Eye Movement Desensitization and Reprocessing treatment in pregnant women with Posttraumatic Stress Disorder after previous childbirth

After childbirth, 1-3% of women will develop a posttraumatic stress disorder (PTSD). Many women will become pregnant again and experience severe anxiety associated with pregnancy and childbirth. Our objective is to assess efficacy and safety of EMDR treatment for pregnant women with PTSD after childbirth. After screening 1667-5000 multiparae, 50 pregnant women with PTSD will be randomized between care-as-usual or 3 sessions of 90 minutes EMDR.

In follow up measurements compared to pre-treatment measurement

1) WITHIN the treatment group there is a decline in the severity of PTSD symptoms and percentage of PTSD diagnoses;

2) BETWEEN treatment group and care-as-usual group there is more reduction in PTSD symptom severity, a lower percentage of PTSD diagnoses, fewer caesarean sections, a more positive childbirth experience, and lower health care costs in the treatment group;

3) EMDR does not lead to more obstetrical or neonatal complications.

Data will be collected at several timepoints:

-Screening (gestational age 8-20 weeks)

-T0:Pre-assessment (circa 20 weeks gestational age)

-In between sessions (every two weeks for care as usual)

-T1: Post-treatment antepartum (30-32 weeks gestational age)

-T2: Post-treatment postpartum (2-3months postpartum)

Care-as-usual group: care-as-usual is defined as standard care during pregnancy, with routine obstetrical checks. Assuming good clinical care, anxious pregnant women and those with traumatic delivery experiences will receive more counseling compared to not-anxious pregnant women, but will (probably) not be referred for EMDR.



Eye Movement Desensitization and Reprocessing (EMDR) group: EMDR is a psychological intervention that was developed for the treatment of traumatic memories. It is internationally recognized as a first choice therapy for treating posttraumatic stress disorder. EMDR is conducted according to the Dutch translation of the basic EMDR protocol 2015, and is provided in 3 sessions of 90 minutes. Eye movements were applied as the distracting stimulus.