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Healing and Hope: Working with trauma and loss in the perinatal period

Heather O’Mahen, Sarah Healy

11 Jan 2024


PTSD during pregnancy or in the postnatal period is common, affecting 3-8% of parents. PTSD may occur as a result of trauma that has happened during the perinatal period (e.g., due to childbirth trauma or infant loss) or may be pre-existing (e.g., childhood maltreatment). Perinatal loss, or loss occurring during pregnancy or the death of the baby during the following postnatal period, may include miscarriage, termination of pregnancy, ectopic pregnancy, molar pregnancy, still birth, neonatal death, and sudden unexpected death in infancy (SUDI). Perinatal loss is often traumatic, commonly occurring suddenly and sometimes without clear understanding of the reason for the loss. Perinatal loss increases women’s risk of PTSD, with 7-28% of women meeting diagnostic criteria for PTSD a 3-12 months after the loss of the baby. 

PTSD that occurs during the perinatal period can be especially challenging because parents are often inescapably confronted with many of their trauma triggers and fears (e.g., in subsequent pregnancies, caring for infant). PTSD can significantly affect the parent’s experience of pregnancy, childbirth, their relationship with their partner and feelings of bonding with the infant. These experiences require thoughtful treatment adaptation. This workshop will address how to adapt evidence-based treatments for PTSD to the perinatal period. 

The event will be equivalent to 5.1/2hrs of CPD.


This workshop will:
• Provide an understanding of the research on both acute (perinatal) and chronic/complex trauma on perinatal mental health.
• Provide an understanding of the prevalence and impact of perinatal loss
• Consider how to conduct a comprehensive assessment for PTSD following perinatal loss
• Provide considerations about how to adapt trauma focussed approaches for the perinatal period
• Provide strategies for working with exposure-based approaches for trauma in the perinatal period
• Discuss approaches for working collaboratively with perinatal health and mental health professionals around PTSD in the perinatal period
• Consider ways to hold baby in mind during treatment for trauma in the perinatal period
• Share tips for including partners in treatment.

Learning Objectives

You will learn:
• How trauma may impact on mental health and the parent-infant relationship during the perinatal period
• What is unique about perinatal loss and the impact of perinatal loss on mental health
• How interventions can be applied in the context of a formulation that includes loss
• The research base on the safety of exposure-based approaches during pregnancy
• Perinatal factors to consider in assessment
• Tips on how to adapt treatment to keep baby in mind
• Timing and sequencing treatment components for PTSD in the perinatal period
• Strategies to help couples manage treatment for PTSD in the perinatal period. When behavioural experiments may enhance cognitive restructuring

Training Modalities

Didactic content, case study examples, experiential components, polls, Q&A.

Key References

Stevens, N. R., Miller, M. L., Soibatian, C., Otwell, C., Rufa, A. K., Meyer, D. J., & Shalowitz, M. U. (2020). Exposure therapy for PTSD during pregnancy: a feasibility, acceptability, and case series study of Narrative Exposure Therapy (NET). BMC psychology, 8, 1-18.

Cloitre, M., Cohen, L. R., Ortigo, K. M., Jackson, C., & Koenen, K. C. (2020). Treating survivors of childhood abuse and interpersonal trauma: STAIR narrative therapy. Guilford Publications.

Arch, J. J., Dimidjian, S., & Chessick, C. (2012). Are exposure-based cognitive behavioral therapies safe during pregnancy?. Archives of women's mental health, 15, 445-457.

Baas, M. A., van Pampus, M. G., Braam, L., Stramrood, C. A., & de Jongh, A. (2020). The effects of PTSD treatment during pregnancy: systematic review and case study. European Journal of Psychotraumatology, 11(1), 1762310.

Becker-Sadzio, J., Gundel, F., Kroczek, A., Wekenmann, S., Rapp, A., Fallgatter, A. J., & Deppermann, S. (2020). Trauma exposure therapy in a pregnant woman suffering from complex posttraumatic stress disorder after childhood sexual abuse: risk or benefit?. European Journal of Psychotraumatology, 11(1), 1697581.

Baas, M. A. M., van Pampus, M. G., Stramrood, C. A. I., Dijksman, L. M., Vanhommerig, J. W., & de Jongh, A. (2022). Treatment of Pregnant Women With Fear of Childbirth Using EMDR Therapy: Results of a Multi-Center Randomized Controlled Trial. Frontiers in psychiatry, 12, 2504.

Christiansen DM. Posttraumatic stress disorder in parents following infant death: A systematic review. Clin Psychol Rev. 2017 Feb 1; 51:60–74.

Herbert D, Young K, Pietrusińska M, MacBeth A. The mental health impact of perinatal loss: A systematic review and meta-analysis. J Affect Disord. 2022 Jan 15;297: 118–29.

Malouf, R., Harrison, S., Burton, H. A., Gale, C., Stein, A., Franck, L. S., & Alderdice, F. (2022). Prevalence of anxiety and post-traumatic stress (PTS) among the parents of babies admitted to neonatal units: A systematic review and meta-analysis. EClinicalMedicine, 43, 101233.

Farren J, Jalmbrant M, Ameye L, Joash K, Mitchell-Jones N, Tapp S, et al. Post-traumatic stress, anxiety and depression following miscarriage or ectopic pregnancy: a prospective cohort study. BMJ Open. 2016;6(11):e011864–e011864.

Gold KJ, Leon I, Boggs ME, Sen A. Depression and Posttraumatic Stress Symptoms After Perinatal Loss in a Population-Based Sample. J Womens Health 2002. 2016 Mar;25(3):263–9.

Daugirdaite V, Akker O van den, Purewal S. (2015) Posttraumatic stress and posttraumatic stress disorder after termination of pregnancy and reproductive loss: a systematic review. J Pregnancy, 33, 1-14.

Horesh, D., Garthus-Niegel, S., & Horsch, A. (2021). Childbirth-related PTSD: is it a unique post traumatic disorder?. Journal of Reproductive and Infant Psychology, 39(3), 221-224.

About the presenter

Heather O’Mahen is Professor of Perinatal and Clinical Psychology at the University of Exeter. She is also a National Clinical Advisor to NHS England’s Perinatal Mental Health policy team. She has over 60 publications in the field of the development and evaluation of treatments for common mental health problems, particularly in the perinatal period, and transdiagnostic emotion-regulation problems such as rumination and memory processes and how these impact on perinatal mental health, bonding and the parent-infant relationship. She is one of the pioneers of the use of digital treatments in perinatal mental health. She is the recipient of several NIMH, NIHR, and MRC grants, most recently leading a large scale NIHR HSDR grant evaluating the effectiveness of perinatal community mental health teams. Professor O’Mahen is also involved in leading the HEE funded national Continuing Professional Development training programme for perinatal psychologists, and the HEE funded SW NHS Talking Therapies Perinatal Champion Training.

Sarah Healy is a specialist Perinatal Clinical Psychologist with extensive experience delivering evidence-based psychological therapies to those in the perinatal period. Clinically, she has experience working in roles across the care pathway, including as the Perinatal Lead in an IAPT service, in Mother and Baby Units and Specialist Perinatal Community teams. She holds postgraduate qualifications in CBT, EMDR and Behavioural Couples Therapy and has also trained in CFT, and ACT. Dr Healy is currently the Clinical Director of the Perinatal Psychology Practice, a private therapy service. She lectures on the Tavistock Perinatal Mental Health Course, is an Associate Clinical Tutor at UCL, and regularly lectures in academic and clinical settings.

Heather and Sarah together led the NHS Talking Therapies perinatal competency framework and the revised NHS Talking Therapies Perinatal Positive Practice Guide.

Who should attend

This webinar is most suitable for practitioners delivering high intensity interventions for perinatal PTSD and trauma in primary care and Maternal Mental Health Services.

Low Intensity clinical contact hours survey - BABCP Low Intensity Special Interest Group

Please click below if you are interested in contributing to the survey.


The BACP Low Intensity SIG are interested in the impact of clinical contact hours on Low Intensity/Wellbeing Practitioner wellbeing. This questionnaire contains six multi-choice questions and a free text box for you to share your experiences. The answers to these questions will help the BABCP SIG plan how to meet CPD topics and other developments within the SIG.  The SIG hope to produce a write up of the answers to this questionnaire to be shared with SIG members and to be used in training.

View Survey

This FREE conference is for Psychological Wellbeing Practitioners working in Talking Therapies for Anxiety and Depression services and is brought to you by Bespoke Mental Health in collaboration with the NHS England Talking Therapies National PWP Leads Network

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