Clinical Skills: Suturing

We learned how to suture today. Or should I say, I learned how to tie a two different types of knots on a piece of foam masking itself as a perineum. Whatever it was, it was neat! (Though I do have to admit, I’ve never heard the word anus used so much in a professional setting.)

While the vocabulary was entertaining, the best part of the class was the hands-on practice with needles and thread. This is a huge skill for us, and I want to be sure I can do it properly. In Canada, midwives are only scoped to repair first and second degree lacerations after birth, and a consult with an obstetrician is required for anything greater (third or fourth degree). These are usually vaginal or perineal (that space between the vagina and the anus) tears. Though our scope is only first and second, there is still a lot at stake if you don’t do this properly, so skill is paramount.

To learn it, we were split into groups and each given our own “perineum”. We started by practicing knot tying on a larger rope before graduating to smaller thread. This, as it turns out, is a surgical knot:

Our teachers were amazing volunteer community midwives. I can’t imagine how hard it must be to teach this skill, but our engagement with the experienced midwife went something like this …

Midwife: “Place the suture material over your hand like SO. Keep the string over your left three fingers and grab the other end with the other finger. Then loop over and under and through and don’t let go of the tail … like that!”
She triumphantly looks up at us with her knot finished. 



Follow-up Me:
“So I place the string in my right hand … “





That midwife had the most patience. With each explanation I got one step closer to tying a surgical knot. About 20 minutes later, my partner and I had successfully tied ONE knot. We patted each other on the back triumphantly, after which she told us to start suturing the sponge.

I got to the part where you put the C-shaped tapered needled into the “tissue” before we had to drop everything and head back to class to learn about placement administrative details.

Needless to say, I will be arranging for some extra suturing lessons before placement starts …. luckily for us, though, our prof (also a midwife) has offered to run some extra sessions to increase our comfort levels. At the end of the class, she also noted to our fearful faces that, “No preceptor midwife is going to say, ‘Hey, welcome to your first clinic day! NOW SUTURE THAT VAGINAL WALL PLEASE. Seriously ladies, it will be fine.

That, oddly, made me feel much much better. Since then, I’ve been practicing knot tying with dental floss while watching Netflix. You know, the normal things you do when you’re a midwife in training ….


Leave a Reply

Fill in your details below or click an icon to log in: Logo

You are commenting using your account. Log Out /  Change )

Google+ photo

You are commenting using your Google+ account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )


Connecting to %s