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Abstract
Introduction A traumatic childbirth can have severe negative effects on the mental health of the mother and can negatively impact the child and partner. Eye movement desensitisation and reprocessing (EMDR) is a psychological intervention used to treat symptoms of trauma. The National Institute for Health and Care Excellence guidelines for antenatal and postnatal mental health recommend that trauma-focused cognitive behavioural therapy or EMDR should be offered to women who suffer from post-traumatic stress disorder resulting from a traumatic birth. However, the use of EMDR for birth trauma has not been clearly outlined in the literature.
Objectives The aim of this scoping review is to explore the extent of the currently available research and to identify knowledge gaps in the use of EMDR for treating birth trauma.
Methods and analysis The Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews guidelines will be followed to provide a comprehensive scoping review of the use of EMDR for birth trauma. Several databases will be searched, such as PsychInfo, Pubmed, the Cochrane Library, Embase, Scopus and CINAHL, from the date the database was developed, until approximately August 2026. The grey literature sources will also be searched, and searches will be limited to include studies written in the English language. Two researchers will independently screen and extract data from both quantitative and qualitative studies, which meet the inclusion criteria. Data will be analysed in a descriptive and thematic manner. Data extraction may include study characteristics, data collection procedures, outcomes and results. Findings will be presented in tabular and narrative formats.
Ethics and dissemination Ethical Approval is not necessary for this review, as only secondary data will be used. It is expected that the review will be disseminated at psychological conferences and in relevant journal articles.
Trial registration number This scoping review protocol has been registered on Open Science Framework. The registration DOI is: https://doi.org/10.17605/OSF.IO/UJZ52.
- Postpartum Women
- MENTAL HEALTH
- Psychosocial Intervention
- Psychological Stress
- PSYCHIATRY
- Midwifery
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STRENGTHS AND LIMITATIONS OF THIS STUDY
A strength of this review is that it will include a comprehensive search strategy using several major databases and the grey literature to ensure inclusion of all relevant research in the area of the use of eye movement desensitisation and reprocessing (EMDR) for birth trauma.
This review will build on previous research that has focused on the use of EMDR, by synthesising the research regarding the application of EMDR to birth trauma specifically.
By including both qualitative and quantitative research, this review aims to capture a wide range of studies.
A limitation to this review is the language restriction, which will only allow the inclusion of research written in the English language.
Another limitation to this review may be the heterogeneity of study designs and outcomes. Due to the broad nature of this review, studies may vary in different characteristics such as symptom severity, follow-up duration and outcome measures, which may limit comparability.
Introduction
Eye movement desensitisation and reprocessing (EMDR) is a structured, empirically validated, therapeutic intervention, used to treat trauma and other negative experiences. There are eight phases of EMDR, which include recalling images, thoughts, emotions and bodily sensations associated with traumatic events, while receiving bilateral stimulation. The theoretical framework that informed the development of EMDR is the adaptive information processing model. This model theorises that due to the high levels of stress experienced during a traumatic event, the memory of this event is stored along with the emotions, beliefs and physical sensations that were experienced at the time of the trauma. It is theorised that reprocessing these memories from episodic memory to explicit and semantic memory systems can improve symptoms of trauma. This involves recollecting past traumatic memories to incorporate them into a more positive emotional and cognitive framework. EMDR uses dual attention, which involves focusing on the traumatic memory and rhythmic bilateral stimulation simultaneously, which activates information processing.1 With over 30 randomised controlled trials, there is a large evidence base indicating the efficacy of EMDR for the treatment of post-traumatic stress disorder (PTSD),2 as well as recommendations for the use of EMDR in the treatment of PTSD in the National Institute for Health and Care Excellence (NICE) clinical guidelines.3
A traumatic birth has been defined as ‘a woman’s experience of interactions and/or events directly related to childbirth that caused overwhelming distressing emotions and reactions; leading to short and/or long-term negative impacts on a woman’s health and well-being’.4 Research has reported a wide range in the prevalence rates of birth trauma from approximately 4%–50%,5–7 with an Irish sample being 18%.8 PTSD differs from birth trauma, as it is classified in the Diagnostic and Statistical Manual of Mental Disorders Fifth edition to include specific symptoms such as re-experiencing traumas, avoidance of trauma reminders, hypervigilance, dissociation and alterations in mood and cognitions.9 When PTSD stems from a traumatic childbirth, this can involve nightmares and re-experiencing of the birthing experience, which may be triggered by postpartum check-ups. This may lead to an avoidance of necessary postpartum care. Childbirth-related PTSD may also impact the mother’s relationship with her partner and lead to hypervigilant monitoring of the baby.10 Other negative consequences of birth trauma can include fear of subsequent births and stress in later pregnancies, breastfeeding difficulties, low infant birth weight, difficulties with attachment and cognitive difficulties for the child.11 Skin to skin contact may be a protective factor against developing PTSD; however, this may be difficult to facilitate during traumatic births, resulting in a lack of skin to skin contact for the mother and baby.12 A systematic review which summarised the prevalence rates of childbirth-related PTSD found that 4.7% of mothers and 1.2% of fathers met the threshold for childbirth-related PTSD. This study also found that 12.3% of mothers and 1.3% of fathers experienced post-traumatic stress symptoms which were subthreshold to the PTSD criteria.13 The NICE guidelines for antenatal and postnatal mental health recommend that trauma-focused cognitive behavioural therapy or EMDR should be offered to women who suffer from PTSD resulting from a traumatic birth.14
There have been several systematic reviews conducted, which have reviewed research related to psychological interventions for birth trauma and have included EMDR interventions as described by Furuta et al, Cunen et al, de Bruijn et al 11 15 16 and Baas et al.17 However, these reviews found a limited number of studies where EMDR was the primary intervention. A scoping review18 of the clinical effectiveness of psychological interventions to reduce PTSD symptoms following childbirth and a meta-synthesis of facilitators and barriers to accessing psychological care included only one study related to EMDR. The authors explain that a number of other studies were found during their search process; however, these studies did not meet their inclusion criteria. They recommended that further research should address this gap in the literature. Similarly, a recent scoping review19 evaluated psychological interventions for traumatic childbirth. They did not include EMDR in their review; however, they described it as a promising treatment intervention and recommended that it be explored in future research for birth trauma. A systematic review and meta-analysis20 of clinical trials, which evaluated interventions that aimed to prevent or treat PTSD following childbirth, included four studies related to EMDR. However, their inclusion criteria were limited to only including clinical trials. Therefore, while the reviews in the current literature indicate promising results for EMDR as a treatment for birth trauma, they only include a limited amount of studies. Furthermore, there appears to be a gap in the literature for a scoping review focusing on the available literature regarding EMDR, specifically, as a treatment for birth trauma.
A preliminary search of MEDLINE, The Cochrane Database of Systematic Reviews and Joanna Briggs Institute (JBI) Evidence Synthesis was conducted and no current or underway systematic reviews or scoping reviews on the topic were identified.
Objectives
The main objective of this scoping review is to explore the extent of the currently available research and to identify knowledge gaps regarding the use of EMDR in the treatment for birth trauma. This aim of this review is to answer the research question: what does the existing literature show about the use of EMDR as a psychological treatment for birth trauma?
Methods and analysis
The methodology of this review will follow the JBI Manual for Evidence Synthesis methodology for scoping reviews.21 The Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR)22 will be used to report the scoping review. This scoping review protocol has been registered on Open Science Framework.23 The registration DOI is: https://doi.org/10.17605/OSF.IO/UJZ52.
Eligibility criteria
The following inclusion and exclusion criteria were developed with the aim to address the research question while allowing for a wide scope of the literature related to this area. Two independent researchers will screen and select studies based on the inclusion and exclusion criteria. Any disagreement between them over the eligibility of particular studies will be resolved through discussion with a third reviewer.
Inclusion
Participants are any individuals, including women or partners who have experienced birth trauma.
The concept is EMDR as a therapeutic intervention for birth trauma.
The context is any setting where EMDR was facilitated including online or in person, in clinical or community-based settings.
Research that includes individuals who have experienced birth trauma with comorbid mental health difficulties will be included, once there are outcomes related to trauma available.
Any research design will be included, incorporating both qualitative and quantitative research.
Exclusion
Research that focuses on EMDR for other mental health difficulties where trauma is not mentioned.
Research regarding EMDR treatment for other types of trauma that is not related to childbirth.
Research where EMDR was not the treatment intervention for birth trauma.
Research not written in the English language.
Information sources and search strategy
The Peer Review of Electronic Search Strategies Checklist24 was used when creating this search strategy. The search strategy was also discussed with the health research methods librarian at the University of Limerick.
SO’D will conduct a scoping literature search in PsychInfo, PubMed, Embase, the Cochrane Library, Scopus and CINAHL from the date the database was developed until approximately August 2026. The grey literature will also be considered for inclusion in this scoping review using possible databases such as Proquest and OpenGrey. The reference lists of included papers will also be reviewed to search for any further relevant studies. Covidence25 will be used to manage the data. The search terms include EMDR, trauma and birth.
The following is an example of a full search strategy for PubMed:
((“Eye Movement Desensitization Reprocessing”[MeSH Terms] OR “eye movement desensiti* reprocess*“[Title/Abstract] OR “Eye Movement Desensiti* Therap*” [Title/Abstract] OR “EMDR”[Title/Abstract]))
AND
((“stress disorders, post traumatic”[MeSH Terms] OR “post traumatic stress disorder*“[Title/Abstract] OR “posttraumatic stress disorder*“[Title/Abstract] OR “post-traumatic stress disorder” [Title/Abstract] OR “PTSD”[Title/Abstract] OR “trauma*")))
AND
(((“Parturition”[Mesh] OR “pregnancy” [Mesh] OR “pregnant people” [Mesh]) OR (“Parturition”[Title/Abstract] OR “childbirth”[Title/Abstract] OR “Birth”[Title/Abstract] OR “labor”[Title/Abstract] OR “labour”[Title/Abstract] OR “postnatal”[Title/Abstract] OR “birth-related”[Title/Abstract] OR “birth related”[Title/Abstract]) OR "pregnan*[Title/Abstract])))
Study records
This scoping review will consider quantitative studies such as randomised controlled trials, non-randomised controlled trials, prestudies and poststudies and prospective and retrospective cohort studies and case studies. Qualitative studies will also be considered that focus on qualitative data including, but not limited to, designs such as phenomenology, grounded theory and ethnography.
The proposed scoping review will be conducted in accordance with the JBI methodology for scoping reviews.21 A pilot screening process will be conducted before study selection occurs. This stage is to ensure that the inclusion and exclusion criteria are feasible and are identifying appropriate studies. This stage is to identify potential difficulties in the screening process so amendments can be made before full screening occurs. A random sample of studies will be chosen from the database after applying the search string. Two reviewers will independently screen the title and abstract of these papers and decide if they meet the inclusion criteria or not. The reviewers will compare their findings to ensure consistency. If any discrepancies occur, they will be discussed and criteria may need to be altered to ensure clarity for full-scale screening. Any outcomes of the pilot study will be documented. Covidence25 will be used to manage the data.
The study selection process will be completed in three phases.
Title and abstract screening: SO’D and LW will independently screen titles and abstracts which are identified from the database searches and the grey literature, based on the inclusion criteria as outlined above. Included studies will be imported to Covidence25 and duplicates will be removed. Each reviewer will label each study as ‘include’ ‘exclude’ or ‘maybe’. Studies labelled ‘include’ and ‘maybe’ will be screened at the full-text screening stage.
Full-text screening: SO’D and LW will independently review the full-text documents to ensure each study meets the inclusion criteria. Any study which is excluded at this stage will be reported.
Conflict resolution: any disagreement between the two researchers over the eligibility of particular studies will be resolved through discussion with a third reviewer, RM.
A data extraction form will be developed, which includes the rules for data extraction. The form will be reviewed by the research team and piloted using a small sample of studies. The form will be revised due to the outcome of this pilot to ensure it is fit for purpose.
Missing data will be documented, where possible. The research team will endeavour to access missing data through contact with the corresponding author where feasible and if available.
Data items
SO’D and LW will independently extract data using Covidence25 and compare their data extraction. Any discrepancies will be resolved with a third reviewer, RM.
Where data allows, the proposed data extraction headings for the review paper may include: authors, year of publication, country of origin, aims / purpose, methods, outcome measures used including primary outcomes and secondary outcomes, intervention delivery / duration, results reported, sample size, session numbers, controls, comorbidities, key findings relating to the scoping review and limitations.
Primary outcomes of this review will include the use of EMDR for birth trauma, as defined above. Secondary outcomes may be included, such as changes in comorbid difficulties. Primary outcomes will be prioritised, and secondary outcomes may be included to add further information to the review.
Data synthesis
Data cleaning will be conducted prior to data synthesis. This will be done by SO’D and LW, by cross-referencing data with the original paper, double-checking entries and removing duplicates or irrelevant information on Covidence.25 Both reviewers will ensure data are stored consistently. Any changes made during data cleaning will be documented.
The PRISMA-ScR22 will be used to report the scoping review. Data will be analysed in a descriptive and thematic manner to provide a comprehensive understanding of the research addressing the use of EMDR for birth trauma. Results will summarise the characteristics of each study, including the details of the EMDR intervention and results reported, which will be presented in this review in both tabular and narrative formats.
Patient and public involvement
Patients or the public were not involved in the design, conduct, reporting or dissemination plans of our research.
Ethics and dissemination
Ethical approval will not be required for this review as only secondary data are being reviewed. This review will be written with the aim of being disseminated in relevant journal articles and at psychological conferences.
Ethics statements
Patient consent for publication
Ethics approval
Not applicable.
Footnotes
X @ruthmelia3
Contributors SO’D developed this scoping review protocol. RM critically reviewed this protocol. LW will be the second reviewer in this scoping review and will screen and extract data. SO’D is the guarantor of this review.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Patient and public involvement Patients and/or the public were not involved in the design, conduct, reporting or dissemination plans of this research.
Provenance and peer review Not commissioned; externally peer reviewed.