A Feasibility and Acceptability Trial of Narrative Exposure Therapy During Pregnancy

Perinatal posttraumatic stress disorder (PTSD) poses a significant risk to maternal and infant mental and physical health. Addressing PTSD during pregnancy is crucial to improving perinatal health; however, evidence-based trauma-focused psychotherapy tailored to this population remains understudied. The current study examined the feasibility, acceptability, and potential treatment effects of Narrative Exposure Therapy (NET) in a diverse sample that includes Black/African American and Hispanic/Latina pregnant women. Pregnant participants (N = 29) in this nonrandomized, open-label trial received a course of NET and completed assessment measures before treatment, one-week and one-month posttreatment, and at one-month postpartum. Measures of feasibility (treatment engagement and retention) and acceptability (participant pretreatment expectations and posttreatment feedback) were examined. Exploratory analyses examined within-subjects changes in PTSD and depression symptoms to investigate potential treatment effects. The majority of participants reported positive pretreatment expectations of NET (91.3%), and a high degree of satisfaction (69.6%) and perceived benefit (100%) from NET posttreatment. Linear mixed models showed significant decreases in PTSD and depressive symptoms over time, with sustained symptom improvement extending into the postpartum period. Within-subjects effect size calculations revealed large treatment effects from pretreatment to one-week posttreatment and from pretreatment to postpartum for both PTSD and depression symptoms. Findings suggest that NET is feasible, acceptable, and beneficial during pregnancy, including among minoritized populations, and suggest it is an appropriate approach to treating perinatal PTSD.