EFT Perinatal Care — Tapping for Pregnancy, Childbirth and Postpartum

Presentation

The perinatal period — from conception through the first year after delivery — is one of the most intense transitions in a woman's life, simultaneously mobilizing profound physiological transformations, major psychological reorganization, and considerable identity and relational rearrangements. While pregnancy and birth are often idealized as moments of pure happiness, clinical reality reveals that a significant proportion of women experience important emotional difficulties during this period: 15 to 25% of pregnant women suffer from clinically significant prenatal anxiety (Dennis et al., 2017), 10 to 15% develop prenatal depression, and 10 to 20% experience postpartum depression (Gaynes et al., 2005).

EFT (Emotional Freedom Techniques) is particularly indicated in the perinatal context for several major reasons: (1) it is a non-invasive, medication-free technique — a crucial criterion during pregnancy where pharmacological prescription is limited by teratogenic and fetal risks; (2) it can be taught for self-application, allowing the pregnant woman to use it autonomously at any time; (3) it acts simultaneously on the physical and emotional components of perinatal suffering; (4) emerging studies show promising results specifically in the perinatal context.

The pioneering study by Chatwin et al. (2016) demonstrated a significant reduction in Edinburgh Postnatal Depression Scale (EPDS) scores among women who received EFT sessions in the postpartum period. Stapleton et al. (2019) documented the efficacy of EFT on prenatal anxiety, with clinically significant anxiety score reductions maintained over time. These results are particularly remarkable in a field where validated non-pharmacological therapeutic options are limited.

Perinatal EFT does not replace standard obstetric and psychological care — it complements it. The EFT practitioner works in collaboration with the midwife, obstetrician, and perinatal psychologist, each bringing their specific competence to a comprehensive approach to the woman and the couple becoming parents.

Core Principles

1. Dyadic Safety Principle (Mother-Baby): The entire perinatal EFT protocol is designed with constant awareness of the mother-baby duo. The baby in utero perceives maternal stress hormones (cortisol, adrenaline) via the placenta, and its own physiology is directly impacted by its mother's emotional state (Van den Bergh et al., 2005). By reducing maternal stress, EFT directly contributes to fetal well-being. Tapping formulations systematically integrate the baby: "Even though I have this intense fear of childbirth, I am safe and my baby is safe too."

2. Trimester Adaptation Principle: Emotional and physical needs vary considerably throughout pregnancy. The first trimester is dominated by nausea, extreme fatigue, miscarriage anxiety, and sometimes pregnancy ambivalence. The second trimester often sees renewed energy but also emerging fears about childbirth and bodily changes. The third trimester concentrates prenatal anxiety, increasing physical discomforts, and apprehension about imminent birth. EFT protocols are adapted to each phase in content, posture, and intensity.

3. Stimulation Point Precaution Principle: Traditional Chinese Medicine identifies certain points as potentially uterine-stimulating. The SP-21 point (Dabao, located under the arm on the spleen meridian) and SP-6 (Sanyinjiao, ankle) are considered potentially contraindicated in early pregnancy. As a precaution, EFT practitioners avoid vigorous stimulation of the under-arm point during the first trimester, replacing it with gentle pressure or skipping it.

4. Maternal Empowerment Principle: A central objective of perinatal EFT is restoring the pregnant woman's sense of competence and personal power. The medicalization of pregnancy and childbirth can paradoxically contribute to a feeling of dispossession. EFT, by offering a powerful and accessible self-regulation tool, restores the woman's agency over her own emotional and physical states. Perceived control during pregnancy and childbirth is one of the most powerful protective factors against postpartum depression and birth-related PTSD.

5. Traumatic Heritage Treatment Principle: Pregnancy frequently reactivates prior traumas — childhood sexual abuse (gynecological exams and childbirth can be powerful triggers), previous obstetric traumas, birth-related traumas, and wounds in the relationship with one's own mother. EFT allows processing these traumatic legacies safely during pregnancy.

6. Partner Inclusion Principle: The partner also experiences a significant perinatal transition, often neglected. Perinatal EFT includes the partner, teaching them tapping points to physically accompany the laboring woman, or offering individual sessions for their own perinatal anxieties.

Technical Details

Main techniques

Pregnancy-adapted standard EFT (modified points and positions), simplified tapping for labor, EPDS-guided postpartum protocol

Scientific references

Chatwin et al. (2016) — significant EPDS score reduction with postpartum EFT; Stapleton et al. (2019) — EFT efficacy on prenatal anxiety; Van den Bergh et al. (2005) — maternal stress impact on fetus

Evidence level

Moderate — promising clinical studies, expanding research in the perinatal field

Applications by period

Preconception (IVF, gynecological trauma), Pregnancy T1/T2/T3, Birth preparation, During labor, Immediate and late postpartum

Session duration

45 to 60 minutes (shorter than standard to respect pregnancy fatigue)

Recommended sessions

4 to 12 sessions distributed across pregnancy and postpartum

Recommended frequency

Biweekly to weekly depending on trimester and identified needs

Assessment tools

EPDS (Edinburgh Postnatal Depression Scale), GAD-7 (anxiety), WDEQ (Wijma Delivery Expectancy Questionnaire), SUD

Points to adapt

Under-arm point (SP-21): gentle pressure or avoid in T1; seated or lateral positions in T3

Self-practice

Systematic self-EFT teaching from the first session — maximum autonomy goal

Interdisciplinary collaboration

Midwife, obstetrician, perinatal psychologist, lactation consultant

Main Indications

Pregnancy — First Trimester

• Morning sickness and hyperemesis gravidarum: tapping on the Stomach point (under the eye) combined with Karate Chop point shows clinically interesting nausea reduction results
• Miscarriage anxiety: particularly intense for women with prior miscarriage history or IVF. EFT reduces hypervigilance and catastrophic thinking without denying the fear's legitimacy
• Pregnancy ambivalence: even when desired, pregnancy can evoke contradictory emotions — joy mixed with terror, happiness mixed with loss of freedom feelings

Pregnancy — Second and Third Trimesters

• Tokophobia (fear of childbirth): affects 6–10% of pregnant women in severe form and up to 20% in moderate form (Nilsson et al., 2018). EFT allows progressive, specific desensitization of fear components
• Generalized prenatal anxiety: baby health worries, malformation fear, prenatal exam anxiety, mothering adequacy fears. Stapleton et al. (2019) demonstrated EFT's specific efficacy on this anxiety
• Pregnancy insomnia: EFT relaxation practiced at bedtime helps calm the nervous system and promote sleep onset
• Pregnancy-related low back pain and sciatica: EFT complements physiotherapy by treating the stress-tension component amplifying pain perception
• Body image and physical changes: can be distressing, especially for women with eating disorder or body dysmorphia history

Birth Preparation

• Pain fear desensitization — structured progressive desensitization of birth scenarios
• Positive anchor creation — positive tapping to anchor calm and confidence states
• Partner preparation — teaching tapping points for active labor accompaniment

During Labor

• Contraction pain management — ultra-simplified protocol using 3–4 accessible points with brief formulations rhythmed to breathing
• Panic and anxiety management — rapid crisis tapping during labor anxiety peaks

Postpartum

• Baby blues: hormonal crash combined with extreme fatigue and social pressure. EFT helps traverse without dramatization
• Postpartum depression: Chatwin et al. (2016) demonstrated significant EPDS score reductions. EFT is offered as complement to psychological/psychiatric follow-up, never as replacement
• Birth trauma: 3–4% develop post-obstetric PTSD, up to 30% report traumatic birth experience (Ayers et al., 2016). EFT uses trauma protocols (Tell the Story, Movie Technique) to reprocess: emergency cesarean, hemorrhage, forceps use, non-consent sensation, forced separation from baby
• Breastfeeding difficulties: stress inhibits prolactin and oxytocin production. EFT targets emotions creating breastfeeding stress
• Separation anxiety: terror of something happening to the baby during sleep, inability to entrust the baby, exhausting maternal hypervigilance

Session Overview

1. Welcome and global well-being assessment (10 min): Attention to physical state (fatigue, nausea, pain, sleep) and emotional state. If postpartum, EPDS check and depression warning signs. Baby welcome if present in session.
2. Priority theme identification (5–10 min): Identifying the most emotionally charged theme. SUD (0–10) assigned to the identified theme.
3. Pregnancy-adapted tapping (25–30 min): Comfortable positioning (seated with cushions, lateral at T3). Slower, gentler rhythm. Formulations systematically integrating baby and maternal bond.
4. Emotional layer exploration (10–15 min): Deeper layers often emerge beneath surface symptoms — ambivalence under nausea, old sexual trauma under birth fear, freedom grief under postpartum depression.
5. Self-EFT teaching (10 min): Identifying practice moments: upon waking for nausea, evening for sleep, before anxious medical appointments. Memo sheets with key points and formulations.
6. Closure and planning (5 min): SUD reassessment, progress celebration, next session planning aligned with obstetric calendar.

Variations and Adaptations

First Trimester Anti-Nausea Protocol: A 5-minute mini-protocol usable as self-EFT upon waking, before even getting up. The patient taps gently on Karate Chop, then facial points, with formulations focused on physical relief and acceptance. The under-eye point (Stomach 1) is particularly targeted. Practiced daily during weeks 6–14.

Tokophobia Desensitization Protocol: Structured over 4–6 sessions, decomposing childbirth fear into individually treated sub-components: pain fear, control loss fear, death fear, tearing/instrumental intervention fear, medical incompetence fear, previous traumatic birth memory. Uses Movie Technique and positive birth visualizations combined with positive tapping.

Labor Tapping Protocol: Ultra-simplified for use during contractions. Only 3–4 accessible points (Karate Chop, eyebrow, under-eye, collarbone). Formulations reduced to brief breathing-rhythmed affirmations: "I am safe," "My body knows how." Partner can tap back points while woman is in forward-leaning position. Taught and rehearsed several times before due date.

EPDS-Guided Postpartum Protocol: Using EPDS items as treatment guide. Each positively scored item is explored in detail and treated with EFT, deconstructed into specific aspects.

Birth Trauma Treatment Protocol: Movie Technique applied to childbirth as "film," advancing scene by scene with tapping at each emotional peak. Frequently traumatic aspects: the moment something went wrong, emergency cesarean decision, baby separation, unmanaged pain, non-consent sensation.

Breastfeeding Difficulties Protocol: Targeting emotions creating breastfeeding stress: anticipated pain, guilt, social pressure, failure feelings. Pre-feeding tapping sessions to improve let-down reflex by reducing emotional tension.

Prenatal Couples EFT: Joint sessions where the future father learns tapping points and practices on his partner. Prepares for birth day and strengthens the couple bond. The partner also benefits from tapping for their own perinatal anxieties.

Contraindications and Precautions

• SP-21 point (under arm) in first trimester: as a precaution inspired by Traditional Chinese Medicine, avoid vigorous stimulation during the first trimester. Replace with very gentle pressure or skip this point
• High-risk pregnancy: in cases of threatened preterm labor, preeclampsia, severe gestational diabetes, placenta previa — EFT is not directly contraindicated but the practitioner must be informed and adjust accordingly
• Severe postpartum depression with suicidal ideation: EPDS score of 13 or above, especially positive item 10 (self-harm thoughts) requires urgent psychiatric care. EFT can complement once stabilized but is never the first-line treatment
• Puerperal psychosis: a psychiatric emergency requiring hospitalization. EFT is not indicated
• Pregnancy denial: standard EFT work is not appropriate — specialized psychological care is needed
• Prior sexual trauma: pregnancy frequently reactivates sexual trauma. EFT work on these traumas during pregnancy is possible but requires a trauma-trained practitioner and careful benefit/risk assessment
• Social pressure regarding breastfeeding or birth mode: the practitioner must not reproduce social pressures. EFT helps the patient clarify her own choices — not convince her to birth "naturally" or breastfeed if that is not her informed wish