Today's post is chock-full of goodness on one midwifery topic: pinards in emergencies!
You know those moments in life when you find you’ve forgotten something critical? Passport. Housekeys. Drove to the vet and took all the correct paperwork and your purse only to find on arrival you haven't actually put the dog in the car 😛
There’s that sinking feeling and then maybe you laugh a bit as you start to put together a plan to correct the mistake.
But imagine you do that as a midwife and suddenly there are two people’s lives on the line.
Midwifery is full of safeguards and checks and it’s crucial to be diligent and careful. But mistakes can happen.
That’s why I wanted to publish this anonymous write in from a midwife who found themselves in a very sticky position (read on).
In those moments of hellish limbo, you need to keep your head and find a safe solution. The worst thing you can do is panic.
This midwife found their way through using an ancient practice that's underrated in the UK.
Of course, I’m talking about being able to auscultate a fetal heart using a pinard!
If you don’t know what pinards are, they’re a type of stethoscope used to listen to the fetal heart. They're low-tech and old-fashioned, a bit like a horn crossed with an egg cup, see here:
(loving the hat!)
It takes time to learn how to use a pinard. Electronic sonicaids, like the one below, pick up the fetal heart much easier and the sound is amplified.
But once you have the skill, pinards are more reliable and accurate. Not to mention more satisfying.
You can hear different tones and it’s easier to distinguish between a fetal heart and maternal blood vessels. You don’t need batteries (a crucial consideration in some parts of the world).
And because you have to be skilled in placing a pinard to pick up a fetal heart, you can also confirm your palpation and work out the position of the baby.
They’re so important that I wanted them to be a motif in my novel. Chloe the student midwife inherits a pinard from her Mum and is determined to use it at every opportunity.
This is the midwife’s email…
‘So I have a midwife birth story for you all.
In the early hours of this morning I was called to attend one of my ladies who had gone into labour. I set out on the 45 minute journey from my house to hers.
On my arrival I took one look at her and could see she was in established labour. So I began to get my birth kit sorted. I opened my kit bag to realise to my horror that I didn’t have my sonic aid or pinards.
At that moment I had realised I had left them by accident at one of our MLUs the day before when doing an antenatal check. This birth centre was approx 1.5hr drive from her home. I must of completely forgotten to pick them up when I left the unit.
I wanted the ground to open up and swallow me up. She was having good FM and I could clearly see these as she was naked and dancing through her labour in a very mammalian way.
So I called a colleague to come and bring me some kit, however she was an hour’s drive away herself so I had to improvise in the mean time, as I could see the labour was advancing quite quickly for a first time Mum.
I asked for a toilet roll tube. Luckily they had one! I used it just like a pinard and it worked wonders! It also gave her birth partners a good laugh but I definitely could hear a good fetal heart.
My lovely colleague arrived an hour later with a pinards and sonicaid.
I used it just like a pinard and it worked wonders! It also gave her birth partners a good laugh but I definitely could hear a good fetal heart.
The labour and birth progressed without any intervention or vaginal examinations to a home waterbirth and a physiological 3rd stage with an intact cord until after placenta birthed. Intact perineum.
So if any of you homebirth midwives do find yourself without something to listen to an FH with, then use a loo roll tube - works wonders!’
The key thing to note about this story is the midwife in question has to be skilled with a pinard to be able to find a substitute.
I’ve heard really experienced midwives can sometimes find and listen to a baby’s heartbeat just using their ear to a woman’s abdomen! Amazing!
I know how difficult it is to find the time to learn how to use a pinard, as sonicaids are quicker. But be brave and start asking women and mentors.
There are some brilliant learning resources on how to use a pinard over on Sara Wickham’s blog:
You never know how useful this skill could be one day. And during the zombie apocalypse, or maybe just if you forget your bag, don't forget the toilet roll trick.
Have you ever been in this position? Or have you used anything else as a pinard? I've heard of wine glasses but would love to know your story, leave a comment 🙂
Please do share this post with anyone who might find it useful as well.
Much Love, Ellie x
P.S. Goes without saying but please don't use a pinard or homemade pinard as reassurance that your baby's okay. Even if you have midwifery training, it's important to get medical advice if you're worried about movements or anything else.