It’s called a speculum. If you are a woman, you have probably seen this strange device before. It is used when gynecologists are to examine the abdomen of women. And if you have experienced it yourself, you know that it is both cold and perhaps painful. – The speculum that is used today was developed around 1850, and will look the same in 2022, says gynecologist Stine Andreasen at Nordlandssjukehuset. But it is much older than that. The oldest find of a speculum instrument was made during the excavations of the ruins of Pompeii, which were destroyed in the year 79, according to the book “A pictorial history of gynecology”. ROMAN EXAMPLE: Copy of a brass vaginal speculum. The original was found in Pompeii and is now in the Museo Nazionale in Naples. The speculum was inserted into the body, the handle was then rotated to widen the distance between the blades. This is a very early Roman example of the gynecological instrument, according to the website of the Science Museum Group. Photo: Jaron Chubb / Science Museum Group Collection Stine Andreasen and midwife colleague Hege Hanssen created a new instrument that they believe will make the experience more pleasant. Looked old-fashioned On a night shift at Nordlandssjukehuset, the gynecologist and the midwife started talking about the equipment they use for births and examinations of women. They thought it looked old-fashioned. In addition, they knew that many people find the instrument unpleasant. Gynecologist Stine Andreasen says that they are now in the process of making a prototype and testing it out. The hope is that they will have the speculum and simulator ready by the latter half of 2023. Photo: Induvita AS – It has a good function in its use, but little has been done to optimize it both for the user and the patient. Therefore, the two colleagues have now constructed a new type of speculum. They have thin, elastic side walls and are made of plastic instead of metal. Then it will also be completely silent. – When we worked on this, we found out that there is a lot that is not good in maternity care. We are at a standstill and there is little innovation. Midwife Hege Hanssen says that they have used the combination of their experiences to develop the new instruments. This is to optimize the equipment for both births and gynecological examinations. Photo: Induvita AS – Why has nothing new been developed in this field until now? – There is probably very little interest in women’s health. And most innovators are men. It is probably not the first time someone has jumped at developing something that is so focused on women. In addition, she believes that there has been little money in the medical industry for women’s health. Therefore, she thinks many people think that there is little profit in developing this. An important development Hanne Charlotte Schjelderup, leader of the Midwives’ Association, says the speculum has been an important instrument that has saved lives. Therefore, she believes that it is important for both women’s health, the profession and the professional field that there is now innovation in the profession. – We get better methods and equipment that make it more comfortable during examinations for the patients, says Schjelderup. Hanne Charlotte Schjelderup, leader of the Midwives’ Association, also believes that, among other things, the simulation doll will be useful: – But such a doll does not have the human factors. It provides good training and becomes an important supplement, but it is not entirely realistic. We need both. Photo: private The head of the Midwives’ Association says that development is slower in women’s health than those in the field would like. – But it is positive that we have progress and good development. It is essential in women’s health. Kirsten Hald, senior physician at the gynecology department at Oslo University Hospital, believes this will be an innovation that will be well received by gynecologists. Kirsten Hald, senior physician at the gynecology department at Oslo University Hospital, says the gynecologists are careful to talk about the equipment they use in examinations in order to keep the patients safe. Photo: Ola Vatn / news – It will help us to do our work in an efficient and good way. It is important in our work that it is as pleasant as possible for the patient. The head doctor says that they talk a lot about the instruments they use with the patients. For example, tongs, which are used to release children, can seem frightening to some. – We are quite observant about it. The job is also about being considerate. Instrument developed for men Andreasen and Hanssen at Nordlandssjukehuset have now received the innovation award from Helse Nord. It’s not just for the speculum, but also for two other innovations: A catheter adapted to women A simulator for abdominal examinations One in three births is started today. In order to start the birth in a natural way, people today use a kind of balloon that they fill with salt water in the womb. The woman must join this for about a day. But the “balloon” one uses is actually a urinary catheter. And the catheter was not developed for women either. It is developed for men. – It is designed to empty a male bladder. The male catheter is designed to hold between 10 and 20 ml of fluid. The balloon they will fill in the uterus of the woman giving birth must be filled with 80 ml of liquid. This equipment is used in gynecological examinations. Much of it has not been developed in almost 200 years. Photo: Stine Andreasen / Induvita AS – Many times the catheter cracks. It is not designed for either the volume or the pressure, says Andreasen. And if he doesn’t crack, fluid often leaks out. Then today the solution is to tape a part of a plastic glove and then tape the glove piece to the woman’s thigh. Andreasen and Hansen think the equipment does not work well enough, and is not worthy. The catheter that is used today to initiate natural births is actually designed to empty a male urinary bladder. This is an illustration of the female catheter that Andreasen and Hanssen have designed. Photo: Induvita AS / Illustration – The first thing we worked on was making a catheter that was big enough. We have also designed it so that it can be inside the patient during treatment. In addition, they have created a model so that midwives and gynecologists can practice at different stages of childbirth. – Then the patient may be exposed to fewer examinations. It is not particularly pleasant to be examined, says Andreasen. Women’s health But why has there actually been so little research into women’s health? – It’s about who has the power to define, says Karin Hovde, who is deputy head and senior adviser at the Equality Center KUN. – We know that there is less research into women’s health, and that the male body has been the standard. Leganes have traditionally been men. Now that there are more female doctors, it may help to change that image, Hovde believes in KUN. Photo: private Nevertheless, she does not want to agree that women have not been inventors historically. – Women have invented things in their sphere, but men have taken credit for female inventions because it is not appropriate for women to do such things. She also points out that these instruments have traditionally been associated with shame. – And if one has seen the need. If no one has protested and it has worked, it has not been completely wrong, even if it could have been more pleasant. – Those who have been patients have not had the power to change that either. The Norwegian Women’s Sanitary Association has long been concerned with promoting women’s health. Marit Stene Severinsen, midwife and project manager at the Norwegian Women’s Sanitation Association, says it is important to have information when you are pregnant. – No question is too stupid before or after you have given birth to a child. Photo: Bård Nafstad / news Marit Stene Severinsen, midwife and project manager at the Norwegian Women’s Sanitation Association, says the aids that can get more focus on women’s health are important. – What is important and wonderful is that innovations are created for the good of women’s health, she says. – It’s great that health personnel take it a little and find out what they can improve on, it’s great. But it is important that it is part of the public health offer at the hospital.
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Gynecologist and midwife have developed a new speculum and catheter – equipment not developed since Roman times – news Nordland
