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Understanding the pain behind the ‘husband stitch’

When a woman gives birth, stitches are sometimes needed. Some doctors have given them an extra stitch to the vagina to make it ‘tighter’ for their male partners – in exchange for unwarranted consequences.

After almost five years of struggling with infertility, Stefani was finally pregnant with her first child. Despite her pregnancy being filled with preterm labours and bed rest after 18 weeks, she gave birth to a baby girl.

After the doctor on call explained the ins and outs of her delivery, he then told her he added an extra stitch for her husband.

“At the time, I didn’t know what that meant,” says Stefani. “It was a snarky kind of joke.”

“He thought it was humorous.”

When she started experiencing unexplained and undiagnosed pain during sex, Stefani decided to go online to find the answer to her discomfort. She then stumbled on a message board and was linked to an article that explained everything – Stefani was given the husband stitch.

A husband stitch, also known as a “daddy stitch”, husband’s knot and vaginal tuck, is an extra stitch given while repairing a natural tear or a cut from an episiotomy after vaginal birth, supposedly to tighten the vagina to increase sexual pleasure for their male partner.

It is not an official medical procedure and is unethical.

“I didn’t even know that he had done an episiotomy until he had done the husband stitch and was finished with everything,” says Stefani. “It was over before I could even say anything.

“It was so bad.”

While no scientific studies show how many women have been affected or a method for evaluating how common it is in the world of obstetrics, many women have shared their experiences online and offline.

“This [husband stitch] was still popular when I was a resident back in the 1970s,” says OB-GYN Dr Mary Jane Minkin. “Some OB-GYNs felt that to repair an episiotomy, one should put an extra tight stitch to make the husband ‘happy’ by keeping the vagina tight.

“The problem is that it may be so tight that the woman will be so uncomfortable that she cannot have sex.”

The scar tissue left after the stitch was stiff and rigid, and Stefani was in so much pain that even wearing a tampon was uncomfortable for her, let alone having intercourse. Coupled with the exhaustion from trying to have kids, she was only having sex with her husband 2-3 times a year at most.

“It was ten years before I was having sex that didn’t hurt, and that’s a whole impact on your marriage in and of itself,” says Stefani. “It was this little, tiny stupid thing, and it has impacted so many parts of our lives.

“It’s wild.”

While women note some degree of “pelvic relaxation” after having a baby, it doesn’t mean any extra stitch is required.

“When a woman pushes out a seven, eight, nine-pound baby, there’s going to be some changes in her vaginal canal,” says relationships and sex therapist Dr Deb Laino. “But based on flexibility and just the healing aspect of the muscles and the pelvic floor, it can go back fairly normal.

“A woman’s body is designed for that contrasting in the vaginal canal.”

Even though the husband stitch is designed for the male partner, it might not necessarily give them any more pleasure.

“It certainly could give guys discomfort,” says Dr Minkin. “It could be too tight for them too.”

And while a “tight” vagina may increase sensation for a male partner during sex, it does not mean that it’s the only way for men to receive sexual pleasure after having a baby.

“Obviously oral sex,” says Dr Laino. “Oral and manual sex is a good option.”

Besides keeping physically fit and doing kegel exercises, Dr Laino also says good communication, effective conflict management, knowing your partner’s body, and doing and working on what pleases them is the key to a perfect sexual relationship with your partner – not an extra stitch.

While the husband stitch is relatively unheard of, it hasn’t stopped people from sharing their stories on social media or even having male partners requesting it to doctors.

Despite the husband stitch being unethical and pain-inducing, it isn’t necessarily an illegal procedure in America.

“As far as illegal, no, it’s not illegal, but ill-advised if it’s going to make the vagina too tight,” says Dr Minkin. “Good judgement should always be used for the women’s comfort.”

But as of January 2022, an amendment to the health and care bill in the UK means that it is illegal to perform procedures intended to reconstruct the hymen – including the husband stitch.

By the time Stefani knew what had happened, the doctor who gave her the stitch had retired, and while she wished she had taken action against him, she knew what to do for her next pregnancy.

“I knew to advocate for myself the next time around and say I really don’t want this unless there’s no other way around it,” says Stefani. “I wish I would’ve [taken action] if I could tell myself now back then, yeah.

“I was just so naïve about it.”

Ten years later, the scar tissue has broken down, and Stefani is finally in a good place with herself and her husband – physically and emotionally.

And as for the husband stitch, it’s not practised as much in the US as it used to be and is considered an outdated procedure in the US.

“No one these days tries to stitch women up too tight,” says Dr Minkin. “I think that providers are much more aware than folks used to be 40 and 50 years ago as far as making a repair too tight.”

From virginity testing to hymen repairs, the husband stitch is one of many procedures that put women’s well-being at risk. And the fact that there are no official statistics or studies of the surgery is alarming in itself.

While these surgeries are slowly being illegalised, it’s important to maintain the conversation on how some parts of the medical world still have an outdated mindset and hold the many licensed professionals accountable for authorising these procedures to happen in the first place.

To help restore her sex life, Stefani was advised to use a lot of lubrication, go slow during sex and wait for the scar tissue to break down.

Other than lubricant Dr Laino recommends experimenting with different positions that might feel a little better.

“Maybe if she’s on top, she has more control, so she can angle her body in different ways that might feel better versus him on top,” says Dr Laino. “Just some inner thigh massage prior to sex because there’s a lot of anxiety of impending pain, even lower abdomen massaging.

“And even using some lavender oil just so the scene, the situation is relaxing, I think is important.”

And as far for episiotomies, it’s rarely performed anymore.

“In general, most obstetricians do not advocate cutting routine episiotomies,” says Dr Minkin. “Most will let the tissue stretch and separate as much as needed to let the baby out, and then we put the tissue back together.”