Warning message

This content is filtered. APPPAH membership is required for full access to journal articles.
-A +A
Publication Date: 
December, 2020
Page Count: 
Starting Page: 
Brief Summary: 

The purpose of this article is to inform about trauma conditions and dissociative processes that are often present, yet buried in pregnant women’s consciousness due to defensive adaptation, and to provide information about the different types of screening tools designed to identify unsettled trauma in the mother. 


Hidden, unresolved traumatic stress caused by childhood adverse experiences often impacts women before their childrearing years with implications for their prenatal bonding, obstetric experience, and their ability to parent children. The purpose of this article is to inform about trauma conditions and dissociative processes that are often present, yet buried in pregnant women’s consciousness due to defensive adaptation, and to provide information about the different types of screening tools designed to identify unsettled trauma in the mother. The Calming Womb Family Therapy Model (CWFTM) integrates questionnaire findings, trauma-informed interventions, and collaborative care to treat and prevent intergenerational trauma, and nurture relational attunement with parents and babies from conception through the first year after birthing.


Alaggia, R., Collin-Vézina, D., & Lateef, R. (2017). Facilitators and barriers to child sexual abuse (CSA) disclosures: A research update (2000–2016). Sage Journals, 20(2), 260—283. https://doi.org/10.1177/1524838017697312

Bernstein, E.M., & Putnam, F.W. (1986). Development, reliability, and validity of a dissociation scale. The Journal of Nervous and Mental Disease, 174(12), 727–735. https://doi.org/10.1097/00005053-198612000-00004

Bowen, M. (1966). Family therapy in clinical practice. Jason Aronson.

Bowen, M. (1976). Family therapy: Theory and practice therapy. Gardner Press.

Chefetz, R. (2015). Intensive psychotherapy for persistent dissociative processes: The fear of feeling real. W.W. Norton & Company, Inc.

Collin-Vézina, D., Sablonni, D.L., Palmer, A.M., & Milne, L. (2015). A preliminary mapping of individual, relational, and social factors that impede disclosure of childhood sexual abuse. Child Abuse & Neglect, 43, 123–134. https://doi:10.1016/j.chiabu.2015.03.010

Cortizo, R. (2019). The calming womb family therapy model: Bonding mother and baby from pregnancy forward. Journal of Prenatal and Perinatal Psychology and Health, 33(3), 207—220.

Cortizo, R. (2020). Prenatal and perinatal EMDR therapy: Early family intervention. Journal of EMDR Practice and Research, 14(2), 104—115. https://doi.org/10.1891/EMDR-D-19-00046

Cox, J.L., Holden, J.M., & Sagovsky, R. (1987). Detection of postnatal depression: Development of the 10-item Edinburgh Postnatal Depression Scale. British Journal of Psychiatry, 150, 782–786. https://doi.org/10.1192/bjp.150.6.782

Dalenberg, C., & Carlson, E. (2010). Brief Dissociative Experiences Scale (DES-B). Modified for the DSM-V by C. Dalenberg and E. Carlson.

Dumont, M., Messerschmitt, P., Vila, G., Bohu, D., & Rey-Salmon, C. (2014). Le processus de révélation dans les agressions sexuelles intrafamiliales et extrafamiliales sur mineurs [The disclosure process in intra-family and extra-family sexual assault in minors]. Annales Médico-Psychologiques [Medico-Psychological Annals], 172, 426–431. https://doi.org/10.1016/j.amp.2012.06.024

Easton, S.D. (2013). Disclosure of child sexual abuse among adult male survivors. Clinical Social Work Journal, 41, 344–355. https://doi.org/10.1007/s10615-012-0420-3

Felliti, V.J., Anda, R.F., Nordenberg, D., Williamson, D.F., Spitz, A.M., Edwards, V., Koss, M.P., & Marks, J.S. (1998). Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults. The adverse childhood experiences (ACE) study. American Journal of Preventive Medicine, 14(4), 245—258.

Fraiberg, S. (1980). Clinical studies in infant mental health: The first year of life. Basic Books, Inc.

Freyd, J. (1996). Betrayal trauma: The logic of forgetting childhood abuse. Harvard University Press.

Herman, J., & Schatzow, E. (1987). Recovery and verification of memories of childhood sexual trauma. Psychoanalytical Psychology, 4(1), 1—14.

International Society for the Study of Trauma and Dissociation (ISSTD). (2011). Guidelines for treating dissociative identity disorder in adults. Journal of Trauma & Dissociation, 12, 115–187. https://doi.org/10.1080/15299732.2011.537247

Kaplan, L.A., Evans, L., & Monk, C. (2008). Effects of mothers’ prenatal psychiatric status and postnatal caregiving on infant biobehavioral regulation: Can prenatal programming be modified? Early Human Development, 84(8), 249—256. https://doi.org/10.1016/ j.earlhumdev.2007.06.004

Klaus, H., Kennell, J., & Klaus, P. (1996). Bonding: Building the foundations of secure attachment and independence. Addison-Wesley.

Kroenke, K., Spitzer, R.L., & Williams, J.B. (2001). The PHQ-9: Validity of a brief depression severity measure. Journal of General Internal Medicine, 16(9), 606—613. https://doi.org/10.1046/j.1525-1497.2001.016009606.x

Lipton, B. (2005). The biology of belief: Unleashing the power of consciousness. Mountain of Love Elite Books.

Lowe, B., Unutzer, J., Callahan, C., Perkins, A., Kroenke, K. (2004). Monitoring depression treatment outcomes with the Patient Health Questionnaire-9. Medical Care, 42(12), 1194—1201. https://doi.org/10.2307/4640875

Mongan, M.F. (2015). Hypnobirthing: The Mongan Method: The natural approach to safer, easier, more comfortable birthing, 4th edition. Health Communications, Inc.

Nathanielsz, P.W. (1999). Life in the womb: The origin of health and disease. Promethean Press.

Putnam, F., & Trickett, P. (1997). The psychobiological effects of sexual abuse. A longitudinal study. In R. Yehuda & A.C. McFarlane (Eds.), Annals of the New York Academy of Sciences: Vol. 821. Psychobiology of posttraumatic stress disorder (pp. 150–159). New York Academy of Sciences.

Putnam F., & Trickett, P. (1987). The psychobiological effects of child sexual abuse. W.T. Grant Foundation.

Seng, J., Low, L., Sperlich, M., Ronis, D., & Liberzon, I. (2009). Prevalence, trauma history and risk of posttraumatic stress disorder among nulliparous women in maternity care. Obstetrics and Gynecology, 114(4), 839—847. https://doi.org/10.1097/AOG.0b013e3181b8f8a2

Seng, J., Low, L., Sperlich, M., Ronis, D., & Liberzon, I. (2011). Posttraumatic stress disorder, child abuse history, birth weight, and gestational age: A prospective cohort study. An International Journal of Obstetrics and Gynaecology, 1329—1339. https://doi.org/ 10.1111j.1471-0528.2011.03071.x

Seng, J., Rauch, S.A.M., Resnick, H., Reed, C.D., King, A., Low, L.K., McPherson, M., Muzik, M., Abelson, J., & Liberzon, I. (2010). Exploring posttraumatic stress disorder symptom profile among pregnant women. Journal of Psychosomatic Obstetrics & Gynecology, 31(3), 176—187. https://doi.org/10.3109/0167482X.2010.486453

Seng, J., Sperlich, M., Low, L., Ronis, D., Muzik, M., & Liberzon, I. (2013). Childhood abuse history, posttraumatic stress disorder, postpartum mental health and bonding: A prospective cohort study. Journal of Midwifery and Women’s Health, 58(1), 57—68. https://doi.org/101111/j.1542-2011.2012.00237.x

Singh, M.M., Parsekar, S.S., & Nair, S.N. (2014). An epidemiological overview of child sexual abuse. Journal of Family Medicine and Primary Care3(4), 430—435. https://doi.org/10.4103/2249-4863.148139

Shapiro, F. (2018). Eye movement desensitization and reprocessing (EMDR) therapy: Basic principles, protocols, and procedures. Guilford Press.

Schuder, M.R., & Lyons-Ruth, K. (2004). ”Hidden trauma” in infancy: Attachment, fearful arousal, and early dysfunction of the stress response system. In J.D. Osofsky (Ed.), Young children and trauma: Intervention and treatment (pp. 69—104). Guilford Press.

Stoltenborgh, M., Bakermans‐Kranenburg, M., Alink, L., & van IJzendoorn, M. (2014). The prevalence of child maltreatment across the globe: Review of a series of meta-analyses. Child Abuse Review, 24(1), 37—50. https://doi.org/10.1002car.2353

Van der Hart, O., & Nijenhuis, E. (1995). Amnesia for traumatic experiences. Hypnosis, 4, 417– 455.

Van der Kolk, B. (2014). The body keeps the score: Brain, mind, and body in the healing of trauma. Penguin Random House Company.

Van der Kolk, B., & Fisler, R. (1995). Dissociation and the fragmentary nature of traumatic memories: Review and experimental confirmation. Journal of Traumatic Stress, 8(4), 505—525.

Verny, T. (2018). Prenatal psychology 100 years: A journey in decoding how our prenatal experience shapes who we become. Cosmoanelixis.

Weinstein, A.D. (2016). Prenatal development and parents’ lived experiences: How early events shape our psychophysiology and relationships. W.W. Norton & Company, Inc.

Wihbey J. (November 15, 2011). Global prevalence of child sexual abuse. Journalist Resourcewww.Journalistsresource.org/studies/ ./ global-prevalence-child-sexual-abuse.

William, L. (1995). Recovered memories of abuse in women with documented child sexual victimization histories. Journal of Traumatic Stress, 8, 649—674.

Zhong, Q., Gelaye, B., Rondon, M., Sanchez, S., Garcia, P., Sanchez, E., Barrios, Y., Simon, G., Henderson, D., Cripe, S., & William, M. (2014). Comparative performance of patient health questionnaire-9 and Edinburg Postnatal Depression Scale for screening antepartum depression. Journal of Affective Disorders, 162, 1—7. https://doi.org/10.1016/j.jad.2014.03.028