The Patient Observer: Eye-Movement Desensitization and Reprocessing for the Treatment of Posttraumatic Stress following Childbirth |
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| Authors: | Claire AI Stramrood MD Janneke van der Velde PhD Bennard Doornbos MD PhD K Marieke Paarlberg MD PhD Willibrord CM Weijmar Schultz MD PhD Maria G van Pampus MD PhD |
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| Institution: | 1. Claire A.I. Stramrood is a Doctoral Candidate and Janneke van der Velde is a Health Psychologist and Sexologist in the Department of Obstetrics & Gynecology, University Medical Center Groningen, Groningen;2. Bennard Doornbos is a Postdoctoral Researcher and Resident in Psychiatry in the Interdisciplinary Center for Psychiatric Epidemiology, University Center for Psychiatry, Groningen;3. K. Marieke Paarlberg is a Gynecologist and Perinatologist in the Department of Obstetrics & Gynecology, Gelre Teaching Hospital, Apeldoorn;4. Willibrord C.M. Weijmar Schultz is a Gynecologist, Professor and Head of the Department of Psychosomatic Obstetrics & Gynecology in the Department of Obstetrics & Gynecology, University Medical Center Groningen, Groningen;5. and Maria G. van Pampus is a Gynecologist and Perinatologist in the Department of Obstetrics and Gynecology, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands. |
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| Abstract: | Abstract: Background: No standard intervention with proved effectiveness is available for women with posttraumatic stress following childbirth because of insufficient research. The objective of this paper was to evaluate the possibility of using eye-movement desensitization and reprocessing treatment for women with symptoms of posttraumatic stress disorder following childbirth. The treatment is internationally recognized as one of the interventions of choice for the condition, but little is known about its effects in women who experienced the delivery as traumatic. Methods: Three women suffering from posttraumatic stress symptoms following the birth of their first child were treated with eye-movement desensitization and reprocessing during their next pregnancy. Patient A developed posttraumatic stress symptoms following the lengthy labor of her first child that ended in an emergency cesarean section after unsuccessful vacuum extraction. Patient B suffered a second degree vaginal rupture, resulting in pain and inability to engage in sexual intercourse for years. Patient C developed severe preeclampsia postpartum requiring intravenous treatment. Results: Patients received eye-movement desensitization and reprocessing treatment during their second pregnancy, using the standard protocol. The treatment resulted in fewer posttraumatic stress symptoms and more confidence about their pregnancy and upcoming delivery compared with before the treatment. Despite delivery complications in Patient A (secondary cesarean section due to insufficient engaging of the fetal head); Patient B (second degree vaginal rupture, this time without subsequent dyspareunia); and Patient C (postpartum hemorrhage, postpartum hypertension requiring intravenous treatment), all three women looked back positively at the second delivery experience. Conclusions: Treatment with eye-movement desensitization and reprocessing reduced posttraumatic stress symptoms in these three women. They were all sufficiently confident to attempt vaginal birth rather than demanding an elective cesarean section. We advocate a large-scale, randomized controlled trial involving women with postpartum posttraumatic stress disorder to evaluate the effect of eye-movement desensitization and reprocessing in this patient group. (BIRTH 39:1 March 2012) |
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| Keywords: | eye-movement desensitization and reprocessing posttraumatic stress disorder childbirth pregnancy postpartum |
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