Abstract
BackgroundUp to 33% of women develop symptoms of posttraumatic stress disorder (PTSD) after a traumatic birth experience. Negative and traumatic childbirth experiences can also lead to fear of childbirth, avoiding or negatively influencing a subsequent pregnancy, mother-infant bonding problems, problems with breastfeeding, depression and reduced quality of life. For PTSD in general, eye movement desensitization and reprocessing (EMDR) therapy has proven to be effective. However, little is known about the preventive effects of early intervention EMDR therapy in women after a traumatic birth experience. The purpose of this study is to determine the effectiveness of early intervention EMDR therapy in preventing PTSD and reducing PTSD symptoms in women with a traumatic birth experience.MethodsThe PERCEIVE study is a randomized controlled trial. Women suffering from the consequences of a traumatic birth experience will be randomly allocated at maximum 14 days postpartum to either EMDR therapy or ‘care-as-usual’. Patients in the EMDR group receive two sessions of therapy between 14 (T0) and 35 days postpartum. All participants will be assessed at T0 and at 9 weeks postpartum (T1). At T1, all participants will undergo a CAPS-5 interview about the presence and severity of PTSD symptoms. The primary outcome measure is the severity of PTSD symptoms, whereas the secondary outcomes pertain to fear of childbirth, mother-infant bonding, breastfeeding, depression and quality of life. The study will be conducted at a large city hospital and at multiple midwifery practices in Amsterdam, the Netherlands.DiscussionIt is to be expected that the results of this study will provide more insight about the safety and effectiveness of early intervention EMDR therapy in the prevention and reduction of PTSD (symptoms) in women with a traumatic birth experience.Trial registrationNetherlands Trial Register NL73231.000.20. Registered on 21 August 2020.
Highlights
Up to 33% of women develop symptoms of posttraumatic stress disorder (PTSD) after a traumatic birth experience
It is hypothesized that early intervention eye movement desensitization and reprocessing (EMDR) therapy is safe and that women who receive early intervention EMDR will report significantly less PTSD 9 weeks after the delivery compared to women who receive no treatment
The PERCEIVE study will be the first randomized controlled trial that examines the safety and effectiveness of early EMDR therapy in preventing or reducing PTSD in women with a traumatic birth experience. We consider this of great importance given the major impact of PTSD on both mother and infant found in the literature [14,15,16,17]
Summary
Up to 33% of women develop symptoms of posttraumatic stress disorder (PTSD) after a traumatic birth experience. Little is known about the preventive effects of early intervention EMDR therapy in women after a traumatic birth experience. The purpose of this study is to determine the effectiveness of early intervention EMDR therapy in preventing PTSD and reducing PTSD symptoms in women with a traumatic birth experience. According to recent meta-analyses, 3–4% of all women develop PTSD following childbirth [1, 2] while up to 33% of women experience symptoms of PTSD [3, 4]. Risk factors for a traumatic birth experience are diverse. Prevalence of traumatic birth experiences has been found to be higher among women with unexpected interventions during labour and delivery, such as unplanned caesarean section or vacuum-assisted delivery [3, 5]. Other reported risk factors include a history of psychiatric illness, previous trauma, fear of childbirth (FoC) and preeclampsia [2, 5]
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