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The husband stitch: Derogatory joke or painful reality?

According to the Centers of Disease Control and Prevention (CDC), on average, an estimated 3,791,712 babies are born each year.

While much of the joy of childbirth is shared with the world, many aspects of pain and recovery are left out of the conversation. 

Mothers often experience both emotional and physical postnatal pain. While there are methods and treatments, both surgical and medicinal, that are intended to help provide a steady recovery, some of these methods remain controversial.

One of these methods is the husband stitch. 

The husband stitch, also referred to as the “daddy knot,” is the name given to an extra surgical stitch that is applied to women after childbirth for a “tighter” vagina. This stitch is often done without the patient’s consent.

While the start of this practice remains unidentified, it was first defined in text through Sheila Kitzinger’s book “The Year After Childbirth” in 1994. Kizinger referred to the husband stitch as the “unnecessary suture.” The topic of the husband stitch was reintroduced through Carmen Maria Machado’s short story “The Husband Stitch” in 2014. The name itself suggests that while this procedure is applied to a new mother, its end result is intended for the father.

The term “husband stitch” is suggestive and derogatory. It positions women as sexual objects who need to be sexually stimulating for men even after childbirth, instead of as people with bodies that need healing and recovery. 

“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,” said Dr. Brenda Kelly, a consultant obstetrician from the John Radcliffe Hospital in Oxford, in an article by Refinery29.

Surgical stitching is not an uncommon procedure after childbirth; it is often utilized to repair tears made during an episiotomy. Stanford Children’s Health defines an episiotomy as “an incision through the vaginal wall and the perineum (the area between the thighs, extending from the vaginal opening to the anus) to enlarge the vaginal opening and facilitate childbirth.”

“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,” said Dr. Kelly.

In some cases, the vaginal opening does not stretch enough to allow the fetus to exit the womb. In these situations, doctors conduct an episiotomy in order to provide a safe delivery for the mother and child. However, an episiotomy is not without its own set of complications.

“A lot of good data has come out recently showing that episiotomies lead to more damage (more tearing into the rectum) than allowing for natural tearing along tissue planes,” said California OB-GYN Dr. Janna Doherty in an article for Vice.

While the suturing that follows an episiotomy is necessary, complications lie with how the stitches are executed and if the skin between the vaginal wall and the perineum is aligned correctly. Sutures are used after an episiotomy to align the incision back to its original state, but the husband stitch is applied for more cosmetic purposes.

Practitioners often believe that the idea of the husband stitch is simply a derogatory joke that does not actually occur in medical practice.

“I have probably had [the] request 10 to 15 times over the course of 18 years,” said Doherty on the topic of whether or not she receives requests from men to perform the husband stitch. “Typically, it is said in a ‘joking’ manner, and … responses from the laboring women range from dirty looks at the partner to laughing.”

While there is some inconsistent information surrounding whether or not the husband stitch is still utilized in the present day, many women report suffering from postnatal pain due to being stitched too tight.

“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,” said a mother for an article for Refinery29, whose name and identity is protected. “The midwife sort of nodded. They didn’t seem surprised, like it was actually quite normal that something like that would have happened.”

The use of the husband stitch is considered to be female genital mutilation, which is illegal in the U.S. as well as 30 other countries and punishable by law. While it is not completely clear whether or not the husband stitch is purposefully applied in current medical practice, the discussion around it has raised questions and sparked conversation surrounding women’s bodily autonomy during childbirth.