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The MAMMI Study

Our research

Our research focuses on the health and health problems of women during pregnancy and after childbirth. The MAMMI study has multiple strands that focus on specific health problems, including urinary incontinence, faecal incontinence, pelvic girdle pain, sexual health, mental health, nutrition and physical activity, and a caesarean section strand.

The MAMMI study journey

The MAMMI study started in 2012 and has grown substantially since then, with continuing new developments. With over 3000 women participating, it has become the largest study in Ireland of its kind, and hopes to improves mothers' health in Ireland and beyond.

The MAMMI study

The MAMMI study has many strands focussing on specific health problems that women might experience during or after pregnancy.

Urinary & faecal incontinence

Urinary incontinence is defined as any involuntary leakage of urine. The International Incontinence Society defined three types of UI: (a) Stress urinary incontinence (SUI) is involuntary loss of urine on effort or physical exertion; (b) urge urinary incontinence (UUI) is associated with a need to pass urine immediately; or (c) mixed urinary incontinence (MUI), which is a combination of both. Among MAMMI study participants, 23.1% experienced stress UI before pregnancy, 33.9% during pregnancy, 51.7% three months after the birth of their first child, 40.9% six months postpartum, and 41.2% a year postpartum. The majority of women were not asked about involuntary loss of urine by their GP (74.4%) or Midwife/Public health nurse (59.9%).

Faecal incontinence is defined as any involuntary leakage of stool. Among MAMMI study participants, 4.4% leak liquid stool before pregnancy, 3.3% during pregnancy, 7.0% three months after the birth of their first child, 5.4% six months postpartum, and 3.2% a year postpartum. At total of 1.5% women leaked solid stool before becoming pregnant, 1.2% during pregnancy, 4.0% three month postpartum, 3.1% six months postpartum, and 2.6% a year after the birth of their first child. The majority of women were not asked about involuntary loss of stool by their GP (78.9%) or Midwife/Public health nurse (65.3%).

Sexual health

Sexual health problems, such as painful sex, changes in libido, vaginal dryness etc., are common during and after pregnancy. Among MAMMI study participants, 21.2% experienced painful intercourse before pregnancy, 14.7% during pregnancy, 43.4% three months after the birth of their first child, 30.1% six months postpartum, and 18.3% a year postpartum. The majority of women were not asked about sexual health problems by their GP (86.8%) or Midwife/Public health nurse (87.9%).

Pelvic Girdle Pain

Pelvic Gridle Pain (PGP) is defined as pain experienced at the back of the pelvis (buttock area, sacroiliac joints) and/or at the front of the pelvis (pubic symphysis). Among MAMMI study participants 68.8% during pregnancy, 51.2% three months after the birth of their first child, 40.5% six months postpartum, and 33.3% a year postpartum. Women with persisent PGP after the birth said they don't feel back to normal but that they put up with the pain. They had not expected their symptoms to persist after the birth and were uncertain about how their symptoms would progress. They also said that their healthcare professional did not enquire about PGP.

Caesarean section

Sunita Panda, a PhD researcher with the study, looked at the factors that have an impact on the rate of caesarean section. 32.2% of women in the sample has a caesarean section (CS) birth (n=888/2755). Common factors significantly associated with the risk of having a planned and unplanned CS were: women aged ≥40 years, having had treatment for infertility, being in private care, multiple pregnancy, fetus in breech and other malpresentations. The risk of having an unplanned CS increased significantly for women who had induction of labour (IOL) and epidural, with or without intravenous (IV) oxytocin. CS signficicantly increased the risk of increased blood loss (≥500mls) at birth, increased duration of hospital stay postpartum (≥4 days), increased use of antiobiotics, and wound infection in the immediate and up to 3-months postpartum. Women in the study described themselves as 'agreeing' or 'going along with the professional's decisions while feeling not being listened to. Clinicians' beliefs and attitude combined with a system of practice were the key drivers in the decision-making process.

Mental health

Depressive symptoms are common during and after pregnancy. Among MAMMI study participants, 9.3% experienced depressive symptoms before pregnancy, 12.2% during pregnancy, 17.7% three months after the birth of their first child, 13.4% six months postpartum, and 12.8% a year postpartum. Many women were not asked about feeling depressed or low by their GP (49.0%) or Midwife/Public health nurse (33.7%).

5.1% of women experienced anxiety before becoming pregnant, 4.4% during pregnancy, 12.1% three month postpartum, 10.5% six months postpartum, and 11.6% a year after the birth of their first child. The majority of women were not asked about feeling anxious by their GP (78.9%) or Midwife/Public health nurse (65.3%).

Nutrition & Physical Activity

Jamile Marchi's Phd research explored the diet, dietary patterns and physical activiity levels of first-time mothers during pregnancy. It also examined associations between diet and pregnancy, birth, neonatal and postpartum outcomes.

MAMMI SIM

MAMMI SIM (Second baby, Intervention and Measuring cost) examines the health and health problems of mothers after having had their second baby. In addition, we examine the costs of maternal health problems to individuals as well as the wider society.

MAMMI 5-year follow up

We started our 5-year follow up in 2018 and is currently ongoing. This involves completing a single survey when your first child is about 5 years old. This will provide very important information on what happens to the health and health problems that mothers experience over time.

Data Sharing and Research Collaborations

Data Sharing with the Maternal Health Study (MHS) research team, Murdoch Children's Research Institute

The MHS research team explored the health and health problems of women in Australia. The MAMMI study surveys were adapted from the MHS surveys and modified for use in Ireland. The MAMMI study team plan to collaborate with the MHS team to merge anonymised data from women recruited in Ireland with the data from women recruited in Australia. By merging the two groups, this will help us to explore certain health issues in depth, such as faecal incontinence and intimate partner violence.

Data Sharing with researchers from the Gothenburg Research Program on Pregnancy and Politics (PregDem), University of Gothenburg, Sweden

In 2014, a collaboration between the Department of Political Science, University of Gothenburg and the MAMMI study involved including additional questions in some of the MAMMI surveys. These additional questions were to explore the extent to which and how political awareness and engagement, citizenship norms and policy preferences shift or develop with the experience of being pregnant and giving birth. The MAMMI study team plan to share an anonymised dataset from consenting women with the PregDem team.

Your data and your rights

We will only share information collected from paper surveys in an electronic format, with the MHS research group in Australia and the PregDem research group in Sweden, None of the researchers accessing this information will know who you are.  

Before sharing any data, we remove any information which could identify you.

As a research participant, you have the right to object to your data being shared for this research project, and you can request that your data is withdrawn, without providing a reason. Please contact (Deirdre Daly) at mammi@tcd.ie

Please note that it will not be possible to withdraw your data if the research is about to be published, as this would affect the results, and all research is in the public interest.  (Article 6,1 e and 9, 2, J of the General Data Protection Regulation (GDPR.)


For MAMMI study participants who are interested in learning more about anonymised data sharing between MAMMI and the MHS team in Australia or the PregDem research team in Sweden, this information is provided in our Participant Information Leaflets. If you have any questions, you can also contact us by emailing mammi@tcd.ie

 

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