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The "husband's knot" or "husband's stitch" is supposedly a medical procedure that involves adding an extra suture when performing an episiotomy in order to make a woman's vagina tighter, resulting more pleasurable sexual intercourse for her husband at her expense.

Numerous discussion boards mention anecdotes of this happening, such as this Yahoo Answer, this Mothering thread, and this book describes the procedure. A Psychology Today article repeats the anecdote but claims it is no longer common practice.

There seems to be a common perception that this was or is common practice. Did doctors ever perform this surgery? Do they still today? How prevalent was/is it?

William Grobman
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  • The husband stitch isn't only about the male's pleasure. My SO had the procedure done and it improved things considerably for her, too. Saying this is only about the husband _at the female's expense_ is misleading. – T. Sar Apr 24 '17 at 18:55

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According to an article by doctors Julie M.L.C.L. Dobbeleir, Koenraad Van Landuyt, and Stan J. Monstrey, titled Aesthetic Surgery of the Female Genitalia, and published in the journal, Seminars in Plastic Surgery (May 2011):

Vaginal tightening surgery has been around since the mid fifties, where gynecologists used to tighten the entrance of a woman's vagina with an extra stitch while repairing vaginal and perineum tears or episiotomies after giving birth. At that time it was notoriously known as the “husband's stitch,” the “husband's knot,” or the “vaginal tuck,” and doctors discreetly referred to this procedure as “improving a woman's well-being.”

The goal of these procedures is to reconstruct (or to narrow) the lower third of the vagina, which includes “the orgasmic platform, internal and external vaginal diameter (introitus) and the perineal body.” The procedure enhances vaginal muscle tone strength and control, and decreases internal and external vaginal diameters. Women choosing to have their vaginas tightened are generally healthy women without true functional disorders. In vaginal tightening procedures, portions of mucosa are excised from the vaginal fornices (via scalpel, needle electrode, or laser) to surgically “tighten” the lower third of the vagina.

The article cites "Green F. From clitoridectomies to ‘designer vaginas’: The medical construction of heteronormative female bodies and sexuality through female genital cutting. Sexualities Evolution and Gender. 2005;7(2):153–187" as a reference.

A 2004 (and 2011 edition of a) book titled, Pregnancy Sucks: What to do when your miracle makes you miserable, by Joanne Kimes and Leslie Young MD, notes:

I do have a secret to let you in on. Some doctors suture your abdominal muscles together again after delivery if you need a C-section. I've also heard that doctors can add an extra stitch if you tear during delivery to tighten yo your vagina (known as a "husband stitch"!). I guess having a baby is as good an excuse as any to have a little work done.

The use of episiotomy during childbirth appears to still be prevalent which could indicate that husband stitches might also still be around. A "birth log" from the '90s (via Snopes) suggests that the practice was perhaps—based on the tone of the article—routinely in use then. Furthermore, the fact that techniques such as vaginal rejuvenation (example) and other solutions such as "vaginal tightening creams" (an astroturfing example) exist, suggest that a corresponding market also exists.

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    +1 This is a fantastic answer. But do you know if any evidence of its effect on female sexual pleasure exists? A component of this claim is often that it's done at the woman's expense. – William Grobman Feb 18 '13 at 18:09
  • @WilliamGrobman Some articles (e.g., the "birth log" from my answer) suggest that the result can be painful presumably when not done right. But the seemingly legitimate "rejuvenation treatments" (such as [this one](http://www.drkarenboyle.com/vaginal_rejuvenation_vaginoplasty.html)) note that "By tightening both the external and internal vaginal diameter, vaginoplasty strengthens the perineal body which enhances female sexual gratification and pleasure". Similar claims can also be seen with "tightening creams". I guess that women aren't going to pay for something that's going to be painful. –  Feb 18 '13 at 18:21
  • I've accepted your answer. If you'd please edit in the info from your comment (maybe fleshed out a bit) the answer would be perfect. – William Grobman Feb 18 '13 at 18:45
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    “I guess that women aren't going to pay for something that's going to be painful.” – uh. Waxing? And in fact all of vaginoplasty. Many of these procedures are purely aesthetic, without any intrinsic benefit for the woman (other than improved mental well-being), and are definitely painful. Note that I’m not passing judgement. – Konrad Rudolph Mar 07 '13 at 11:36
  • @KonradRudolph To clarify, I wasn't referring to pain _during_ the procedure, but _after_ it. IOW, women aren't going to pay for a procedure that will make it painful to have sex. –  Mar 07 '13 at 11:59
  • @coleopterist My answer is still: waxing, and most other aesthetic procedures involving the genital area. Waxing for instance can lead to lasting skin irritation, inflammation etc. Yet that doesn’t deter many women. – Konrad Rudolph Mar 07 '13 at 12:37
  • @KonradRudolph Painful and pleasurable aren't opposite to each other. Several activities can be both at the same time, and sometimes the pain is even sought after. – T. Sar Apr 24 '17 at 19:00
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    @TSar Possible, but I was specifically attacking the argument that women wouldn’t do something if it were painful (meaning, in context: unpleasant) for them. And that’s clearly false, as my example shows. Even if individual women derive pleasure from pulling their pubic hair out, the accompanying negative side-effects will hardly be desired. Many women do it anyway, because there are other benefits that outweigh displeasure. – Konrad Rudolph Apr 24 '17 at 19:09
  • @KonradRudolph There is a difference between painful and unpleasant. Most of the things that give some sort of discomfort for sometime, like the mentioned surgical procedure or waxing, are _painful_ but end up being _pleasant_, even if just after some time has passed. If something is just plainly unpleasant - like bonking your head somewhere - I doubt any people would pay for that unless they derive some pleasure out of it (which kills the unpleasant argument for starters) – T. Sar Apr 24 '17 at 19:16
  • @TSar I thought I had just acknowledged that difference, and noted that it's irrelevant for the argument. Just replace "painful" with "unpleasant" in my initial comments if you're getting hung up on the word. – Konrad Rudolph Apr 24 '17 at 19:18
  • @KonradRudolph Then your initial argument stop making sense. Waxing _is pleasant_ for a lot of ladies because it gives then _nice feelings_ and _confidence_, at the cost of some discomfort for some time. Same goes for most of vaginoplasty. Doing something that is just _unpleasant_ (aka without net benefits) isn't something people do. Even smoking has some upside to it (feeling good, for example). – T. Sar Apr 24 '17 at 19:20
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    @TSar If you look again you'll notice that I mentioned decidedly unpleasant side effects of waxing. The fact that women still do it for the reasons you mention is, in fact, the crux of my argument. – Konrad Rudolph Apr 24 '17 at 19:29