The OptiMUM-study: EMDR therapy in pregnant women with posttraumatic stress disorder after previous childbirth and pregnant women with fear of childbirth: Design of a multicentre randomized controlled trial
Open accessAbstract
Background: Approximately 3% of women develop posttraumatic stress disorder (PTSD) after giving birth, and 7.5% of pregnant women show a pathological fear of childbirth (FoC). FoC or childbirth-related PTSD during (a subsequent) pregnancy can lead to a request for an elective caesarean section as well as adverse obstetrical and neonatal outcomes. For PTSD in general, and several subtypes of specific phobia, eye movement desensitization and reprocessing (EMDR) therapy has been proven effective, but little is known about the effects of applying EMDR during pregnancy.Objective: To describe the protocol of the OptiMUM-study. The main aim of the study is to determine whether EMDR therapy is an effective and safe treatment for pregnant women with childbirth-related PTSD or FoC. In addition, the cost-effectiveness of this approach will be analysed.Method: The single-blind OptiMUM-study consists of two two-armed randomized controlled trials (RCTs) with overlapping design. In several hospitals and community midwifery practices in Amsterdam, the Netherlands, all eligible pregnant women with a gestational age between eight and 20 weeks will be administered the Wijma delivery expectations questionnaire (WDEQ) to asses FoC. Multiparous women will also receive the PTSD checklist for DSM-5 (PCL-5) to screen for possible PTSD. The clinician administered PTSD scale (CAPS-5) will be used for assessing PTSD according to DSM-5 in women scoring above the PCL-5 cut-off value. Fifty women with childbirth-related PTSD and 120 women with FoC will be randomly allocated to either EMDR therapy carried out by a psychologist or care-as-usual. Women currently undergoing psychological treatment or women younger than 18 years will not be included. Primary outcome measures are severity of childbirth-related PTSD or FoC symptoms. Secondary outcomes are percentage of PTSD diagnoses, percentage caesarean sections, subjective childbirth experience, obstetrical and neonatal complications, and health care costs.Results: The results are meant to provide more insight about the safety and possible effectiveness of EMDR therapy during pregnancy for women with PTSD or FoC.Conclusion: This study is the first RCT studying efficacy and safety of EMDR in pregnant women with PTSD after childbirth or Fear of Childbirth.
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EMDR shows promising results in alleviating PTSD symptoms in pregnant and postpartum women.
“Furthermore, promising results in EMDR’s ability to alleviate PTSD symptoms have been observed in a variety of settings, including the treatment of PTSD in pregnant women and postpartum [79,80].”
From Clinical Efficacy of Psychotherapeutic Interventions for Post-Traumatic Stress Disorder in Children and Adolescents: A Systematic Review and Analysis. (2024) · cites this paper as [80]
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Posttraumatische Belastungsstörung in der Peripartalzeit
Martini, J., Weidner, K., Junge‐Hoffmeister, J., & Garthus‐Niegel, S. (2017) · Trauma und Gewalt · doi:10.21706/tg-11-4-280 · Cited by 1 · see citing works
Tcheshmedjiev, I., & Farrell, D. P. (2023) · Journal of EMDR Practice and Research · doi:10.1891/emdr-2022-0049 · Cited by 1 · see citing works
Cesarean Section Recovery: Multidimensional Strategies for Maternal and Neonatal Health
Hedman, K., & Denisov, P. (2026) · Obstetrics and gynecology. · doi:10.5772/intechopen.1014105
Eye movement desensitization and reprocessing treatment for birth trauma: a scoping review
O’DONOVAN, S., Ward, L. G., & Melia, R. (2026) · European Journal of Psychotraumatology · doi:10.1080/20008066.2026.2678658
“For example, Baas et al. (2017) published a multicentre RCT protocol, the ‘The OptiMUM-study’.”
- Authors
- Baas, M. A. M., Stramrood, C. A. I., Dijksman, L. M., de Jongh, A., & van Pampus, M. G.
- Affiliations
- OLVG (NL)
- University Medical Center Utrecht (NL)
- St. Antonius Ziekenhuis (NL)
- Department of Behavioral Sciences, Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, the Netherlands
- Department of Obstetrics and Gynaecology, Onze Lieve Vrouwe Gasthuis, Amsterdam, the Netherlands
- Venue
- European Journal of Psychotraumatology
- Publisher
- Informa UK Limited
- Published
- 2017-01-01
- Volume
- 8
- Issue
- 1
- Pages
- 1293315-1293315
- ISSN
- 2000-8066 (ISSN-L)
- PMC
- PMC5345578
- OpenAlex
- W2590582942
- Cited by
- 31
- References
- 59
- Citations by year
- 2026: 3 · 2024: 3 · 2023: 4 · 2022: 4 · 2021: 5 · 2020: 4 · 2019: 3 · 2018: 3 · 2017: 2
- FWCI
- 3.86
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- European Journal of Psychotraumatology (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- VU Research Portal (publishedVersion, cc-by)
- UvA-DARE (University of Amsterdam) (submittedVersion, cc-by)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Figshare (submittedVersion, cc-by)
- Worcester Research and Publications (University of Worcester) (submittedVersion, cc-by)
- Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
- Data Archiving and Networked Services (DANS) (submittedVersion, cc-by)
- Figshare (cc-by)
- Topics
- Health Sciences › Medicine › Obstetrics and Gynecology › Maternal and Perinatal Health Interventions
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Keywords
- EMDR, post-traumatic stress disorder, fear of childbirth, pregnancy, multiparous women, cesarean section, obstetrical complications, neonatal outcomes, treatment safety, cost-effectiveness
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