CoChat
Sign Up
Cited by 18Maternal Mental Health During Pregnancy and PostpartumMaternal and Perinatal Health InterventionsAnxiety, Depression, Psychometrics, Treatment, Cognitive Processes

Treatment of Pregnant Women With Fear of Childbirth Using EMDR Therapy: Results of a Multi-Center Randomized Controlled Trial

Open access
Baas, M. A. M., van Pampus, M. G., Stramrood, C. A. I., Dijksman, L. M., Vanhommerig, J. W., de Jongh, A.·2022·Frontiers in Psychiatry
DOI 10.3389/fpsyt.2021.798249PMC PMC8866441
Open this paper in CoChat — free accountOpen PDF

Abstract

Fear of childbirth (FoC) occurs in 7. 5% of pregnant women and has been associated with adverse feto-maternal outcomes. Eye Movement Desensitization and Reprocessing (EMDR) therapy has proven to be effective in the treatment of posttraumatic stress disorder (PTSD) and anxiety; however, its effectiveness regarding FoC has not yet been established. The aim was to determine the safety and effectiveness of EMDR therapy for pregnant women with FoC. This single-blind RCT (the OptiMUM-study, www.trialregister.nl , NTR5122) was conducted in the Netherlands. FoC was defined as a score ≥85 on the Wijma Delivery Expectations Questionnaire (WDEQ-A). Pregnant women with FoC and a gestational age between 8 and 20 weeks were randomly assigned to EMDR therapy or care-as-usual (CAU). The severity of FoC was assessed using the WDEQ-A. Safety was indexed as worsening of FoC symptoms, dropout, serious adverse events, or increased suicide risk. We used linear mixed model analyses to compare groups. A total of 141 women were randomized (EMDR n = 70; CAU n = 71). No differences between groups were found regarding safety. Both groups showed a very large (EMDR d = 1.36) or large (CAU d = 0.89) reduction of FoC symptoms with a mean decrease of 25.6 (EMDR) and 17.4 (CAU) points in WDEQ-A sum score. No significant difference between both groups was found (p = 0.83). At posttreatment, 72.4% (EMDR) vs. 59.6% (CAU) no longer met the criteria for FoC. In conclusion, the results are supportive of EMDR therapy as a safe and effective treatment of FoC during pregnancy, albeit without significant beneficial effects of EMDR therapy over and above those of CAU. Therefore, the current study results do not justify implementation of EMDR therapy as an additional treatment in this particular setting.

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.3389/fpsyt.2021.798249

Cites

10 of 10 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Encouraging data in adults with clinical anxiety problems showed reduced anxiety symptoms after using EMDR with prospective images of feared catastrophe, for instance in anxiety related to the course of a degenerative disease and fear of childbirth.

    “Encouraging data in adults with clinical anxiety problems showed reduced anxiety symptoms after using EMDR with prospective images of feared catastrophe, for instance in anxiety related to the course of a degenerative disease (Wallis and de Vries 2020) and fear of childbirth (Baas et al. 2022).”

    From Negative Flashforward Imagery in Adolescent Social Anxiety Disorder: A Pilot Study of Imagery Reports and a Short EMDR Intervention. (2024) · cites this paper as Baas et al. 2022

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Cites

Flagged first, then by citations

Research works printed but not linked: 36

  1. [2]Adams SS Eberhard-Gran M Eskild A. Fear of childbirth and duration of labour: a study of 2206 women with intended vaginal delivery. Br J Obstet Gynaecol. (2012) 119: 1238– 46. 10.1111/j.1471-0528.2012.03433.x 22734617 · DOI · Paper page
  2. [5]Salomonsson B Wijma K Alehagen S. Swedish midwives'perceptions of fear of childbirth. Midwifery. (2010) 26: 327– 37. 10.1016/j.midw.2008.07.003 18774630 · DOI
  3. [6]Hofberg K Brockington I. Tokophobia: an unreasoning dread of childbirth. A series of 26 cases. Br J Psychiatry. (2000) 176: 83– 5. 10.1192/bjp.176.1.83 10789333 · DOI
  4. [7]Ryding EL Wijma B Wijma K Rydhström H. Fear of childbirth and risk of cesarean delivery: a cohort study in six European countries. Birth. (2015) 42: 48– 55. 10.1111/birt.12147 25676793 · DOI · Paper page
  5. [8]Størksen HT Garthus-Niegel S Adams SS Vangen S Eberhard-Gran M. Fear of childbirth and elective caesarean section: a population-based study. BMC Pregnancy Childbirth. (2015) 17: 221. 10.1186/s12884-015-0655-4 26382746 PMC4573308 · DOI
  6. [9]Waldenström U Hildingsson I Ryding EL. Antenatal fear of childbirth and its association with subsequent caesarean section and experience of childbirth. BJOG. (2006) 113: 638– 46. 10.1111/j.1471-0528.2006.00950.x 16709206 · DOI · Paper page
  7. [10]Söderquist J Wijma B Thorbert G Wijma K. Risk factors in pregnancy for post-traumatic stress and depression after childbirth. Br J Obstet Gynaecol. (2009) 116: 672– 80. 10.1111/j.1471-0528.2008.02083.x 19220236 · DOI
  8. [11]van Heumen MA Hollander MH van Pampus MG van Dillen J Stramrood CAI. Psychosocial predictors of postpartum posttraumatic stress disorder in women with a traumatic childbirth experience. Front Psychiatry. (2018) 9: 348. 10.3389/fpsyt.2018.00348 30108530 PMC6079202 · DOI
  9. [12]Raïsanen S Lehto SM Nielsen HS Gissler M Kramer MR Heinonen S. Fear of childbirth in nulliparous and multiparous women: a population-based analysis of all singleton births in Finland in 1997-2010. Br J Obstet Gynaecol. (2014) 121: 965– 70. 10.1111/1471-0528.12599 24494605 · DOI
  10. [13]Lima SAM El Dib RP Rodrigues MRK Ferraz GAR Molina AC Neto CAP. Is the risk of low birth weight or preterm labor greater when maternal stress is experienced during pregnancy? A systematic review and meta-analysis of cohort studies. PLoS ONE. (2018) 13: e0200594. 10.1371/journal.pone.0200594 30048456 PMC6061976 · DOI · Paper page
  11. [16]Abdollahi S Faramarzi M Delavar MA Bakouei F Chehrazi M Gholinia H. Effect of psychotherapy on reduction of fear of childbirth and pregnancy stress: a randomized controlled trial. Front Psychol. (2020) 11: 787. 10.3389/fpsyg.2020.00787 32528340 PMC7265090 · DOI
  12. [17]Klabbers GA Wijma K Paarlberg KM Emons WHM Vingerhoets AJJM. Haptotherapy as a new intervention for treating fear of childbirth: a randomized controlled trial. J Psychosom Obs Gynaecol. (2019) 40: 38– 47. 10.1080/0167482X.2017.1398230 29157055 · DOI
  13. [18]Saisto T Salmela-Aro K Nurmi JE Könönen T Halmesmäki E. A randomized controlled trial of intervention in fear of childbirth. Obstet Gynecol. (2001) 89: 820– 6. 10.1097/00006250-200111000-00019 11704175 · DOI
  14. [22]Shapiro F. Eye Movement Desensitization and Reprocessing (EMDR) Therapy: Basic Principles, Protocols, and Procedures. 3rd ed. New York, NY: Guilford Press (2018).
  15. [23]WHO. Guidelines for the Management of Conditions That Are Specifically Related to Stress. Geneva: World Health Organization (2013). 24049868
  16. [25]Baas MAM van Pampus MG Braam LM Stramrood CAI de Jongh A. The effects of PTSD treatment during pregnancy: systematic review and case study. Eur J Psychotraumatol. (2020) 11: 1762310. 10.1080/20008198.2020.1762310 33029304 PMC7473051 · DOI
  17. [26]Sandström M Wiberg B Wikman M Willman AK Högberg U. A pilot study of eye movement desensitisation and reprocessing treatment (EMDR) for post-traumatic stress after childbirth. Midwifery. (2008) 24: 62– 73. 10.1016/j.midw.2006.07.008 17223232 · DOI
  18. [27]Stramrood CAI Van der Velde J Doornbos B Paarlberg KM Weijmar Schultz WC Van Pampus MG. The patient observer: eye-movement desensitization and reprocessing for the treatment of posttraumatic stress following childbirth. Birth. (2012) 39: 70– 6. 10.1111/j.1523-536X.2011.00517.x 22369608 · DOI
  19. [28]de Jongh A Ernst R Marques L Hornsveld H. The impact of eye movements and tones on disturbing memories involving PTSD and other mental disorders. J Behav Ther Exp PSychiat. (2013) 44: 477– 83. 10.1016/j.jbtep.2013.07.002 23892070 · DOI
  20. [29]Kavakci O Yenicesu GI. Eye movement desensitization and reprocessing (EMDR) for hyperemesis gravidarum. J Psychiatry Neurol Sci. (2014) 27: 335– 41. 10.5350/DAJPN2014270408 · DOI
  21. [31]Calderani E Giardinelli L Scannerini S Arcabasso S Compagno E Petraglia F. Tocophobia in the DSM-5 era: Outcomes of a new cut-off analysis of the Wijma delivery expectancy/experience questionnaire based on clinical presentation. J Psychosom Res. (2019) 116: 37– 43. 10.1016/j.jpsychores.2018.11.012 30654992 · DOI
  22. [32]Nilsson C Hessman E Sjöblom H Dencker A Jangsten E Mollberg M. Definitions, measurements and prevalence of fear of childbirth: a systematic review. BMC Pregnancy Childbirth. (2018) 18. 10.1186/s12884-018-1659-7 PMC5766978 29329526 · DOI
  23. [33]American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders (fifth edition). Washington, DC (2013).
  24. [34]Sheehan DV Lecrubier Y Sheehan KH Amorim P Janavs J Weiller E. The Mini-International Neuropsychiatric Interview (M.I.N.I.): the development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. J Clin Psychiatry. (1998) 59: 34– 57. 10.1037/t18597-000 9881538 · DOI
  25. [35]Ryding EL Wijma B Wijma K Rydhström H. Fear of childbirth during pregnancy may increase the risk of emergency cesarean section. Acta Obstet Gynecol Scand. (1998) 77: 542– 7. 10.1080/j.1600-0412.1998.770512.x 9654177 · DOI
  26. [38]de Jongh A ten Broeke E. Handboek EMDR: Een Geprotocolleerde Behandelmethode voor de gevolgen van psychotrauma. Amsterdam: Pearson Assessment and Information (2019).
  27. [39]Logie R de Jongh A. The “Flashforward procedure”: confronting the Catastrophe. J EMDR Pract Res. (2014) 8: 25– 32. 10.1891/1933-3196.8.1.25 · DOI · Paper page
  28. [40]Wijma K Wijma B Zar M. Psychometric aspects of the W-DEQ; a new questionnaire for the measurement of fear of childbirth. J Psychosom Obstet Gynaecol. (1998) 19: 84– 97. 10.3109/01674829809048501 9638601 · DOI
  29. [41]Cohen J. Statistical Power Analysis for the Behavioral Sciences. New York, NY: Routledge Academic (1988).
  30. [42]Evans C Margison D Barkham M. The contribution of reliable and clinically significant change methods to evidence-based mental health. Evid Based Ment Heal. (1998) 1: 70– 2. 10.1136/ebmh.1.3.7032628120 · DOI
  31. [43]Wise EA. Methods for analyzing psychotherapy outcomes: a review of clinical significance, reliable change, and recommendations for future directions. J Pers Assess. (2004) 82: 50– 9. 10.1207/s15327752jpa8201_10 14979834 · DOI · Paper page
  32. [46]Lukasse M Schei B Ryding EL Group Group on behalf of BS. Prevalence and associated factors of fear of childbirth in six European countries. Sex Reprod Healthc. (2014) 5: 99– 106. 10.1016/j.srhc.2014.06.007 25200969 · DOI
  33. [47]Nieminen K Stephansson O Ryding LR. Women's fear of childbirth and preference for cesarean section – a cross-sectional study at various stages of pregnancy in Sweden. Acta Obstet Gynecol Scand. (2009) 88: 807– 13. 10.1080/00016340902998436 19488882 · DOI
  34. [48]Rouhe H Salmela-Aro K Halmesmäki E Saisto T. Fear of childbirth according to parity, gestational age, and obstetric history. Br J Obstet Gynaecol. (2009) 116: 67– 73. 10.1111/j.1471-0528.2008.02002.x 19055652 · DOI
  35. [49]Hildingsson I Nilsson C Karlstrom A Lundgren I. A longitudinal survey of childbirth-related fear and associated factors. J Obstet Gynecol Neonatal Nurs. (2011) 40: 532– 43. 10.1111/j.1552-6909.2011.01274.x 22273410 · DOI
  36. [50]O'Connell MA Khashan AS Leahy-Warren P. Women's experiences of interventions for fear of childbirth in the perinatal period: a meta-synthesis of qualitative research evidence. Women Birth. (2021) 34: e309– 21. 10.1016/j.wombi.2020.05.008 32522443 · DOI

Cited by

Sorted by citations

Authors
Baas, M. A. M., van Pampus, M. G., Stramrood, C. A. I., Dijksman, L. M., Vanhommerig, J. W., & de Jongh, A.
Affiliations
  • OLVG (NL)
  • St. Antonius Ziekenhuis (NL)
ORCID
Venue
Frontiers in Psychiatry
Publisher
Frontiers Media SA
Published
2022-02-10
Volume
12
Pages
798249-798249
ISSN
1664-0640 (ISSN-L)
DOI
10.3389/fpsyt.2021.798249
PMC
PMC8866441
OpenAlex
W4211042957
Cited by
18
References
10
Citations by year
2026: 6 · 2025: 4 · 2024: 4 · 2023: 4
FWCI
2.65
Type
journal article
Language
en
Open access
Licence
Locations
  • Frontiers in Psychiatry (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • VU Research Portal (publishedVersion, other-oa)
  • Worcester Research and Publications (University of Worcester) (acceptedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • Research Portal (Queen's University Belfast) (submittedVersion, cc-by)
  • Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
  • Health Sciences › Medicine › Obstetrics and Gynecology › Maternal and Perinatal Health Interventions
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Keywords
fear of childbirth, EMDR, pregnancy, treatment safety, usual care

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review