title: The patient observer: eye-movement desensitization and reprocessing for the treatment of posttraumatic stress following childbirth.
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.
authors.affiliation: Department of Obstetrics & Gynecology, University Medical Center Groningen, Groningen, The Netherlands.
authors.forename: Claire A I
authors.initials: CA
authors.lastname: Stramrood
authors.forename: Janneke
authors.initials: J
authors.lastname: van der Velde
authors.forename: Bennard
authors.initials: B
authors.lastname: Doornbos
authors.forename: K
authors.initials: K
authors.lastname: Marieke Paarlberg
authors.forename: Willibrord C M
authors.initials: WC
authors.lastname: Weijmar Schultz
authors.forename: Maria G
authors.initials: MG
authors.lastname: van Pampus
mesh_terms: D000328:Adult; D004420:Dystocia / Q000523:psychology*; D057169:Eye Movement Desensitization Reprocessing; D005260:Female; D006801:Humans; D036801:Parturition / Q000523:psychology*; D049590:Postpartum Period / Q000523:psychology*; D011247:Pregnancy; D013313:Stress Disorders, Post-Traumatic / Q000628:therapy*