Keeping It Clean

Like other midwives, I like some things to be clean, really, really clean. And some things, like hypodermic needles, sutures and surgical instruments, need to be sterile.

Like other midwives, I like to reduce, reduce and recycle. Currently, some sterile items, like needles and sutures, are not considered reusable. These I purchase in sterile condition and discard after one use. Others, like medical instruments can be reused and need to be sterilized after every use.

One of the best ways to sterilize is with steam under pressure. A pressurized, steam filled environment of 250 degrees for 30 minutes (less time if more pressure) will kill most anything. Hospital and many offices use autoclaves for this propose. Others use a pressure cooker. Both systems work. For my first five years in practice, I used a pressure cooker, a very large pressure cooker, to sterilize my medical instruments. Now, thanks to a good friend and colleague, I now use an autoclave.

Newborn babies have umbilical cords. The umbilical cord is a literal lifeline for the fetus. After birth, the umbilical cord is generally severed from the placenta shortly after birth. If that cord is to be cut, sterile scissors should be used. A pressure cooker is how I sterile my scissors used for this precious purpose.

So, for those that are interested, here is how I clean and sterilize my reusable, medical instruments.

First, the instruments all get a good, thorough cleaning with soapy ware and firm, bristled brush for cleaning crevices.

Next, they are all rinsed with copious amounts of clean water.

Then the instruments are lubed. Really.
I spray instrument lube into hinges, teeth and blades.

Instruments are then sorted into sets, wrapped and taped. For example, a birth set have two clamps, one set of scissors (and a small ring forcep). The tape is a special heat sensitive tape. (See below)

Next, the packages go into the pressure cooker, or autoclave.*(NOTE 2019. I now able able to also use an InstaPot with Sterilizing cycle. Not all InstaPots have this function.) The operating directions for use and time are followed and….