A new application of EMDR: Treatment of posttraumatic stress following childbirth

Purpose: To evaluate the possibility of using eye-movement desensitization and reprocessing (EMDR) treatment for women with posttraumatic stress following childbirth. EMDR is internationally recognized as one of the treatments of choice for posttraumatic stress disorder (PTSD). However, as outlined in a recent article on the management of PTSD following childbirth, very little is known about the effect of the intervention in women who experienced the delivery as traumatic. Methods: Two patients suffering from posttraumatic stress symptoms following childbirth were treated with EMDR. Patient A developed PTSD symptoms following the lengthy labor of her first child that ended in an emergency cesarean section (CS) after unsuccessful vacuum and forceps extraction. Patient B suffered from PTSD symptoms since the birth of her first child, during which a second degree vaginal rupture occurred, causing pain and resulting in the inability to use tampons and engage in sexual intercourse for several years. RESULTS: Both patients received EMDR treatment during their second pregnancy, using the standard protocol. After 2 sessions of EMDR including RDI and future template, patient A felt strong and confident about the upcoming delivery. She did not prefer a CS over vaginal birth or vice versa, as long as she would end up psychologically undamaged. Due to insufficient engaging of the fetal head, patient A underwent a secondary CS, but nonetheless looks back positively at the experience. Patient B felt calm and less anxious after two sessions of EMDR. Despite her initial request for an elective CS, she agreed to attempt vaginal delivery, and a healthy infant was born. Even though she suffered another second degree vaginal rupture, which fortunately did not cause dyspareunia this time, patient B also looks back positively at the second delivery. Conclusion: Treatment with EMDR reduced PTSD symptoms in these two women, and hence proved to be an effective intervention. Furthermore, both women were confident enough to attempt vaginal birth rather than demanding an elective CS. We advocate a large scale RCT involving women with postpartum PTSD to confirm the effect of EMDR in this patient group.

Conference

English

Claire A. I. Stramrood
Janneke van der Velde
Willibrord C. M. Weijmar Schultz
Maria G. van Pampus

Stramrood, C., van der Velde, J., Weijmar Schultz, W. C. M., & van Pampus, M. (2011, March). A new application of EMDR: Treatment of posttraumatic stress following childbirth. Poster presentation at the American Psychosomatic Society 69th Annual Scientific Meeting, San Antonio, TX