Basic Midwifery Equipment Every Nurse Should Know

Are you a midwife or aspiring midwife looking to improve your knowledge of essential equipment? Delivering babies is a fantastic experience, and having the right tools is critical.

In this blog post, we’ll examine the must-have equipment for midwives, from monitoring their tiniest patients to caring for precious newborns.

Foetal Monitoring

During pregnancy, keeping a close eye on the little one is essential. Foetal monitoring allows midwives to listen to the baby’s heartbeat, a vital sign that provides valuable information about their well-being. It’s like listening to a tiny drumbeat, a reassuring rhythm that signals all is well.

Peanut Stethoscope (Fetoscope)

The most common tool for foetal monitoring is the peanut stethoscope, also known as a foetal scope. This lightweight, portable stethoscope is designed to comfortably fit around the mother’s belly, allowing the midwife to listen directly to the baby’s heartbeat. However, depending on the situation, midwives may have other tools in their arsenal. 

Regardless of the specific method, foetal monitoring is crucial in prenatal care. Some options include:

• Doppler ultrasound: This handheld device uses sound waves to detect the baby’s heartbeat. It’s often used during prenatal checkups to assess the baby’s heart rate quickly.
• Electronic foetal monitor (EFM): This device uses straps placed on the mother’s belly to monitor the baby’s heart rate and contractions during labour. While not routinely used in all pregnancies, an EFM can provide more detailed information about the baby’s well-being during childbirth.

Vaginal Visualisation

During pregnancy and childbirth, a midwife sometimes needs a clearer view of what’s happening inside the vagina. This is where vaginal visualisation comes in. Midwives can assess the mother’s health, monitor labour progress, and ensure safe delivery. 

Here are some tools: 

Vaginal Speculum

A vaginal speculum is a medical instrument designed to widen the vaginal walls gently. It resembles a beak-shaped device with two hinged blades.  When inserted and opened, it provides a clear view of the cervix, the opening to the uterus. 

This improved visualisation allows midwives to perform essential examinations and procedures during pregnancy and childbirth.

Sims Speculum

This single-handed instrument is frequently used for routine examinations, such as Pap smears. It offers a good view but requires the midwife to hold it.

Cusco’s Speculum

This self-retaining speculum is a game-changer! With wider blades that stay open independently, it provides a more comprehensive view. Midwives often use this during labour to assess how dilated and effaced (thinned) the cervix is and to check the baby’s head position.

Overlock Speculum

Like Cusco’s speculum, this self-retaining option offers good visualisation and is sometimes used for procedures like episiotomy (a surgical incision in the perineum during childbirth).

Delivery Instruments

The miracle of childbirth often requires a helping hand, and midwives have a specialised toolkit to ensure a safe and smooth delivery for both mother and baby. Here are some key delivery instruments used by midwives.

Episiotomy Scissors

Sometimes, during childbirth, the perineum (the area between the vagina and anus) may not stretch enough for the baby’s head to pass through comfortably. In such cases, midwives might use episiotomy scissors to make a small, controlled incision in the perineum. This can help prevent tearing and make delivery easier.

Sutures

The birthing process can sometimes involve minor tears or surgical incisions. Thankfully, midwives have a trusty tool in their kit to promote healing and minimise discomfort: Sutures, often called stitches, threads close wounds and encourage tissues to knit back together.

Different types of sutures are used in midwifery, each with its own advantages. The choice of suture material also depends on the location and nature of the wound. For instance, stronger sutures might be used for an episiotomy incision, while finer sutures might be used for delicate repairs:

• Absorbable sutures dissolve naturally over time, eliminating the need for removal in a follow-up appointment. They are a common choice for internal stitches or areas where traditional suture removal might be uncomfortable.
• Non-absorbable sutures: These sutures require removal by a healthcare professional after the wound has healed. They are typically used for external wounds where strength and support are crucial during healing.

Needle Holder

A midwife ensures a safe and smooth birthing experience for both mother and baby during delivery. While episiotomy scissors or a uterine sound might grab more attention, the needle holder is another essential tool that plays a crucial behind-the-scenes role.

A needle holder is a tiny pair of tongs designed explicitly for handling sutures. The midwife can precisely grasp, manipulate, and guide the needle during stitching procedures. This is especially important for suturing delicate areas like the perineum (the area between the vagina and anus) following an episiotomy or minor tears that might occur during delivery.

Uterine Assessment

After childbirth, the focus shifts towards the mother’s recovery, and the uterus plays a starring role in this process. The uterus, which housed the baby during pregnancy, must shrink back to its pre-pregnancy size. Here’s where uterine assessment allows midwives to monitor this crucial process.

Uterine Sound 

This is a vital tool for uterine assessment. It is a long, slender, and flexible instrument that resembles a ruler. The midwife gently inserts the uterine sound into the vagina and measures the distance from the cervix (the opening of the uterus) to the top of the uterus. This measurement helps track how quickly the uterus is shrinking, also known as involution.

Regular uterine assessment with the sound helps midwives in several ways:

• Monitoring Involution: A rapidly shrinking uterus is a sign of healthy postpartum recovery. By tracking the uterine size with the sound over time, midwives can ensure the involution process is progressing as expected.
• Identifying Potential Complications: In some cases, the uterus might not involute properly, leading to a condition called postpartum haemorrhage (excessive bleeding). Regular uterine assessments with sound can help identify potential problems early on, allowing for prompt intervention if necessary.
• Promoting Uterine Tone: During the examination, the midwife can also assess the firmness of the uterus. A firm uterus indicates good muscle tone, essential for controlling bleeding and promoting involution.

Newborn Care

The arrival of a newborn marks a joyous occasion, and midwives play a crucial role in ensuring their first moments outside the womb are comfortable and healthy. Let’s examine some essential tools used by midwives specifically for newborn care:

Umbilical Scissors

One of the most symbolic moments after childbirth is the severing of the umbilical cord, the lifeline that connects mother and baby throughout pregnancy. This task falls to a specialised tool in the midwife’s kit: the umbilical scissors.

Unlike regular scissors, umbilical scissors are explicitly designed for this delicate job. Here’s what makes them unique:

• Sharp but Safe Blades: These scissors feature short, blunt-tipped, incredibly sharp blades. This sharpness ensures a clean and precise cut of the umbilical cord, minimising bleeding and discomfort for the baby. The blunt tips, however, prevent accidental injury to the baby or mother.
• Sturdy Construction: Umbilical scissors are typically made from high-quality stainless steel, making them durable and corrosion-resistant. This ensures they remain sterile and functional for multiple deliveries.
• Lightweight and Easy to Handle: The umbilical scissors’ compact size and lightweight design allow for comfortable handling during cord-cutting, which is crucial for ensuring a clean and controlled cut.

The Cord Clamp

The umbilical cord is crucial in connecting a mother and a baby. After delivery, it’s time to sever this cord, and a seemingly simple tool is used: the cord clamp. While it might not be as flashy as some other instruments, the cord clamp is vital for a safe and smooth delivery.

Here’s why this unassuming clamp is so important:

• Preventing Blood Loss: Immediately after birth, the umbilical cord still contains blood. The cord clamp quickly and effectively stops blood flow from the cord after it’s cut. This minimises blood loss for both mother and baby, ensuring a safe delivery process.
• Facilitating a Clean Cut: The cord clamp is typically applied in two places on the umbilical cord, with a designated spot for cutting in between. This allows for a clean and controlled cut with the umbilical scissors, minimising the risk of tearing or uneven separation.
• Promoting Safe Handling: The cord clamp provides a secure hold on the umbilical cord, preventing accidental snags or manipulation during delivery and immediate newborn care. This is crucial for the baby’s safety and well-being.

Bulb Aspirator 

The arrival of a newborn is a momentous occasion, but those precious first moments can be congested for the little one. Thankfully, midwives have a tool that helps. 

The bulb aspirator is a simple yet effective tool crucial in clearing mucus from a baby’s nose and mouth, making it easier for them to breathe and take those critical first breaths.

Here’s why the bulb aspirator is such a valuable tool for newborn care:

• Gentle Suction: Unlike harsher suction devices, the bulb aspirator relies on manual pressure to create gentle suction. This is crucial for a newborn’s delicate airways, preventing irritation or discomfort.
• Easy to Use: The bulb aspirator is incredibly user-friendly. The midwife squeezes the bulb to create suction, then inserts the soft, rounded tip into the baby’s nostril (one at a time) and releases the bulb. This gentle suction helps remove any mucus that might obstruct the baby’s airway.
• Portable and Convenient: The bulb aspirator is small, lightweight, and portable. This makes it ideal for use in the delivery room, nursery, or even at home during those first few days with the newborn.

The Mucus Extractor 

While the bulb aspirator is a trusty tool for clearing mucus in newborns, there are situations where a more robust approach might be necessary. This is where the mucus extractor comes in. It’s a specialised device that provides the additional suction power to remove stubborn mucus that might be deeper in the baby’s airway, ensuring a clear passage for breathing.

Here’s how the mucus extractor differs from the bulb aspirator:

• Increased Suction Power: Unlike the gentle suction of the bulb aspirator, the mucus extractor offers a more powerful suction. This allows it to remove thicker mucus or mucus that might be lodged more profoundly in the baby’s airway, which the bulb aspirator might not reach effectively.
• Electric or Manual Options: Mucus extractors come in electric and manual versions. Electric models offer consistent suction power, while manual versions require squeezing a bulb to create suction. The choice typically depends on the specific needs of the baby and the midwife’s preference.
• Specialised Tips: Mucus extractors often come with various-sized tips designed for safe and effective use in a newborn’s delicate nostrils. These tips are softer and more flexible than the bulb aspirator tip, further minimising discomfort for the baby.

When is a Mucus Extractor Used?

While the bulb aspirator is usually the first line of defence for clearing mucus, a mucus extractor might be necessary for specific situations, such as:

• Congestion after delivery: Sometimes, a newborn might be born with a significant amount of mucus in their airway, making breathing difficult. The mucus extractor can help clear this congestion and ensure smooth breathing.
• Meconium aspiration: Meconium is the baby’s first stool, which can sometimes be inhaled during delivery. The mucus extractor can be used to remove any meconium that might be obstructing the airway.
• Premature babies: Premature babies often have weaker respiratory systems and might require additional support to clear mucus effectively. The mucus extractor can be a helpful tool in such situations.

Final Thoughts

The Midwifery field is filled with compassion, care, and a dedication to ushering new life into the world. However, exceptional care relies not just on skill but also on the right equipment. From monitoring the tiny heartbeat with a stethoscope to ensuring a safe delivery with episiotomy scissors, these instruments empower midwives to provide comprehensive care for mothers and their precious newborns.