Healing while expecting: effects and experiences of trauma-focused interventions during pregnancy

Abstract

Section A
Mental health difficulties during pregnancy, such as anxiety, depression, and post-traumatic stress disorder (PTSD), are common but often underreported. PTSD in particular is of concern during pregnancy due to its negative impact on both maternal and child outcomes if left untreated. Although there is a strong evidence base for trauma-focused therapies, pregnant individuals are underrepresented in research due to perceived risks, leaving gaps in our understanding of treatment effectiveness during pregnancy. This review aims to better understand the treatment effects and drop-out rates of evidence-based trauma therapies delivered during pregnancy. A systematic review was conducted following PRISMA guidelines, searching Embase, PsycInfo, PsycArticles, and MIDIRS for synonyms of ‘pregnancy’ and trauma-focused therapies. Of 1296 papers screened, 12 studies were deemed suitable for inclusion. A narrative synthesis showed that trauma-focused therapies reduce key symptoms (e.g., PTSD, fear of childbirth, anxiety, and nausea and vomiting) without adverse effects. However, the majority of randomised controlled studies found no significant differences in treatment effects when compared to control groups. Drop-out rates were generally low (0% to 19%), except for one study (40%). Future research should compare different types of trauma-focused therapies and explore pregnant individuals’ lived experiences through high-quality qualitative studies.

Section B
Over a third of birthing people experience a traumatic birth, which can lead to post-traumatic stress disorder. Emerging evidence suggests that Eye Movement Desensitization and Reprocessing (EMDR) is an effective and time-efficient treatment for birth trauma. Nevertheless, the research base is scarce and lacks lived experience insights. This study investigated the experience of receiving EMDR for birth trauma during a subsequent pregnancy. Eight interviews were analysed using Interpretative Phenomenological Analysis, revealing four key themes: ‘There’s nothing like it’, ‘A ticking clock’, ‘I’m the architect’ and ‘Widening the lens’. The study highlights the clinical benefits, emphasising EMDR’s acceptability, effectiveness, and the importance of a strong therapeutic relationship. Further research is required to validate these findings as the small sample size and possible sampling
biases limit generalisability.

Date of Award	2025
Original language	English