suturing, although she did admit that having delivered with the help of a ventouse might have caused a more severe tear that would need repairing. At the time, Robyn was in an abusive relationship where she was pressured into having sex despite experiencing pain. When she became pregnant with her second baby, two and a half years later, she asked on her birth plan to be stitched by a woman, in the event that she tore. Eventually, the laceration from that delivery fixed the problem.
“I said I had had an experience where I was stitched up really tight last time by a man, and I didn’t want to go through that again,” she explained to the hospital staff. “The midwife sort of nodded. They didn’t seem surprised, like it was actually quite normal that something like that would have happened.”
While many women experience tears during childbirth and need stitches, the so-called ‘husband stitch’ is not a recognised practice in the UK, as Doctor Daghni Rajasingam, consultant obstetrician and spokesperson for the Royal College of Obstetricians and Gynaecologists, warns. But a recent article, focused on US stories, reignited public debate, prompting more women to come forward with their own experiences.
“About six weeks [after giving birth], when the stitches had started dissolving, it was very painful still. So I had a look and realised there was an extra bridge of skin,” says Mary*, a 25-year-old from Birmingham who had her first son in August 2015. “I had such a traumatic experience during the delivery that I was hoping afterwards everything would be okay.” Acknowledging the problem, her GP referred her to a gynaecologist who confirmed that she had been given too many stitches – again, by a male consultant.
No one mentioned the ‘husband stitch’ or anything similar to her or her husband inside or outside the delivery room, and it is impossible to know whether it was deliberate. “I like to think it was more of a medical error, but it seems quite odd that, when you do this every day, you accidentally give too many [stitches].”
To this day, she still experiences pain when sitting down or going to the toilet. She was prescribed a dilator, to try and stretch the skin out, but it’s not been working that much, so far. She’s managing the pain and hoping she will get better in time. “The attitude seems to be: ‘Well, it’s not life-threatening, so get on with it!’ There aren’t many treatment options,” she adds.
Doctor Susan Bewley, professor of women’s health at King’s College London, writes in an email that she hasn’t heard the 'husband stitch' being discussed in decades – “even in the appalling jokes anxious or misogynist men make”. And in over 20 years of clinical experience, Doctor Brenda Kelly, a consultant obstetrician from the John Radcliffe Hospital in Oxford, was never asked to put in ‘extra stitches’. “If anything, a doctor or a midwife is very careful when closing to put as few stitches as necessary, because of the very delicate part of the body,” she says.
The aim of any healthcare professional working on a woman who’s had a tear because of childbirth is to put the anatomy back as closely as possible to how it was, she points out. “Sometimes the damage is great, there can be a lot of bleeding and it can be more challenging to realign it exactly; some women, unfortunately, do experience soreness or a tightness that wasn’t there beforehand,” she explains.
If the woman continues to have consistent pain or discomfort, four to six weeks after giving birth, she should go and see her GP and make sure there is no infection of the skin or the tissue. Dilators could help with tightness, as they are meant to progressively and gently help to stretch the skin. In severe cases, there are surgical procedures to try and rebuild the tissue back to the most anatomically correct position possible.
The so-called ‘husband stitch’ can be considered a form of female genital mutilation (FGM) which any UK doctor should be suitably terrified of doing and, of course, it’s important to draw a line between what’s done intentionally and what can happen as part of a routine medical procedure.
“FGM specifically refers to any alteration of a female’s genitals for non-medical reasons,” clarifies Dr. Kelly. “If there’s no medical reason to be stitching in a particular place and it’s done, that would be considered illegal.” Particularly if it is done without consent, and with the idea of improving a man’s pleasure during intercourse – which is also a myth, by the way. As the doctor explains, the tightness of the entrance of the vagina doesn’t have much influence on a man’s pleasure, which mostly derives from the internal muscular vault.
Having worked with women who have been subjected to FGM, Dr. Kelly says that in certain cultures – Sudanese, for instance – there has been a practice of re-infibulation of women, post-childbirth, who had previously been stitched closed. “After birth, the midwife may well put extra stitches in – it is called ‘adal’,” she explains.
FGM aside, Dr. Kelly finds the general emphasis on women to conform to a tight vaginal ideal concerning: “There is a rise of surgery being done on a woman’s genitals with the sole purpose of enhancing sexual pleasure that seems to be drawing very much from the concept that the tighter we are, the better it is for men, and the more sensational it will be for a woman,” she says, talking about procedures like vaginal rejuvenation, clitoral hood alteration, G-spot enhancement, and so on.
So although procedures such as the ‘husband stitch’ are hopefully very rare in the UK, the misleading importance still given to the tightness of the vaginal opening is very real, and potentially very dangerous. As Dr. Kelly warns: “The vaginal area, the area just outside of the vagina, is heavily invested with nerve fibres, and if we have nerves damaged in the process of unnecessary surgery, that can lead to chronic genital pain.”
*Names have been changed to protect identities