Why do doctors use a new thread for each stitch?

Why do doctors use a new thread for each stitch?

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Why do doctors use a new thread of the same kind for each stitch instead of using a single thread for the entire stitch?

Using a single thread for a suture also known as continuous stitching has a major con that it has higher risk of failing if the suture is cut in just one place. So it is generally avoided eventhough it is very easy to do.

On the other hand interrupted stitching ( one thread for each stitch) is favoured because of lesser risk of failing, eventhough it is time consuming than continuous stitch.


If they used a single thread, then a single break in that thread would cause the entire thread to fall out of place. Using multiple threads means that if a break were to occur, the rest of the stitches would still be able to hold their place.

One time I had 5 stitches in my hand while I was snowboarding. Sometime during the day I fell down and one of the stitches came out; there was a lot of blood, but it was probably nothing compared to how much blood there would've been if it was a continuous thread and the whole wound opened.

How to Tie a Surgeon's Knot

In medicine, a surgeon's knot is used to secure suture threads during surgical procedures. However, it's also one of several types of knots useful for making jewelry and working with beads. It's similar to a square knot, but it has an extra pass-through on the first half of the knot. This makes the cords less likely to slip, both while you are tying the knot and once the knot is complete.

Surgeon's knots are a good knot to use with elastic cord. The extra pass-through at the base will help to keep the knot in place while you are tying the second half of the knot. It also makes the knot less likely to untie. Depending on the beadwork stitch being used, a surgeon's knot may be used to join two ends of the beading thread together, such as when tying off the threads or adding a new thread. Using it in this way would depend on having enough room between the beads to add the knot.

Surgeon's knots work well with beading thread such as Nymo or FireLine. They can be used to add a thread to a component, as in brick-stitched bead-wheel earrings. A surgeon's knot can also be used on the thread end to make a bulkier knot that resists slipping through the beading foundation when doing bead embroidery.

Surgeon's knots are not decorative. It is best to use them when you can hide the knot inside of the beadwork or inside of a bead. The surgeon's knot is slightly larger than other knots used in beadwork, so be sure you can pull it inside the hole of the beads you are working with.

1 Answer 1

Well it's not really that hard:

Sure, this won't do much because the work performed by each thread is so small that the overhead to start the threads is actually higher, but whatever.

You should also learn to use the ExecutorService for higher efficiency. Pure threads are heavyweight and are rarely a good solution for anything, especially in groups. Here's an ExecutorService version of the above:

Here we are creating a pool of 10 threads and submitting 10 tasks. The threads are recycled betweeen task executions, so only 10 threads are ever created, no matter how many tasks you submit. Since the tasks are so small several tasks may even be executed on the same thread, but that's actually a good thing.

Stitches (Sutures, Wound Closures)

The ability to close a skin wound is an important surgical skill learned by medical care providers. Whether a fall in the street or a scalpel made the skin injury in an operating room, the decision as to how and when to repair the damage needs to be individualized for each patient and situation.

The skin has many layers from the epidermis on the outside, to the deeper subcutaneous tissues and the dermis in between. Each of these layers has other sub-layers that help the skin perform its functions. The skin provides a barrier to the outside world and the dangers of infection, environmental hazards and chemicals, and temperature. It contains melanocytes that can darken or tan the skin while protecting the body from ultraviolet radiation. It also plays an important role in temperature and fluid regulation.

Different options exist for repairing lacerated skin and providing a nice cosmetic outcome. There are two important steps that need to occur before the skin is closed.

  • Exploration: A doctor will need to examine and explore most wounds need to their full depth, looking for dirt and debris that may have entered, and making certain that the anatomic structures beneath the damaged skin are intact and not injured. For example, in a hand or finger laceration, the care provider will want to make certain that the blood vessels, nerves, and tendons beneath the skin have not been cut. This is done both by physical examination of the hand and finger, evaluating their power and motion, blood supply and nerve sensation, and also by looking inside the wound, identifying the tendon and perhaps the artery and nerve bundles to make certain that they are intact.
  • Cleaning: When the skin is broken, the outside world invades the body and may cause infection. Before closing the skin, a doctor must wash out or thoroughly irrigate a wound to prevent the occurrence of an infection. Sometimes, it's necessary to cut out a small amount of dirty tissue (a process called debridement).

The purpose of wound care is not simply to yield a good-looking scar. All wounds will eventually heal over time, although closing the skin edges will make that healing time shorter. The primary purpose of seeking medical care from a health care professional is to get the wound properly cleaned and make certain everything is in good working order beneath the damaged skin.

When a laceration occurs, there are some reasonable first aid and home care steps to consider. Washing with tap water to clean the wound is always helpful. Studies show that plain tap water is as good as any special fluids used in hospitals for cleaning wounds. Lightly bandage the wound and elevate it if possible.

The amount of blood supplied to different parts of the body varies. A wound on the face, scalp, or hand may bleed profusely while one on the shin or back may not. Bleeding will often stop with direct pressure at the bleeding site and elevation of the injured part of the body.

Caring for Stitches

Whenever the skin has been damaged, there is potential for infection. The wound and the stitches that hold it together may be cleansed gently with mild soap and water after 24 hours. Twice daily washing may decrease the risk of infection. Sometimes, your doctor may recommend the use of an antibiotic ointment like bacitracin or Neosporin to help minimize infection.

It is important to avoid getting the wound dirty or very wet. Briefly showering may be advisable, but swimming should be avoided until the stitches are removed. Kids should avoid playing in the mud, sand, or water. A bandage or other covering might be necessary if the wound rubs up against clothing or if it is draining fluid.

How does the health care professional assess a wound?

Lacerations are common injuries treated in physicians' offices, walk-in clinics, and emergency departments. The approach to the injury is often the same. The history taken by the health care provider is very important to decide whether the benefit of repairing the wound outweighs the potential risk of complications. Infection is the most common worrisome complication. The provider will want to know the circumstances of the injury.

  • Where did the accident occur? Was it washing dishes in the sink, or did it occur in a farm field, cleaning dirty equipment covered in mud?
  • When did it happen? The older the wound, the higher the potential for infection since there is more time for bacteria to invade the wound and begin the infection/inflammation process.
  • Was it due to a fall or other trauma? Is there damage to other parts of the body?
  • Were there unusual circumstances, like an animal bite, or did it occur underwater in a river or lake (both situations posing a high risk for infection)? One can imagine a variety of scenarios that may greatly increase the infection risk.

Physical examination is key to making certain that underlying structures are undamaged. This is especially important in the extremities where arteries, nerves, and tendons run beneath the skin. When there is damage to skin over a broken bone, it is called an open fracture, and often patients with such a fracture require surgery and are taken to the operating room so that the wound can be extensively cleaned to prevent osteomyelitis (an infection of the bone). This same situation may also occur if the laceration goes deep into a joint.

It may be necessary to take X-rays to look for foreign material that may be imbedded in the laceration. While metal objects are easier to see, it may also be possible to identify nonmetallic foreign objects.

A doctor has many options when it comes to repairing a wound: sutures, staples, glue, Steri-Strips, and Band-Aids. First, the wound needs to be prepared for sewing (or suturing or stitching the words all describe the same procedure).

  • Ideally, the injured area is exposed and cleaned with water, saline (salt water), and/or soap.
  • A health care provider administers a local anesthetic to allow full exploration of the wound, looking for foreign objects or damage to underlying structures. Minimizing the pain in the area allows for better exploration and visualization of the underlying anatomy.
  • A health care provider may wash or irrigate a wound a second time to try to minimize the risk of infection.


How do health care providers choose the type of closure material?

The purpose of repairing a wound is to provide good cosmetic results. All wounds will eventually heal by themselves however, bringing the edges together and without tension will allow for a better result. All lacerations will leave a scar, and a good wound closure will minimize the visibility of that scar.

Since there are many layers of skin, a doctor uses layers of suture to bring those layers together. A deep wound increases the risk of infection, and if only the skin is closed, empty spaces may exist beneath the outer skin layer. Fluid can accumulate within these empty spaces, and stagnant fluid can increase the risk for infection.

For skin sutures, the hope is to cause minimal inflammation so that the scar will form nicely. When a doctor places deep sutures, that suture material gradually disintegrates or dissolves as part of the inflammatory response of the body.

The strength of the suture depends upon the thickness of the suture material. Some suture materials used to repair nerves may be so thin that the surgeon needs a microscope to see the suture and be able to sew. Some suture material is as thick as string. The thinner the suture, the less tension it can tolerate and the more stitches need to be placed closer together, to keep the wound from breaking open as it heals.

Doctors use different types of needles depending upon the situation. The two major kinds are cutting and non-cutting. The cutting needles have a diamond-shaped tip designed to "cut" through skin. The non-cutting needle tips are circular and designed for use on deep tissues that do not have the resistance of skin. There are different shapes of the needle curve as well to help guide the needle and the attached suture on its path.

Almost all suture material is preloaded on a needle and does not need to be hand-threaded. The care provider will specify the type of suture, the thickness, and the type of needle when planning to repair a laceration.

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How do doctors close a wound?

Most frequently, the closure of choice for the skin layer repair is a single filament suture, meaning that it is not braided. This non-absorbable suture does not cause irritation and inflammation, minimizing scar formation. The two main choices are nylon and polypropylene (Prolene). Doctors may use staples when potential scarring isn't as important. They often use staples to close scalp wounds. Often surgeons who have made a long incision on the abdomen, back, or extremity use staples to close the skin.

If the laceration follows the crease lines of the body (lines of Langerhans) and is not under stress or stretch, Steri-Strips or butterfly Band-Aids may be considered. Dermabond or skin glue is another potential option for repairing the skin. For this option, the wound must be superficial and run along the crease lines, not be under stress or stretch, and not have blood or hair present at the wound site. If a doctor uses Steri-Strips or Dermabond, the principles of wound cleaning and exploration still are important considerations.

In some circumstances, doctors use very thin absorbable sutures to close the skin. A medical professional may use material made of polyglycolic acid (Dexon), polyglactic acid (Vicryl), poliglecaprone (Monocryl), or polydioxanone (PDS II) just beneath the epidermis (subcuticular area) to allow for good skin closure. The decision to use absorbable suture in the skin depends upon the situation and the skill and experience of the provider performing the repair.

How do doctors repair wounds to deep tissues?

If the laceration requires layered closures in which it will not be possible to remove the sutures, dissolvable suture material may be used. Polyglycolic, polyglactic acid, poliglecaprone, and polyglyconate (Maxon) may be considered. Other materials may include silk or catgut (chromic). Depending upon the type of material and the circumstances, absorbable suture may take from 3 weeks to 3 months to dissolve.

What actually happens when a medical professional places stitches?

Once a doctor decides to sew or stitch up a wound, a medical professional brings an instrument tray to the patient's side. The tray usually contains the following items:

  • A needle holder (to grasp the needle and suture material)
  • Forceps (medical tweezers) to help grasp the wound edges
  • Scissors to cut the suture.
  • A syringe with local anesthetic
  • Sponges
  • Cleansing liquids

The care provider will need to decide the type of suture or thread required, including whether it is absorbable or non-absorbable and its thickness. (The thicker the suture, the higher its tensile strength, and the stronger it is.) Another decision is the size and type of needle this also affects the size of needle holder required. Tinier needles need smaller instruments to guide them through tissue and skin.

The first step is to clean the wound and inject local anesthetic. Wound exploration and cleansing follows.

How a doctor closes an incision depends upon how the wound was made. A wound created due to a sharp scalpel in the operating room will need less planning for closure than one with a jagged wound edge because of a burst laceration from a fall.

The medical professional needs to bring the skin edges close together with minimal tension. The doctor grasps one side of the wound skin edge with the forceps and brings it near to the other edge. If possible, the doctor passes the needle through both skin edges and by pulling on the suture thread, brings the skin edges together. It is important that there is not too much pulling because the stitch can pull right through the skin.

The skin edges need to be everted, meaning that the undersides of the skin, the layer just below the epidermis, on each side of the laceration need to contact each other. When a health care provider ties and knots the stitch, the edges tend to relax, and the epidermis tends to lay flatter. Without eversion, the scar can cave in and potentially appear depressed.

It is important that a doctor ties the knot with the right amount of tension too loose and the wound edges separate, widening the scar, but too tight and the skin edges can strangulate and cause damage to the skin surface.

There are different types of stitches, depending upon the situation and the expertise of the care provider. Examples include the following:

  • Simple interrupted suture
  • Simple running or continuous suture
  • Purse-string suture
  • Horizontal mattress suture
  • Vertical mattress suture
  • Subcuticular running suture

Knot tying is very important. The stitch needs to be secure so that it does not unravel and fall out prematurely. The surgical knot really consists of multiple layered knots to prevent the suture from falling out. A doctor needs to tie a knot to make removal easy when the time comes. Tying the knot too tightly results in skin damage from the knot itself.

The equipment used in urgent care or the emergency department to stitch a wound is the same as that found in the operating room. Surgical sutures in the operating room are the same as those used as an outpatient. Those used inside the body for specific purposes may be of different sizes and made of different materials, depending on the tissue they are being used to repair, from arteries and nerves to muscles and bowel and everything in between.

While the surgical incision in the skin is all the patient and family can see, it is the surgical sutures located deep in the body that a doctor really needs to place precisely. Those stitches cannot fail to hold tissue together because a doctor cannot replace them without another surgical procedure.


When and how do medical professionals remove sutures?

The optimal time for suture removal depends upon both the location of the laceration and how much stress one places on the laceration. For example, a knee laceration will require the suture to remain in place longer than on the thigh, since the skin will be stressed each time the knee flexes and extends with walking, sitting, and standing.

Sutures form a loop that surrounds the laceration and when pulled tight cause the wound to close. The body can start to form a scar around the suture itself, and it is important to remember this when deciding the appropriate time to remove the sutures. This scarring tends to occur within 7 to 8 days and can have an appearance resembling crosshatching or railroad tracks.

Follow-up for suture removal on the face usually occurs within 3 to 5 days, since there is such good blood supply in this region and healing occurs more quickly. The goal is to minimize scarring therefore, the risk of the sutures causing a scar in their own right is balanced against the strength and potential weakness of the healing laceration. Elsewhere on the body, health care providers may leave sutures in for 7 to 10 days. In some circumstances, in which scarring is not an issue or if there is concern that wound is under mechanical stress (like a laceration over a joint), the sutures may be left in longer.

What happens to the site after suture removal?

After suture removal, the scar continues to mature over time. For the first 3 months, there will be a raised, red healing ridge at the laceration site. Over the next 2 to 3 months, the ridge will flatten and then will start to weather and lighten. It may take 6 to 8 months or longer before a patient can appreciate the result of the laceration repair.

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Are there any special considerations regarding wound repair?

People with diabetes or those with peripheral vascular disease may have delayed healing and increased risk of infection.

Animal bites are especially prone to infection, and the decision to repair a bite with sutures must balance the risk of infection with the benefit of a better-looking scar. Approximately 50% of dog bites, 80% of cat bites, and 100% of human bites will develop infections.

When the risk of infection is high, the health care provider may choose from different options to allow wound healing. When a health care provider cleanses and dresses a laceration but does not repair it, it will gradually heal on its own. This called healing by secondary intention. (Primary closure describes a wound that is sutured or stitched.)

Another alternative is delayed primary closure, in which a health care provider cleans and dresses a dirty or contaminated wound and then evaluates it in a few days (usually 2 or 3). If the wound is not infected, it might be possible to then suture it closed, as if it is a new injury.

The threads dissolve gradually over a 6- to 8-month period, but formation of new collagen occurs for the next 9 to 18 months. We often recommend a follow-up treatment a few weeks later which will extend the rejuvenation. While the Sugar Thread Lift produces immediate, natural results, it does not replace, or last as long, as a facelift surgery.

Polydioxonone is a complex sugar that naturally breaks down into carbon dioxide and water which are both are naturally excreted by the body with no adverse effects. Cardiologists have been using polydioxonone sutures in surgery for over 40 years.

Watch for Signs of Infection

Even as you continue to take care of your stitches, watch for any signs of infection. They include:

  • Increasing pain
  • Redness around the wound that gets worse, not better
  • A red streak from the wound traveling upward
  • Swelling
  • Pus or bleeding
  • A bad smell coming from the area

Call your doctor if you see signs of infection. You should get treatment as soon as possible.

How does gene therapy work?

Arthur Nienhuis, a hematologist at St. Jude Children's Research Hospital in Memphis, Tenn., and president of the American Society of Gene Therapy, responds:

Gene therapy is the addition of new genes to a patient's cells to replace missing or malfunctioning genes. Researchers typically do this using a virus to carry the genetic cargo into cells, because that&rsquos what viruses evolved to do with their own genetic material.

The treatment, which was first tested in humans in 1990, can be performed inside or outside of the body. When it&rsquos done inside the body, doctors may inject the virus carrying the gene in question directly into the part of the body that has defective cells. This is useful when only certain populations of cells need to be &ldquofixed.&rdquo For example, researchers are using it to try to treat Parkinson's disease, because only part of the brain must be targeted. This approach is also being used to treat eye diseases and hemophilia, an inherited disease that leads to a high risk for excess bleeding, even from minor cuts.

Early in-the-body gene therapies used a virus called adenovirus&mdashthe virus behind the common cold&mdashbut the agent can cause an immune response from the body, putting a patient at risk of further illness. Today, researchers use a virus called adeno-associated virus, which is not known to cause any disease in humans. In nature, this agent needs to hitch a ride with an adenovirus, because it lacks the genes required to spread itself on its own. To produce an adeno-associated virus that can carry a therapeutic gene and live on its own, researchers add innocuous DNA from adenovirus during preparation.

In-the-body gene therapies often take advantage of the natural tendency of viruses to infect certain organs. Adeno-associated virus, for example, goes straight for the liver when it is injected into the bloodstream. Because blood-clotting factors can be added to the blood in the liver, this virus is used in gene therapies to treat hemophilia.

In out-of-the-body gene therapy, researchers take blood or bone marrow from a patient and separate out immature cells. They then add a gene to those cells and inject them into the bloodstream of the patient the cells travel to the bone marrow, mature and multiply rapidly, eventually replacing all of the defective cells. Doctors are working on the ability to do out-of-the-body gene therapy to replace all of a patient's bone marrow or the entire blood system, as would be useful in sickle-cell anemia&mdashin which red blood cells are shaped like crescents, causing them to block the flow of blood.

Out-of-the-body gene therapy has already been used to treat severe combined immunodeficiency&mdashalso referred to as SCID or boy-in-the-bubble syndrome&mdashwhere patients are unable to fight infection and die in childhood. In this type of gene therapy, scientists use retroviruses, of which HIV is an example. These agents are extremely good at inserting their genes into the DNA of host cells. More than 30 patients have been treated for SCID, and more than 90 percent of those children have been cured of their disorder&mdashan improvement over the 50 percent chance of recovery offered by bone marrow transplants.

A risk involved with retroviruses is that they may stitch their gene anywhere into DNA, disrupting other genes and causing leukemia. Unfortunately, five of the 30 children treated for SCID have experienced this complication four of those five, however, have beaten the cancer. Researchers are now designing delivery systems that will carry a much lower risk of causing this condition.

Three “Why Major” Essay Examples

Why Electrical Engineering?

My decision to major in Electrical Engineering was inspired by my desire to improve security through technology. When I lived in Mexico, my father’s restaurant security system lacked the ability to protect our property from robbers, who would break in multiple times a year. Thanks to the influence of my cousin, who now studies Autonomous Systems, I developed an interest in electrical engineering. I am inspired to not only improve my father’s security system, but contributing to security innovations for larger companies and perhaps, one day, national security. (89 words)

Why Electrical Engineering?

Thesis: I want to improve security through technology

Robbers broke into dad’s restaurant

Cousin taught me about Autonomous Systems

In the future: work with large companies or on national security

Here’s a medium-length example with the thesis at the end:

Why Gender and Sexuality Studies?

My interest in Gender and Sexuality Studies was sparked in my eighth grade Civics class when we studied topics pertaining to sexual equality. I went into the class knowing I believed women had a right to make choices for their own bodies and that view remained the same, but I discovered the complexity of abortion debates. I challenged myself by thinking about the disparity between actual and potential personhood and the moral rights of unconscious lives. If pregnancy had the same consequences for men as it does women, how might the debate be different? Would this debate even exist?

A year later, I shadowed an OB/GYN at a nearby hospital. On my first shift, I watched an incarcerated woman receive a post-partum exam after giving birth in her cell toilet with just Advil, and the issues discussed in Civics suddenly became urgent and real.

My school projects have often focused on reproductive rights. I’ve spent numerous hours delving into summaries of Supreme Court cases on abortion and contraception, and am even known as the “Tampon Fairy” at school because I frequently restock the school bathrooms with tampons and condoms.

I’m interested in exploring how Gender and Sexuality Studies connect to Public Health and Reproductive Biology, as well as Public Policy and Law. The interdisciplinary nature of this major will allow me to investigate many other areas of study and create a more nuanced understanding of how this particular field interacts with our world and society. (246 words)

Why Gender and Sexuality Studies:

Eighth grade Civics class conversations

Shadowing OB/GYN at a nearby hospital and seeing woman receive post-partum exam

Being the school “tampon fairy” (restocking school bathrooms with tampons and condoms)

School projects on reproductive rights

Thesis: name my major and briefly say why

You can also use a hook to grab your reader’s attention. Here’s a medium-length example that does this:

Why Neuroscience?

Imagine all the stars in the universe. The brain has a thousand times the number of synapses, making neurological errors a near certainty. I learned this fact firsthand as a 14 year-old, when I suffered from sleepless nights because of an uncomfortable, indescribable feeling in my leg. It took months of appointments and tests to be told it was a condition called cortical dysplasia. Even after the diagnosis, there is no cure.

I am lucky. My condition does not severely affect my quality of life. However, I know this is not the case for everyone. After this experience, I took AP Biology and attended a neuroscience program, which reinforced the subject as my future calling. One of the most impactful lectures discussed the plight of healthcare in developing nations. Newborns with extreme neurological deficits are common, but finding treatments is not. Without prenatal care, this is becoming a growing epidemic, leaving millions of children helpless.

With a degree in neuroscience, I will gain a strong understanding of neural tube development and neuronal migration in infants. I will then become a neurologist, specializing in pediatric care. I hope to work for humanitarian organizations, such as Doctors Without Borders, in Africa, where HIV and polio are rampant, as are numerous other diseases.

Imagine the stars once more. From across the world, I will look at the same stars in the future, as I help children secure the ability to not only look at the stars, but do much more. (247 words)

Hook: Connect number of stars to number of connections in brain (and maybe mention cortical dysplasia)

AP Bio + neuroscience program: learning about healthcare in developing nations

Thesis: say why neuroscience (get specific) and what I’ll do with degree

Return to opening (stars) and look to future

Bird Adaptations

Did you ever wonder why there are so many types of bird beaks (scientists call them bills)? The most important function of a bird bill is feeding, and it is shaped according to what a bird eats. You can use the type of bill as one of the characteristics to identify birds. Here are some common bill shapes and the food they are especially adapted to eat:

Cracker Seed eaters like sparrows and cardinals have short, thick conical bills for cracking seed.
Shredder Birds of prey like hawks and owls have sharp, curved bills for tearing meat.
Chisel Woodpeckers have bills that are long and chisel-like for boring into wood to eat insects.
Probe Hummingbird bills are long and slender for probing flowers for nectar.
Strainer Some ducks have long, flat bills that strain small plants and animals from the water.
Spear Birds like herons and kingfishers have spear-like bills adapted for fishing.
Tweezer Insect eaters like warblers have thin, pointed bills.
Swiss Army Knife Crows have a multi-purpose bill that allows them to eat fruit, seeds, insects, fish, and other animals.

Another characteristic that can be used to learn more about birds is feet shapes! The shape of the feet reflects the habitat that the bird will be found in and the type of food it might eat. Here are some common feet shapes and the environment they are especially adapted to live in:

Ways to Avoid an Episiotomy

It’s a good idea to talk to your doctor about your feelings about an episiotomy. Include your thoughts, as well as your doctor’s thoughts in your birth plan.

There are times when an episiotomy is unavoidable. However, there are ways which can help prevent it. The following methods can be tried to deliver your baby easily and without having an episiotomy.

Perineal Massage

Massaging the perineal and vaginal area helps in stretching the tissues and aids in childbirth without episiotomy or tearing of the skin and muscles. Massage should be done for at least 5—10 minutes everyday beginning with week 34 until delivery. Lubricants like KY jelly, olive oil, vitamin E oil, almond oil or pure vegetable oil should be used for massage. Make sure your fingernails are trimmed and your hands are clean before doing the massage. Also, talk with your doctor before starting the massages, especially if you have a history of vaginal infections or are at risk for preterm birth.

To do perineal massage: apply a water soluble lubricant like vitamin E to the thumb or index finger, and insert the finger or thumb into the vagina about an inch. Slide the finger with pressure in a semicircular motion, starting at the side of the vagina and moving down toward the anus, and back up to the other side of the vagina. Do the massage for a 5 minutes every day. Clean off the excess oil when you finish so you won’t get it on your clothes. When you go into labor, tell your obstetrician that you have done perineal massage. There is no guarantee you won’t need an episiotomy, but by doing the massage you may reduce trauma to the perineum during delivery.

Do Kegel Exercises

Muscles of the perineum used doing Kegel Exercises

You were probably doing Kegels while you were pregnant and you should keep doing them after your baby is born. Pelvic muscles are just like any other muscle—exercise makes them stronger. Kegel exercises include tightening and relaxing of the pelvic muscles. Kegels can help strengthen the perineum muscles which support the organs in the pelvis (uterus, bowel, bladder).

First you have to figure out which muscles to exercise. To find these muscles, alternately start and stop urinating while using the toilet. However, when you do Kegel exercises, don’t do them while you’re urinating. Do Kegel exercises lying, sitting, standing, walking, and driving to make the pelvic muscles the strongest.

Kegel Exercise: Tighten the perineal muscles slowly a small amount at a time, like an elevator going up 10 floors. The release the muscles slowly—one “floor” at a time. Repeat. Start off with 5-10 times and then work up to 20-30 each time. Do the exercises 3 times a day—morning, afternoon and evening. Try to keep up a regular schedule each day such as after meals, in the shower, or just before bedtime.

Try not to squeeze your buttocks or abdomen while you tighten up as this puts pressure on the pelvic floor muscles. Keep the muscles of your abdomen, thighs and hips relaxed.

Think about your perineal muscles when you are lifting, sneezing, coughing or laughing and do Kegels then, too. After a while it will become a habit and you won’t have to think about it.

Correct Breathing and Pushing During Labor

Controlled breathing, along with proper pushing, helps you have a non-emergency vaginal delivery and avoid an episiotomy. Pushing only when you’re told to can give your perineum time to stretch and avoid tears.


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