Suturing sucks

I feel like I’ve just barely been holding it together the past few weeks, and just barely (by the skin of my teeth) managing to keep on top of things…not that I’m even coming close to getting all of my reading and homework done, but I’ve been doing enough to feel like I’m working hard at it, and therefore, the stress has been kept somewhat at bay. Until today, that is. Today, it all came crashing down on me in one overwhelming heap. I blame the suturing.

Yes, ladies and germs, today I learned to suture—“learned” being a very generous word for what I actually did today. Mostly I flailed around with a needle holder. Usually I’d consider myself pretty competent at things: I’m smart, I catch on quickly, I can generally master most tasks I set my mind to in just a matter of a few tries. Suturing? Er, no. Suturing is going to take a lot longer than just a few tries.

We were all given large, thick blocks of foam rubber to practice on, and a set of instruments, and suture. We learned about the different types of suture today—chromic v. vicryl—learned about the sizes and shapes of needles, the instruments we’d need, knot tying (instrument and hand ties), how to cut an episiotomy if you absolutely have to (the indications for cutting one being, basically, almost never—except in cases of extreme emergency, or when you need to enlarge the perineal opening in order to perform additional manuevers, such as during a shoulder dystocia). We spent the entire afternoon trying to sew up the episiotomy we’d cut. Oye! Achor stitches defy me! How in the world do you manage to sew sideways through the muscle layer, instead of up and down, so that you don’t end up sewing through the woman’s rectum? I can’t seem to get the angle of the needle right, and all of my stitches are uneven and either too deep or too shallow, too close together, dimpling, too taut or too loose. And if this is foam I’m working with, and I still can’t do it…what am I going to when it’s actual skin and tissue and muscle, none of it neatly delineated, but all blurred together, and bleeding, no less?

This is actually the best motivation I can imagine for trying to preserve the perineum during birth: so long as the woman is intact, you don’t ever have to suture!

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  1. Posted September 22, 2006 at 1:32 am | Permalink

    suturing does suck! I’ve only done it about five times on a real live person and every time I’m not so sure I did it right. It’s why I choose not to suture so often – if the edges come together then I keep my suture pack closed.

    hands off the perineum and vulva during pushing is key to preventing tears…seriously. 🙂

  2. The Student
    Posted September 22, 2006 at 6:35 am | Permalink

    Once I am eventually a midwife (*knock on wood* assuming I manage to get through this year and pass my comps and boards), my plan is to keep my hands off of women as much as possible, especially during pushing. *At most*, I think maybe a warm perineal compress or two? Do you ever use those? We were talking about them in class yesterday, and they sounded so nice and warm and soothing and comforting: just what I’d want on my perineum while it was stretching to such new, awe-inspiring heights. Course, I’ll be doing my clinicals in the hospital, so it will be very interesting to see how my hospital-based preceptors handle the perineum during pushing. I love the way you attend so many hands-off births (hands-free births?), though! And I’m also glad to hear that suturing doesn’t come easily to other people, either. What a difficult skill!

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