By: 20 April 2023
Midwife in focus with Malene Hegenberger

Malene is a practising midwife from Denmark who has spent the last five of her 20 year career, developing a new tool to help midwives and clinicians with the task of identifying and repairing perineal tears following childbirth.   

The Hegenberger Retractor has been designed by Malene to overcome the challenges presented to both clinician and patient during the routine procedure of postpartum suturing, by helping visualise the tear or injury and simplify/optimise the procedure and patient comfort during the repair.

As well as being part of the team at Hegenberger Medical, and writing and presenting training courses on suturing and the use of the Hegenberger Retractor, Malene is still actively practising Midwifery 2 days a week at the Slagelse Labor and delivery ward  in Denmark.

 

Obs: What drove you to choose your career as a midwife?

MH: When I was 16 years old I had a summer job cleaning and tidying in my local hospital’s labour ward.  I was immediately inspired by not only the midwives supporting the women through childbirth but also the whole experience of seeing women coming into the hospital in labour and feeling anxious, but then seeing their joy of leaving with a new baby, and the start of a new life.  I was drawn to the environment and vowed to train to be a midwife which I did.  Once I had completed my schooling I studied as a general nurse for 4 years in Denmark and then went on to do two years training as a Midwife in Norway. 

I am still in contact today with two of the lovely Midwives I first met when I was 16.  In fact they came along and supported me just recently when I did a talk at a gallery in celebration of International Women’s Day!

 

Obs: What’s the best part of your job?

MH:  I get the most pleasure when women have a really good experience of birth.  When they feel heard and know they’ve been treated well and ultimately leave feeling very happy with the experience they have had, as well as the joy of  having their new baby.  

I also really enjoy the diversity of the women I meet.  Their different stories and different coping mechanisms.  It’s always very satisfying to be able to adapt to each woman individually to ensure the best possible outcome and experience of labour and giving birth. 

It is always an honour to have a brief glimpse into people’s lives and family at such an intimate and life-changing time. 

 

Obs: … and the worst?

MH:   Oh that has to be when things don’t progress as it should and / or when a woman, who is in a potentially difficult birth situation resists complying with what you believe is ultimately the best course of action for the safety of both the mother and child.  It doesn’t happen very often but can be very uncomfortable when it does.      

It’s also difficult when you know patients have a difficult or challenging history, either medically or emotionally and sometimes you can feel overwhelming pressure to make things as good as it can possibly be, even when you know it will be a challenge. It’s never easy to watch someone going through a hard time.  

 

Obs: What has been the highlight of your career so far?

MH:  The last few years since launching The Hegenberger Retractor have been beyond exciting.  I have been travelling to lots of different countries and just getting out and meeting other clinicians who are as motivated and excited about making a difference to women’s health is so inspiring and rewarding.

 

Obs: Tell us more about how you developed your new device, the Hegenberger Retractor and how it can help with a positive birthing experience

MH:  I knew I wanted to do something after a particularly difficult experience following delivery with one woman.  She had a straightforward tear but it was high up in the birth canal and it had been stressful trying to suture her injury.  At the time I thought I wish there was something I could place in the birth canal to see this better and I was visualising some sort of horse shoe shaped device.  

I went home and stayed up half the night thinking about it and came up with the idea of some sort of device along the lines of the horseshoe shape. 

I was convinced I was on to something important and set about creating the first prototype.  Many more followed until we ended up with the final patented design that is now in use today. 

Obs: What training is available to interested clinicians who would like to upskill their suturing techniques and learn the skill of using the Hegenberger Retractor?

MH:  Training is now available to UK clinicians who would like to upskill their suturing techniques and learn the skill of using the Hegenberger Retractor.

I present the training course personally, which is available on-demand via our Hegenberger Institute eLearning Platform, as well as via iOS and Android apps.  We offer training on 1st degree, 2nd degree and Episiotomy repairs and the course covers subcuticular techniques, knot tying, the use of the Hegenberger Retractor in clinical use.  Everyone who attends the course receives a full assessment and successful candidates receive CPD certification. 

Clinicians can sign up for further information by visiting Hegenberger Medical and following the links for Training. Visit: https://hegenbergermedical.com/training, or contact Hegenberger Medical by email on customer.service@hegenbergermedical.com.

 

Obs: Over the past few years, it is clear that the healthcare industry has been greatly impacted by the pandemic, what has been the greatest impact within your work and how has it affected birthing mothers and new parents?

MH:  The impact of the pandemic cannot be underestimated. I think before this we took for granted how important to our job it is to have a very visual form of communication.  Having to wear masks definitely had a negative impact and it’s so much nicer for mum and midwife to be able to read each others’ expressions more clearly again now. 

On a more positive note, the pandemic has taught everyone about the importance of hand-hygiene and it’s great to see mums, dads, and family members much more switched on about using alcohol hand sanitiser and being more aware and discreet with coughs and sneezes.  This also translates to home hygiene once parents leave hospital with their newborn which is a great thing for keeping babies safe and healthy in the early months following birth.    

We are also now very prepared should we be unfortunate to see another pandemic in the future.  This can only be a good thing to be ready and not be on the back foot like we were in 2020.  

 

Obs: What’s next with your research? Are you currently involved in any new developments?

MH:  Our focus is now very much on supporting the global roll out. We are already in 25 different countries but there is still a lot of work to be done to find a way into all medical training scenarios as well as being introduced to qualified clinicians.

My ultimate vision is to support clinicians and women globally to have the best possible outcome following birth, and for the Hegenberger Retractor to become a symbol of  women’s  health and for shining a spotlight on this important part of delivery and the impact it has on lives when things go wrong.     

Many women are paying a very high price for not being sutured properly following birth so it is my mission to ensure everyone has the opportunity to be examined and repaired using the Hegenberger Retractor post delivery.

 

Obs: Are you planning to attend any training events in 2023 aimed at midwives or new parents?

MH:  We are very excited as a team to be attending the American College of Obstetricians and Gynaecologists’ Annual Clinical & Scientific Meeting in Baltimore this May where we will be demonstrating the use of The Hegenberger Retractor to attending clinicians and midwives.  

We are also looking at similar events where we have a chance to meet face to face with midwives in the UK. 

This is just the start and we plan to get out and directly meet as many clinicians and midwives as possible around the world.  

 

Obs: What would you tell your 21-year-old self?

MH:   I would say believe in your vision and ability, work hard and stay focussed on your goals.  I would also undertake to myself that no matter what choices or decisions you make, they are all positive and all experiences are used to help you grow and achieve your dreams.    

 

Obs: If you were Health Minister for the day what changes would you implement?

MH:  I would wish to put more resources in place for looking after women post birth.  I would implement follow-up clinics for all women who have experienced tears.   I would also campaign for women to speak out about their experience and not live in silence.  The more women open up and share their experience of birth injury the more women we will be able to help in the future.

 

Obs: How do you think the future looks in the field of midwifery and what are your predictions for 2023 and the next decade?

MH:  My goal is to help give more focus and funding to the field of midwifery and for midwives to get better support and training, especially when it comes to postpartum repairsWe need to give more time for women recovering following birth, particularly when they have undergone suturing. We want women to be reassured as they look to their upcoming birth, that they will be properly supported in their ability to give birth, and also when things don’t go according to plan.  Women should always approach their upcoming birth with confidence and belief in their ability to have a good birth and knowledge they will be fully supported.