I'm not sure if they always have a pinard. First time I declined the doppler was 2 days before my scan so I said I'd wait till then for a heartbeat and they left it. Next time the midwife said "Oh, so you want to use the pinard?" and got it off the shelf. I hadn't really considered the pinard- I just didn't want the doppler So from now on when I say no to the doppler I point to the pinard and say I use that but I don't think many of the midwives have even used it before.