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Trinity College Dublin, The University of Dublin

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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

The rate of caesarean section (CS) in the study sample was 32.2% (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

TO BE ADDED

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.

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 will examine the costs of maternal health problems to individuals as well as the wider society.

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