During a single shift, a nurse midwife working in a health center in Blantyre, Malawi had six pregnant women referred from the antenatal care clinic to receive an obstetric scan. On days where a nurse midwife trained in ultrasound scanning (USS) is not on duty, pregnant women referred for scans are sent home. On this day, among the six women scanned, four had multiple gestation pregnancies. Without this scan, these women would have been diagnosed with twins right on the delivery bed. This would have put them at high risk for postpartum hemorrhage which is a major cause of maternal morbidity and mortality in Malawi. The nurse midwives working on this day appreciated both the importance of the availability of an ultrasound machine and also their knowledge and skill on how to use it.