# The effects of expressive writing following traumatic childbirth

> **NIH NIH R21** · MASSACHUSETTS GENERAL HOSPITAL · 2024 · $210,000

## Abstract

PROJECT SUMMARY
Maternal mental illness following childbirth is associated with substantial public health burden. Postpartum
psychopathology is a leading contributor of maternal morbidity and mortality and can endanger the child’s
wellbeing onward from birth. This suggests intergenerational effects. While efforts exist to reduce postpartum
depression, childbirth-related posttraumatic stress disorder (CB-PTSD), a condition that affects 240,000
American women each year, is underdiagnosed and undertreated. The adversity of CB-PTSD is demonstrated
by 1) the close temporal relationship between the onset of CB-PTSD symptoms and the birth of the infant, 2) the
child themselves becoming an unfortunate, constant reminder of the trauma (childbirth), which can distance the
mother from the child during an important time for the formation of mother-infant bonding instrumental for healthy
child development. Symptoms of PTSD follow a distinct triggering event and early signs appear in the period
after a traumatic experience, providing a unique opportunity for an intervention of targeted individuals during a
critical window when treatment could avert the PTSD symptom trajectory. This means that at-risk individuals
could be approached and screened in the hospital following childbirth and receive an early intervention to buffer
CB-PTSD symptoms and optimize mother and child outcomes. In this randomized controlled trial (RCT), we
identify individuals who have acute stress response in the hours following delivery indicative of risk for
subsequent CB-PTSD. They will be randomized to take part in a brief expressive writing (EW) about their recent
childbirth or about a neutral experience over 3 consecutive days starting from Day 5 postpartum (PP). We will
then follow them at repeated time points, to assess immediate (Day 8 PP) and sustained (Mo. 2) treatment
effects. Their infants will be studied at Mo. 2 PP to examine the influence of the intervention on the foundation
of mother-infant bonding. Maternal CB-PTSD will be quantified using psychodiagnostic, psychometric, and
psychophysiologic measures and mother-infant bonding using psychometrics and a behavioral observational
assessment of mother-child interaction. This study will begin to fill the critical clinical gap in interventions to
support maternal mental health following traumatic childbirth and enhance opportunities for maternal resilience
and psychological growth. Establishing an effective intervention, may lead to the implementation of a safe,
feasible, cost-effective therapy in hospital settings that is adherent to the special needs of mothers, thereby
reducing the odds of developing a potentially preventable, costly, posttraumatic disorder and fostering healthy
child development. In addition, the proposed study will further the NICHD missions that “women avoid harmful
effects from reproductive processes and children achieve healthy and productive lives.”

## Key facts

- **NIH application ID:** 10774333
- **Project number:** 5R21HD109546-02
- **Recipient organization:** MASSACHUSETTS GENERAL HOSPITAL
- **Principal Investigator:** Sharon Dekel
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $210,000
- **Award type:** 5
- **Project period:** 2023-02-02 → 2026-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10774333

## Citation

> US National Institutes of Health, RePORTER application 10774333, The effects of expressive writing following traumatic childbirth (5R21HD109546-02). Retrieved via AI Analytics 2026-05-27 from https://api.ai-analytics.org/grant/nih/10774333. Licensed CC0.

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