Before preparing the woman to put in stitches the caregiver will need to inspect the vaginal area to see if they will be required. This can be a little uncomfortable, as the area is usually very tender and quite sensitive for the woman.
The woman may wish to participate in this by using a mirror with the caregiver. The caregiver will usually use a sterile gauze pad to soak up any blood in the area and a strong examination light or a torch to help make any tears easier to see. They will probably use their other hand to part the woman's labia and to help see inside the vagina. This procedure may be done soon after the placenta is born, or in some cases while the caregiver is waiting for the placenta to come. If the suturing is being delayed it can be done when the woman is 'ready'.
Positioning the woman
The woman will need to lie in a position that will help the caregiver put in the stitches easily. If the tear is small and it is decided that only one or two stitches are needed, then it may be done with the woman lying on the bed with her knees bent and her feet on the bed. Her caregiver will usually stand at her side to put the stitches in (although this can hurt the caregiver's back if this position is prolonged).
If the suturing is more involved, then the woman will need to have her bottom sitting just over the edge of the bed (similar to when a pap test is done) and her legs supported. In most delivery suites this will entail using stirrups or dropping the end of the bed down a level to support the feet. If the birth occurred at home or in a birth centre, the woman may lie on the lounge or end of the bed and support her feet on 2 chairs or the arm rests of the caregiver's chair.
This position allows the caregiver to sit in a comfortable position directly in front of the woman (usually seated themselves), allows the woman to rest her legs apart and relax her bottom (and therefore relax her vagina), making putting in the stitches easier.