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The "Husband Stitch"

Updated: Sep 12


If you are a woman in America, you understand that the patriarchy is unequivocally involved in your health care.


This is of course where the concept of the "husband stitch," or an extra stitch applied to the perineum following an episiotomy or perineal tear after birth, was derived.


The thought process behind the "husband stitch," and I literally cringe every time I type that, is that it will tighten the vagina postpartum for an improved sexual experience for the woman's partner.


And though I believe this is an old practice that is rarely seen today, especially with more female ob/gyn and midwives attending births, sadly it is not completely dead.


And the reasoning behind it is certainly alive and well.


Let's Breakdown The Concept of a "Tight Vagina"


Let's assume for the moment that people with penises prefer a "tight vagina" for sex.


Tension in the vaginal wall comes from muscle strength of the pelvic floor. It's very unusual for a woman of child-birthing age, with good hormonal balance, to have a super weak pelvic floor that's open and breezy, flapping in the wind, no matter how severe the tear.


If there is weakness in the pelvic floor in this population, it is likely due to a disruption in neurological input that can be restored fairly quickly with good pelvic floor physical therapy.


So, does overstitching a perineal tear create more tension in the pelvic floor? No, it creates more scar tissue.


Scar tissue in the vaginal wall can create pain along that region if not treated properly. A healthy vaginal wall stretches 360 degrees around, and scar tissue won't stretch easily with it.


This can create a pulling, stinging or burning sensation around the scar tissue. A husband stitch will narrow the vaginal opening, creating more scar tissue and pain for insertion during sex.


Is It Actually Better For Men?


Now, is increased tension in the pelvic floor muscles better for sexual partners?


No. This is because the pelvic floor needs to be able to relax for intercourse. An extra stitch will create painful insertion and the pelvic floor will contract as a pain response.


Orgasm is difficult to achieve with a non-relaxing pelvic floor. Insertion will also be difficult to achieve with a non-relaxing pelvic floor.


A tight pelvic floor will more than likely result in far less sexual pleasure for the woman.


Of course the patriarchy isn't worried about that, but I am here to argue that when women are enjoying sex, their partner's generally will enjoy it more as well.


Therefore, the goal for women to increase their partner's sexual pleasure, is to find out how to increase their own first.


Should I Be Worried My Provider Will Give Me A Husband Stitch?


It's difficult to know for sure if your tear will have been overstitched unless your provider tells you or your partner they are doing it.


Scar tissue will form after a tear no matter what, and it can become painful and tight if not rehabilitated properly.


If you are worried about being overstitched, make sure you have that conversation with your ob/gyn or midwife ahead of time.


And take heart in knowing that this is an old practice that is very rare today.


Conclusion


Although extremely rare, the husband stitch does still happen from time to time. But what is even more insidious is the false concept that women are "loose" after childbirth and this is deleterious to their partner's sexual pleasure.


Your vagina is not loose. It doesn't not need to tightened with stitches. If you are struggling with issues that you might normally attribute to a "loose vagina," make sure you book your appointment for pelvic floor physical therapy today!

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