The MAMMI Study

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 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 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.

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.

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%).

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.