animated goddess mdbs banner animated goddess

MoonDragon's Women's Health Procedures Information
For Lacerations & Tears

(A Midwife's Tutorial)

For "Informational Use Only".
For more detailed information, contact your health care provider
about options that may be available for your specific situation.

  • Prevention Is Always Better Than Repairs
  • Dealing With Lacerations or Tears
  • Suturing Alternatives & Repair Hints
  • Suturing Repair-Related Products



    Unfortunately, even with the best techniques and care, midwives still get an occasional laceration that needs to be repaired. Fortunately, they rarely need more than a few stitches, if any at all. Many midwives prefer not to use any type of medical anesthetic for suturing for legal reasons and because the risk of anesthetic complications may occur. For those who feel the need or have a client that insists on some kind of anesthetic, here are some helpful suggestions and recommendations.

    The information given below assumes knowledge of syringe use. For more information see links at the bottom of this article.


    For minor lacerations or tears requiring only a stitch or two, anesthetic may not be required if repairs are performed on the perineum within a short time of placenta delivery. The perineal tissue will still be relatively numb from the birth and the suturing will feel like a slight "pinch" as the needle goes through the tissue. It may be repaired easily and quickly without the use of and the worries about anesthetic complications.

    However, if the repair is going to require more than a few stitches, repair is delayed after the birth, and/or requires extra time to repair, anesthetic may be considered if you carry it in your birth bag. Keep in mind allergic reactions and tissue swelling associated with it's use. Be aware of any signs of adverse reactions with the use of any anesthetic and how to treat reactions before using any anesthetic product.

    If anesthetic is to be administered, it should be injected prior to beginning suturing. It takes a few minutes to really take effect. 1 or 20percent plain xylocaine (lidocaine) may be used. Epinephrine should not be included in with the xylocaine as it is more likely to cause allergic reactions and it is a vasoconstrictor. Ask the resource supplier about anesthetic product options.

    The purpose of the anesthetic is to deaden the skin and just under the skin surface. Use only enough to achieve a result. There is no need to use anything further back as there are very few nerve endings in this region. Make sure you have noted any matching skin tags or other "land marks" prior to anesthetic injections since the injections may cause the tissues to swell and become slightly distorted. You will want to make sure the tissue is appropriately aligned for good repair and proper healing.

    Begin by using 4 cc of 2-percent medication or 6 cc of 1-percent medication. This should be enough, however, up to 10 cc of 2-percent medication and 15 cc of 1-percent medication total amount can be administered. If the mother can still feel it with this amount, then it is important to simply get the sutures in as fast as can be done.


  • Keeping the mother occupied (distraction technique) with her new baby can help to distract her while repairs are being performed. This is helpful with or without anesthetic use.

  • Using a pre-frozen syringe needle will help to keep injection discomfort to a minimum. Freezing the needle while still in the package can be done during labor and the needle is removed from the freezer when repairs need to be performed.

  • Use small gauge needles (27 to 30 gauge, no larger than a 25 gauge needle should be used - the larger the gauge, the smaller the needle).

  • Infiltrate skin slowly.

  • Inject through wound edge if possible.

  • Warm xylocaine to body temperature.

  • Applying ice packs on the perineum can help cool the skin, numb the area, reduce swelling, slow bleeding and can be useful prior to repairs and for the discomfort after repairs.

  • Have the client/patient keep her eyes open during repairs (analogous to labor pain management).

  • Vibrate or pinch skin as you inject anesthetic.

  • Talk calmly to client/patient. Let her know what you are doing and what to expect. No surprises.


  • Some midwives that are not able to obtain injectable anesthetic will often use a spray-on or gel local anesthetic that can be purchased at a local drug store or through a medical supply retailer. Keep in mind, it only works on the surface and there still may be some discomfort during suturing. Topical anesthetic can be used to help with injection discomfort when applied prior to injections. Spray-on lidocaine has alcohol in it and it does sting. But if you fan it, it is more tolerable than the injections. Cetacaine gel or Xylocaine spray applied and waiting about 3 to 4 minutes, gives about 50-percent numbness, which is usually sufficient for a normal 1st to small 2nd degree tear at a normal birth.

  • Tea Tree Oil put on the perineal wound before suturing to aid healing seems to help numb the area instead of or prior to injecting lidocaine may be helpful for one or two stitches. I have never tried this, but this is a suggestion from a midwife from the Midwife Archives (see link below).

  • Verbal anesthesia helps such as talking or singing (another form of distraction). Favorites may be "Leaving on A Jet Plane", "Hundred Bottles of Beer on the Wall" or some other well known, easy song can be used during repairs. The midwife can sing along with the mother and other people present at the birth.

  • "Suture" glue, a wound adhesive (similar to "Super Glue"), may be used to "glue" the wound edges back together. It can be used alone or along with sutures by applying and holding the wound edges together until bonding occurs. Suturing may be done after the tissue edges have bonded. The ability to adhere properly is dependent on a dry surface. A midwife may have an extra person fanning the perineum after mom has been cleaned up and while glue is being applied. If you choose to suture, use a small suturing needle to reduce discomfort.


    The tear needs to be fresh, clean, and fairly shallow with straight edges that lie together on their own. The glue is applied to bridge over the closed edges, not inside on raw surfaces. (Covering the raw surfaces with Super Glue could actually PREVENT the surfaces from knitting together!) Insert a tampon first and insert your finger between the edges and pull it out to bring the edges forward slightly. This ensures that edges will not roll inward toward each other, but meet perfectly. You could also use a tissue forceps for this. Hold gauze below apex to catch any drips and apply tiny dots of glue sparingly where the edges meet. You can also apply a bead of tiny droplets to bridge the edges. Use a hair dryer or fan to dry, which takes about 30 seconds. The adhesive stiffens as it dries and prolonged soaking is not too good for it. It will flake off by itself in usually less than a week. Some rare allergic reactions are inflammation and swelling. Be careful not to glue your glove or gauze pads to the mother during application. Some midwives prefer using a "gel super glue" over the liquid version since it has more control and less dripping. After all, you do not want to glue the mother's anus shut during the application process. Many midwives have had great success in using skin glue in place of sutures and the mothers like it too since needles are rarely used with the glue.


    From Anne Frye's Healing Passage, 5th edition, p. 44.:

    A Note About Tissue Adhesive: In 1959, a variety of cyanoacrylate adhesives were developed, some types of which are now used for wound closure in Canada and Europe. Some midwives have assumed that retail cyanoacrylate adhesives such as Super Glue are identical to medical adhesives. However, retail products contain methyl alcohol because it is much cheaper to produce, and are manufactured to industrial, not medical, standards. Cyanoacrylates cure by a chemical reaction called polymerization, which produces heat. Methyl ester has a pronounced heating action when it contacts tissue and may lead to tissue necrosis during metabolism.

    Medical grade products contain either butyl, isobutyl or octyl esters. They are bacteriostatic and painless to apply, produce minimal thermal reaction when applied to dry skin and break down harmlessly in tissue. They are essentially inert once dry and have been shown not to be carcinogenic. Butyl products are rigid when dry, but provide a strong bond. Available octyl products are more flexible when dry, but produce a weaker bond. Ideally the wound to be closed is fresh, clean, fairly shallow, with straight edges that lie together on their own. The glue is applied to bridge over the closed edges; it should not be used within the wound, where it will impair epithelization. The only FDA approved adhesives suitable for use as suture alternatives are veterinary products; n-butyl-cyanoacrylate tissue adhesives Vetbond (3M) and Nexaband liquid and octyl-based Nexaband S/C (intended for topical skin closure when deep sutures have been placed). Histoacryl Blue (butyl based) (Davis & Geck) and Tissu-Glu (isobutyl based) (Medi-West Pharmaceuticals) are sold in Canada for human use. DMSO (dimethyl sulfoxide) or acetone serve as removers. (Helmstetter, 1995; Quinn & Kissick, 1994)

    Midwife Archives: Suturing / Super Glue GluSeal Liquid Bandage


    MoonDragon's Procedures: How to Give Injections
    MoonDragon's Procedures: Suturing Equipment & Supplies
    MoonDragon's Procedures: Pre-Suturing Preparation
    MoonDragon's Procedures: Episiotomy Repair by Suturing
    MoonDragon's Procedures: Episiotomy

    MoonDragon's Womens Health Index

    | A | B | C | D | E | F | G | H | I | J | K | L | M | N | O | P | Q | R | S | T | U | V | W | X | Y | Z |

    Health & Wellness Index


    Allspice Leaf Oil
    Angelica Oil
    Anise Oil
    Baobab Oil
    Basil Oil
    Bay Laurel Oil
    Bay Oil
    Benzoin Oil
    Bergamot Oil
    Black Pepper Oil
    Chamomile (German) Oil
    Cajuput Oil
    Calamus Oil
    Camphor (White) Oil
    Caraway Oil
    Cardamom Oil
    Carrot Seed Oil
    Catnip Oil
    Cedarwood Oil
    Chamomile Oil
    Cinnamon Oil
    Citronella Oil
    Clary-Sage Oil
    Clove Oil
    Coriander Oil
    Cypress Oil
    Dill Oil
    Eucalyptus Oil
    Fennel Oil
    Fir Needle Oil
    Frankincense Oil
    Geranium Oil
    German Chamomile Oil
    Ginger Oil
    Grapefruit Oil
    Helichrysum Oil
    Hyssop Oil
    Iris-Root Oil
    Jasmine Oil
    Juniper Oil
    Labdanum Oil
    Lavender Oil
    Lemon-Balm Oil
    Lemongrass Oil
    Lemon Oil
    Lime Oil
    Longleaf-Pine Oil
    Mandarin Oil
    Marjoram Oil
    Mimosa Oil
    Myrrh Oil
    Myrtle Oil
    Neroli Oil
    Niaouli Oil
    Nutmeg Oil
    Orange Oil
    Oregano Oil
    Palmarosa Oil
    Patchouli Oil
    Peppermint Oil
    Peru-Balsam Oil
    Petitgrain Oil
    Pine-Long Leaf Oil
    Pine-Needle Oil
    Pine-Swiss Oil
    Rosemary Oil
    Rose Oil
    Rosewood Oil
    Sage Oil
    Sandalwood Oil
    Savory Oil
    Spearmint Oil
    Spikenard Oil
    Swiss-Pine Oil
    Tangerine Oil
    Tea-Tree Oil
    Thyme Oil
    Vanilla Oil
    Verbena Oil
    Vetiver Oil
    Violet Oil
    White-Camphor Oil
    Yarrow Oil
    Ylang-Ylang Oil
    Healing Baths For Colds
    Herbal Cleansers
    Using Essential Oils


    Almond, Sweet Oil
    Apricot Kernel Oil
    Argan Oil
    Arnica Oil
    Avocado Oil
    Baobab Oil
    Black Cumin Oil
    Black Currant Oil
    Black Seed Oil
    Borage Seed Oil
    Calendula Oil
    Camelina Oil
    Castor Oil
    Coconut Oil
    Comfrey Oil
    Evening Primrose Oil
    Flaxseed Oil
    Grapeseed Oil
    Hazelnut Oil
    Hemp Seed Oil
    Jojoba Oil
    Kukui Nut Oil
    Macadamia Nut Oil
    Meadowfoam Seed Oil
    Mullein Oil
    Neem Oil
    Olive Oil
    Palm Oil
    Plantain Oil
    Plum Kernel Oil
    Poke Root Oil
    Pomegranate Seed Oil
    Pumpkin Seed Oil
    Rosehip Seed Oil
    Safflower Oil
    Sea Buckthorn Oil
    Sesame Seed Oil
    Shea Nut Oil
    Soybean Oil
    St. Johns Wort Oil
    Sunflower Oil
    Tamanu Oil
    Vitamin E Oil
    Wheat Germ Oil


  • MoonDragon's Nutrition Basics Index
  • MoonDragon's Nutrition Basics: Amino Acids Index
  • MoonDragon's Nutrition Basics: Antioxidants Index
  • MoonDragon's Nutrition Basics: Enzymes Information
  • MoonDragon's Nutrition Basics: Herbs Index
  • MoonDragon's Nutrition Basics: Homeopathics Index
  • MoonDragon's Nutrition Basics: Hydrosols Index
  • MoonDragon's Nutrition Basics: Minerals Index
  • MoonDragon's Nutrition Basics: Mineral Introduction
  • MoonDragon's Nutrition Basics: Dietary & Cosmetic Supplements Index
  • MoonDragon's Nutrition Basics: Dietary Supplements Introduction
  • MoonDragon's Nutrition Basics: Specialty Supplements
  • MoonDragon's Nutrition Basics: Vitamins Index
  • MoonDragon's Nutrition Basics: Vitamins Introduction


  • MoonDragon's Nutrition Basics: 4 Basic Nutrients
  • MoonDragon's Nutrition Basics: Avoid Foods That Contain Additives & Artificial Ingredients
  • MoonDragon's Nutrition Basics: Is Aspartame A Safe Sugar Substitute?
  • MoonDragon's Nutrition Basics: Guidelines For Selecting & Preparing Foods
  • MoonDragon's Nutrition Basics: Foods That Destroy
  • MoonDragon's Nutrition Basics: Foods That Heal
  • MoonDragon's Nutrition Basics: The Micronutrients: Vitamins & Minerals
  • MoonDragon's Nutrition Basics: Avoid Overcooking Your Foods
  • MoonDragon's Nutrition Basics: Phytochemicals
  • MoonDragon's Nutrition Basics: Increase Your Consumption of Raw Produce
  • MoonDragon's Nutrition Basics: Limit Your Use of Salt
  • MoonDragon's Nutrition Basics: Use Proper Cooking Utensils
  • MoonDragon's Nutrition Basics: Choosing The Best Water & Types of Water


  • MoonDragon's Nutrition Information Index
  • MoonDragon's Nutritional Therapy Index
  • MoonDragon's Nutritional Analysis Index
  • MoonDragon's Nutritional Diet Index
  • MoonDragon's Nutritional Recipe Index
  • MoonDragon's Nutrition Therapy: Preparing Produce for Juicing
  • MoonDragon's Nutrition Information: Food Additives Index
  • MoonDragon's Nutrition Information: Food Safety Links
  • MoonDragon's Aromatherapy Index
  • MoonDragon's Aromatherapy Articles
  • MoonDragon's Aromatherapy For Back Pain
  • MoonDragon's Aromatherapy For Labor & Birth
  • MoonDragon's Aromatherapy Blending Chart
  • MoonDragon's Aromatherapy Essential Oil Details
  • MoonDragon's Aromatherapy Links
  • MoonDragon's Aromatherapy For Miscarriage
  • MoonDragon's Aromatherapy For Post Partum
  • MoonDragon's Aromatherapy For Childbearing
  • MoonDragon's Aromatherapy For Problems in Pregnancy & Birthing
  • MoonDragon's Aromatherapy Chart of Essential Oils #1
  • MoonDragon's Aromatherapy Chart of Essential Oils #2
  • MoonDragon's Aromatherapy Tips
  • MoonDragon's Aromatherapy Uses
  • MoonDragon's Alternative Health Index
  • MoonDragon's Alternative Health Information Overview
  • MoonDragon's Alternative Health Therapy Index
  • MoonDragon's Alternative Health: Touch & Movement Therapies Index
  • MoonDragon's Alternative Health Therapy: Touch & Movement: Aromatherapy
  • MoonDragon's Alternative Therapy: Touch & Movement - Massage Therapy
  • MoonDragon's Alternative Health: Therapeutic Massage
  • MoonDragon's Holistic Health Links Page 1
  • MoonDragon's Holistic Health Links Page 2
  • MoonDragon's Health & Wellness: Nutrition Basics Index
  • MoonDragon's Health & Wellness: Therapy Index
  • MoonDragon's Health & Wellness: Massage Therapy
  • MoonDragon's Health & Wellness: Hydrotherapy
  • MoonDragon's Health & Wellness: Pain Control Therapy
  • MoonDragon's Health & Wellness: Relaxation Therapy
  • MoonDragon's Health & Wellness: Steam Inhalation Therapy
  • MoonDragon's Health & Wellness: Therapy - Herbal Oils Index


    Starwest Botanicals

    Educational materials and health products are available through
    Use the search box provided below to search for a particular item.

 Herbs, Foods, Supplements, Bath & Body

    Herbs Direct

    Chinese Herbs Direct

    Ayurvedic Herbs Direct

    Pet Herbs Direct

    ShareASale Merchant-Affiliate Program


    A website map to help you find what you are looking for on's Website. Available pages have been listed under appropriate directory headings.