EMDR Research Foundation Newsletter Vol. 5, Issue 5

Prevalence and risk factors for the development of post traumatic stress disorder (PTSD) after childbirth is well described in the literature. However, its management and treatment has only begun to be investigated. The aim of this article is to describe the studies that examine the effects of interventions on PTSD after childbirth. MedLine, PILOTS, CINAHL and ISI Web of Science databases were systematically searched for randomised controlled trials, pilot studies and case studies using key words related to PTSD, childbirth, treatment and intervention. The reference lists of the retrieved articles were also used to supplement the search. A total of nine studies were retrieved. Seven studies that examined debriefing or counselling were identified; six randomised controlled trials and one pilot study. Also found were one case report describing the effects of cognitive behavioural therapy (CBT) on two women, and one pilot study of eye movement desensitisation and reprocessing (EMDR). Overall, there is limited evidence concerning the management of women with PTSD after childbirth. The results agree with the findings from the nonchildbirth related literature: debriefing and counselling are inconclusively effective while CBT and EMDR may improve PTSD status but require investigation in controlled trials before conclusions could be drawn. -------------------------------------------------------------------------------------------Kendall-Tackett, K. (2014). Intervention for mothers who have experienced childbirthrelated trauma and posttraumatic stress disorder. Clinical Lactation, 5(2), 56-61. https://doi.org/10.1891/21580782.5.2.56 Abstract: Lactation consultants may be one of the first healthcare providers who see mothers following a difficult birth. As such, they can be key sources of support and information for mothers at this critical time. Several aspects of the International Board Certified Lactation Consultant's (IBCLC) scope of practice can fit within trauma-informed care, including helping mothers identify possible trauma symptoms and posttraumatic stress disorder (PTSD), and addressing breastfeeding issues that may be sequelae of a traumatic birth. IBCLCs can inform mothers about their treatment options and refer them to additional sources of support. This article describes breastfeeding issues that might arise in the wake of a traumatic Lactation consultants may be one of the first healthcare providers who see mothers following a difficult birth. As such, they can be key sources of support and information for mothers at this critical time. Several aspects of the International Board Certified Lactation Consultant's (IBCLC) scope of practice can fit within trauma-informed care, including helping mothers identify possible trauma symptoms and posttraumatic stress disorder (PTSD), and addressing breastfeeding issues that may be sequelae of a traumatic birth. IBCLCs can inform mothers about their treatment options and refer them to additional sources of support. This article describes breastfeeding issues that might arise in the wake of a traumatic birth and summarizes evidence-based treatment options for PTSD so that IBCLCs can share this information with mothers. -------------------------------------------------------------------------------------------Additionally, the case consultation question (on use of EMDR therapy with pregnant women) is available full text/free: Forgash, C., Leeds, A., Stramrood, C. A., & Robbins, A. (2013). Case consultation: Traumatized pregnant woman. Journal of EMDR Practice and Research, 7(1), 45-49. https://doi.org/10.1891/1933-3196.7.1.45 Abstract: .... In this article, Amy Robbins, a certified eye movement desensitization and reprocessing (EMDR) therapist from Atlanta, Georgia, briefly describes a challenging case in which a pregnant woman seeks treatment for trauma suffered in a tornado. The clinician asks if it is advisable to provide EMDR treatment and what concerns she should be aware of. The first expert, Carol Forgash, provides some general information about pregnancy and psychotherapy and outlines considerations, concerns, and contraindications for proceeding with EMDR. She recommends that if treatment is chosen, the therapist proceed with a recent trauma protocol to specifically target the traumatic memories of the recent tornado. The second expert, Andrew Leeds, comments on the absence of randomized controlled trials (RCTs) or other scientific reports exploring the safety of EMDR treatment of pregnant women. He states that pregnant women with symptoms of posttraumatic stress should understand that there is a high probability that EMDR will improve maternal quality of life and that the risks of adverse effects on stability of pregnancy are probably low, but that these remain unknown. The third expert, Claire Stramrood, explains that the few case studies that evaluated EMDR during pregnancy have found positive effects but pertained to women with posttraumatic stress disorder (PTSD) following childbirth. She asserts that once obstetricians have been consulted, women have been informed about possible risks and benefits, and, given their informed consent, they should be able to choose to commence EMDR therapy during pregnancy. .... In this article, Amy Robbins, a certified eye movement desensitization and reprocessing (EMDR) therapist from Atlanta, Georgia, briefly describes a challenging case in which a pregnant woman seeks treatment for trauma suffered in a tornado. The clinician asks if it is advisable to provide EMDR treatment and what concerns she should be aware of. The first expert, Carol Forgash, provides some general information about pregnancy and psychotherapy and outlines considerations, concerns, and contraindications for proceeding with EMDR. She recommends that if treatment is chosen, the therapist proceed with a recent trauma protocol to specifically target the traumatic memories of the recent tornado. The second expert, Andrew Leeds, comments on the absence of randomized controlled trials (RCTs) or other scientific reports exploring the safety of EMDR treatment of pregnant women. He states that pregnant women with symptoms of posttraumatic stress should understand that there is a high probability that EMDR will improve maternal quality of life and that the risks of adverse effects on stability of pregnancy are probably low, but that these remain unknown. The third expert, Claire Stramrood, explains that the few case studies that evaluated EMDR during pregnancy have found positive effects but pertained to women with posttraumatic stress disorder (PTSD) following childbirth. She asserts that once obstetricians have been consulted, women have been informed about possible risks and benefits, and, given their informed consent, they should be able to choose to commence EMDR therapy during pregnancy. -------------------------------------------------------------------------------------------The information provided above indicates a great deal of promise using EMDR therapy with women with childbirth PTSD. However, the RCTs are not there. Donate now to increase our funding ability. -------------------------------------------------------------------------------------------For a complete list of Clinical Newsletter Archives, click here. 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