GRACE
Research type
Research Study
Full title
LearninG from women’s expeRiences of Anal inContinencE after vaginal birth (GRACE)
IRAS ID
299199
Contact name
Sarah Hillman
Contact email
Sponsor organisation
University of Warwick
Duration of Study in the UK
1 years, 5 months, 28 days
Research summary
Over one in five women cannot reach a toilet in time or lose control of wind or waste from their back passage within five years of an injury to their anus and pelvic floor during childbirth. This is called Anal Incontinence, or AI for short. Women suffering AI report anger, feeling unclean, relationship breakdown, isolation and loss of self-esteem. Women often find it difficult to talk about symptoms to health care professionals. It takes on average seven years before women with AI are seen by a professional with the experience and training to treat their symptoms. NICE guidance (2017) recognised the limited evidence, particularly the lack of women’s perspectives on what they consider important.
This research aims to understand the experiences of women who develop AI following childbirth injuries and find out what they would like in an online resource. We will interview women with AI after a birth injury. This will include women who have AI within seven years of birth, and those who developed symptoms around the menopause. After analysing the interviews, we will make a website for women to access information and support. The website information will be chosen by women with AI, and it will include real women talking about their own experiences.
We will improve community health care professionals awareness and training on AI, an area highlighted as a priority by our PPI group. We will hold focus groups with GPs at different stages of their careers to find out about the difficulties, and things that help, when asking women about symptoms of AI. Findings from these focus groups will be used to make an online learning education resource (OLE) for health care professionals through the Royal College of General Practitioners (RCGP), to improve education in AI.Summary of study results:
Over one in five women cannot reach a toilet in time or lose control of wind or waste from their back passage within five years of an injury to their anus and pelvic floor during childbirth. This is called Anal Incontinence, or AI for short. Some women have AI after birth, but others find it starts or worsens around the time of the menopause.
The physical, emotional and social impact of AI can be profound and long lasting. Women often find it difficult to talk about symptoms to health care professionals. Many GPs fail to detect and direct women to services, with delays in accessing treatment. It takes on average seven years before women with AI are seen by a professional with the experience and training to treat their symptoms. NICE guidance (2017) recognised the limited evidence, particularly the lack of women’s perspectives on what they consider important.
This research aimed to understand the experiences of women who develop AI following childbirth injuries and find out what the barriers are to care and what they would like in an online resource. We interviewed 41 women with AI after a birth injury. This included women who have AI within seven years of birth, and those who developed symptoms around the menopause. After analysing the interviews, we created a website for women to access information and support. We held focus groups with GPs at different stages of their careers to find out about the difficulties, and things that help, when asking women about symptoms of AI. Findings were used to make an online learning education resource (OLE) for health care professionals through the Royal College of General Practitioners (RCGP) this will improve community health care professionals awareness and training on AI.REC name
East of England - Essex Research Ethics Committee
REC reference
21/EE/0167
Date of REC Opinion
3 Aug 2021
REC opinion
Further Information Favourable Opinion