Preventing Childbirth-Related PTSD With Expressive Writing

NCT ID: NCT05662423

Last Updated: 2025-12-26

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Clinical Phase

NA

Total Enrollment

136 participants

Study Classification

INTERVENTIONAL

Study Start Date

2023-11-08

Study Completion Date

2026-01-31

Brief Summary

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The goal of this clinical trial is to test a brief psychological intervention given to individuals in the first days following childbirth who have experienced a potentially stressful childbirth. The treatment is aimed at preventing post-traumatic stress disorder following childbirth and promoting maternal-infant bonding.

In the days following childbirth, participants will be asked to write about their childbirth experience or a neutral event for three consecutive days, for around 15 minutes each day. Additionally, they will complete a short survey before and after the intervention about their birth experience and mental health. Around 2 months postpartum (with the option of up to around Month 3 PP), participants will take part in mental health and physiological assessments, and in a brief play session with their infant.

Detailed Description

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Childbirth-related PTSD (CB-PTSD) is a debilitating maternal mental disorder that undermines the well-being of mothers and can interfere with bonding with their infants during an important time of infant development. A significant portion of delivering women, particularly those who have experienced complicated deliveries, are at-risk for developing CB-PTSD. Underrepresented minorities are also at higher risk for CB-PTSD. An estimated 240,000 American women are likely to be affected by CB-PTSD each year.

Currently, there is no recommended intervention for individuals exposed to traumatic childbirth in hospitals in the United States. Immediate postpartum interventions delivered to at-risk women that are low-cost, low-burden, and feasible are lacking. This study will attempt to fill this gap in effective treatment. Evidence shows that expressive writing (EW), or briefly disclosing in writing mainly thoughts and feelings about a highly stressful event, can have positive effects on mental and physical health. Therefore, the investigators will test the therapeutic effects of EW about recent childbirth in women at-risk for CB-PTSD.

Conditions

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PTSD (Childbirth-Related)

Keywords

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Mother-Infant Bonding Postpartum Depression Postpartum PTSD Expressive Writing

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

PREVENTION

Blinding Strategy

DOUBLE

Investigators Outcome Assessors

Study Groups

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Expressive Writing about Childbirth

Subgroup of participants will write about their recent childbirth.

Group Type ACTIVE_COMPARATOR

Expressive Writing about Childbirth

Intervention Type BEHAVIORAL

Participants will write repeatedly about their deepest emotions and thoughts related to their recent childbirth, focusing on the most stressful experiences.

Neutral Writing

Subgroup of participants will write about neutral daily events.

Group Type PLACEBO_COMPARATOR

Neutral Writing

Intervention Type BEHAVIORAL

Participants will write repeatedly about neutral daily events/tasks not related to childbirth.

Interventions

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Expressive Writing about Childbirth

Participants will write repeatedly about their deepest emotions and thoughts related to their recent childbirth, focusing on the most stressful experiences.

Intervention Type BEHAVIORAL

Neutral Writing

Participants will write repeatedly about neutral daily events/tasks not related to childbirth.

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

* Women who recently delivered at Massachusetts General Hospital (MGH).
* Women who are at risk for developing CB-PTSD based on their scoring of \>16 on the Peritraumatic Distress Inventory (PDI).

Exclusion Criteria

* Age \<18 or \>50.
* Stillbirth.
* Down's Syndrome, other serious genetic disorder in the newborn, or serious birth defect (e.g., microcephaly, spina bifida).
* Admission to the neonatal intensive care unit (NICU) for more than 1 week or infant that is not medically healthy.
* Current diagnosable DSM-5 psychotic or bipolar disorder, or current substance abuse disorder.
* Active suicidality (assessed case by case).
* Present substance abuse as indicated in medical records.
* Severe maternal morbidity (assessed case by case).
* General anesthesia.
* Inability to understand the study procedures, risks, and side effects, or to otherwise give informed consent for participation due to neurological or other reasons.
* Inability to understand English.
Minimum Eligible Age

18 Years

Maximum Eligible Age

50 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

Yes

Sponsors

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Massachusetts General Hospital

OTHER

Sponsor Role lead

Responsible Party

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Sharon Dekel, PhD

Assistant Professor in Psychology

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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Massachusetts General Hospital

Boston, Massachusetts, United States

Site Status RECRUITING

Countries

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United States

Central Contacts

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Sharon Dekel, Ph.D. M.Phil., M.S.

Role: CONTACT

Phone: 617-726-1352

Email: [email protected]

Facility Contacts

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Sharon Dekel, Ph.D., M.Phil., M.S.

Role: primary

References

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Yildiz PD, Ayers S, Phillips L. The prevalence of posttraumatic stress disorder in pregnancy and after birth: A systematic review and meta-analysis. J Affect Disord. 2017 Jan 15;208:634-645. doi: 10.1016/j.jad.2016.10.009. Epub 2016 Oct 27.

Reference Type BACKGROUND
PMID: 27865585 (View on PubMed)

Pennebaker JW. Expressive Writing in Psychological Science. Perspect Psychol Sci. 2018 Mar;13(2):226-229. doi: 10.1177/1745691617707315. Epub 2017 Oct 9.

Reference Type BACKGROUND
PMID: 28992443 (View on PubMed)

Pennebaker JW. Putting stress into words: health, linguistic, and therapeutic implications. Behav Res Ther. 1993 Jul;31(6):539-48. doi: 10.1016/0005-7967(93)90105-4.

Reference Type BACKGROUND
PMID: 8347112 (View on PubMed)

Dekel S, Thiel F, Dishy G, Ashenfarb AL. Is childbirth-induced PTSD associated with low maternal attachment? Arch Womens Ment Health. 2019 Feb;22(1):119-122. doi: 10.1007/s00737-018-0853-y. Epub 2018 May 21.

Reference Type BACKGROUND
PMID: 29786116 (View on PubMed)

Dekel S, Stuebe C, Dishy G. Childbirth Induced Posttraumatic Stress Syndrome: A Systematic Review of Prevalence and Risk Factors. Front Psychol. 2017 Apr 11;8:560. doi: 10.3389/fpsyg.2017.00560. eCollection 2017.

Reference Type BACKGROUND
PMID: 28443054 (View on PubMed)

Chan SJ, Thiel F, Kaimal AJ, Pitman RK, Orr SP, Dekel S. Validation of childbirth-related posttraumatic stress disorder using psychophysiological assessment. Am J Obstet Gynecol. 2022 Oct;227(4):656-659. doi: 10.1016/j.ajog.2022.05.051. Epub 2022 May 29.

Reference Type BACKGROUND
PMID: 35640702 (View on PubMed)

Dekel S, Ein-Dor T, Dishy GA, Mayopoulos PA. Beyond postpartum depression: posttraumatic stress-depressive response following childbirth. Arch Womens Ment Health. 2020 Aug;23(4):557-564. doi: 10.1007/s00737-019-01006-x. Epub 2019 Oct 25.

Reference Type BACKGROUND
PMID: 31650283 (View on PubMed)

Berman Z, Thiel F, Dishy GA, Chan SJ, Dekel S. Maternal psychological growth following childbirth. Arch Womens Ment Health. 2021 Apr;24(2):313-320. doi: 10.1007/s00737-020-01053-9. Epub 2020 Jul 23.

Reference Type BACKGROUND
PMID: 32705348 (View on PubMed)

Other Identifiers

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2022P003320

Identifier Type: -

Identifier Source: org_study_id