The experts, Chairman, Society of Gynaecology and Obstetrics of Nigeria, Lagos State chapter, Dr. Akinde Joseph; and Lagos-based public health physician and general practitioner, Dr. Fatai Oloyede, said that suturing should only be for corrective repairs to help women heal faster and not a method of reducing the size of the vagina.

An episiotomy is a surgical cut made in the perineum during childbirth. The perineum is the muscular area between the vagina and the anus. The doctor may make an incision in this area to enlarge a woman’s vaginal opening before child delivery.

An episiotomy may be necessary to assist some women to give birth, and the surgical incision is intentionally made to increase the diameter of the vulval outlet to enable childbirth.

Episiotomy is usually performed during second stage of labor to quickly enlarge the opening for the baby to pass through.

According to the United Kingdom’s National Institute for Health and Care Excellence, up to nine in 10 first-time mothers who have a vaginal birth will have some sort of tear, graze, or episiotomy.

The NICE stated further that an episiotomy makes the opening of the vagina a bit wider, allowing the baby to come through quickly, noting that it is recommended if the baby is in distress and needs to be delivered quickly.

Episiotomy, NICE also stated, can help to prevent a severe tear or speed up delivery, adding that suturing after episiotomy is always necessary to close the wounds to the skin or other tissues.

Speaking with PUNCH HealthWise, Dr. Oloyede said that episiotomy is normally used by physicians when the baby is big and the mother has difficulty in delivering.

“Episiotomy is especially necessary when the outlet is small and you want to prevent severe tears; and after the delivery, you suture the cut.

“Suture is to help the woman heal faster. It is not to ‘help’ her male partner. No physician should use such suture to reduce the size of the vagina.”

Continuing, Oloyede warned, “You cannot and should not suture where you did not cut. So, how can you help to enhance a male partner’s sexual pleasure when you are not doing reconstructive surgery?

“I don’t think any good doctor will be thinking about helping any man’s sexual pleasure while suturing a woman after delivery. The person you are helping is the woman, not the man.”

Recounting his experience, the physician said, “I even know some women who refuse suture after delivery because of their fear of pain, but I always advise that the cut should be sutured because if it isn’t, it might make the vaginal opening wide.

“Women who refuse suture are made to sign that they don’t want it. But, a suture is just to put the vaginal opening back the way it was and to enable the women to heal faster,” he said.

‘Stop undue worries about your vagina’

Oloyede also urged women to stop getting unduly worried about what men feel about the vagina size after delivery, adding that the vagina wall is elastic and usually returns to almost its normal state after delivery.

“Once you suture if a tear occurs during vaginal birth or because you have to do an episiotomy, the vagina will be back to almost the way it was, because it is elastic.

“However, after having two or three children, it may not completely go back to what it was exactly because of the stretch, but it will return to almost what it was,” he said.

The public health physician also noted that both the female and male sex organs shrink as people advance in age.

“As ageing occurs and women approach menopause, the female hormones, particularly the oestrogen, reduces and that actually reduces the size of the female sex organ.

“This also happens to men when they are advancing in age. Once the testosterone reduces, the male sex organ also shrinks. In fact, the whole body size usually reduces, and not just the sex organ.

‘Tight suturing is wrong’

Also speaking with PUNCH HealthWise, Dr. Joseph said that a woman should not be sutured tightly after episiotomy.

“If it is too tight, it is a wrong repair. The suture is supposed to basically repair the cut made to enable the delivery and avoid more serious tears.

“The suture should not be a corrective surgery to reduce vaginal size. It is to help the woman to heal quickly.

“I know that when a baby has passed through the vagina with or without episiotomy, especially when a woman has had several children, the vagina may not be as it was before. That is normal.

“While the vagina may not be 100 percent as it was before childbirth, I must add that it would return to almost normal. So, it shouldn’t be a thing to worry about.

“However, I have always advised that any woman that observes a problem with her body should always see a gynaecologist for appropriate diagnosis and treatment and not to resort to patronising quacks for all sorts of spurious agents to use on their sex organ,” Joseph said.

source: Punch