Explore This Research Lab
Ensuring the well-being of women from the very early postpartum period is important for mother and child health. Research in the Dekel lab at Massachusetts General Hospital is focused on identifying the factors that are implicated in optimal adaptation as well as psychopathology of mothers following childbirth. To this end, we combine psychological, physiological and neuroimaging tools to prospectively study women from pregnancy across childbirth. Ultimately our goal is to develop novel tools for early detection of mothers at risk for postpartum mental disorders and preventive treatments that are effective and safe.
Although childbirth is usually considered a uniformly happy event, some women may experience a traumatic childbirth. Some will go on to develop a postpartum posttraumatic stress disorder (PTSD), a condition we know very little about. We study the psychological and biological mechanisms underlying the various mental health trajectories in the wake of a traumatic delivery and what allows some women to be resilient and even grow psychologically. We are also interested in learning the ways in which distress in the mother may influence child development.
What do we know about PTSD after childbirth?
What puts women at risk for developing PTSD following childbirth?
Current Lab Studies
Impact of Coronavirus on Mother’s Birth Experience and Wellbeing
The outbreak of the COVID-19 pandemic has turned the lives of millions of people upside down all over the globe and is affecting our wellbeing. Our mothers wellness coronavirus project is an international study and is open to ALL women (in the U.S. and other countries) who have recently given birth. This study is being done to understand the impact of COVID-19 on women’s birth experience and mental health. The knowledge gained can help inform appropriate care of women during their stay in hospital postpartum units and afterwards. Over 3,000 new mothers have enrolled in our study as of June 26, 2020.
Please see below the study ad.
Preventing Postpartum Depression with Oxytocin
Our NIH funded clinical trial introduces a novel therapeutic approach with the use of oxytocin administered to mothers at risk immediately following childbirth. We are testing whether oxytocin, an anxiolytic and pro-social hormone, can reduce postpartum depression and anxiety and boost mother-infant bonding as well as breastfeeding to the ultimate benefit of the child’s health. Boosting mother-infant bonding at a critical stage for infant development can modify the long-term health trajectory of the child. This study is done in collaboration with an interdisciplinary team of Mass General researchers and the Mass General Obstetrics Program. Women who plan to deliver at Mass General are being recruited for this study. Clinical TrialPredicting Peripartum Depression Using Machine Learning
Peripartum depression (PPD) occurring during pregnancy or after childbirth is the most common complication surrounding childbirth, and in extreme cases, can result in maternal suicide and infanticide. Currently, there are no accurate screening methods to identify women at risk before the condition fully develops. In this NIH funded study, we are using advanced computational methods and integrating the massive health and sociodemographic information in women’s medical records to improve the prediction of a debilitating maternal mental illness. Our model can lay the foundation for effective screening methods using big data. It could be developed into a low-cost screening protocol useful in clinical settings to provide highly informative guidance for clinicians making diagnostic and treatment decisions. This in turn could reduce treatment costs, avoid a potentially preventable disease, and ultimately, improve the quality of care for mothers and their children.
The Maternal Brain: Examining Neural Alterations Following Traumatic Childbirth
As much as a third of women experience a traumatic childbirth and a significant portion can go on to develop PTSD. Nevertheless, research on the underling biological mechanism of this maternal condition that can detect disease biomarkers is completely lacking. Neuroimaging is currently the only technique that provides direct non-invasive access to the living human brain. This NIH funded study is the first of its kind to examine potential changes in the maternal brain associated with traumatic childbirth and the development of PTSD. We use magnetic resonance imaging (MRI) tasks to reveal the core neural abnormalities of childbirth-related PTSD and how these abnormalities can mediate problems in early mother-infant attachment and impair healthy child development. Elucidating the neural correlates of postpartum PTSD and yielding clinically relevant biomarkers could translate into the development of new therapies and improve clinical diagnosis. This study is open for enrollment.
Childbirth-induced Postpartum Psychological Outcomes
Identifying at risk women for postpartum mental health disorders is crucial for implementing preventive treatment tailored to different symptoms. In this large-scale prospective, longitudinal study, we are examining women’s mental health trajectories from pregnancy through childbirth into the early postpartum period. We study the experience of childbirth and subsequent heterogeneous psychological responses to better capture the dynamic nature of postpartum coping over time. We assess negative as well as positive mental health outcomes induced by the childbirth experience and the factors predicting these responses. Women who plan to deliver at Mass General are recruited for this study, which is conducted in collaboration with Mass General Obstetrics Program. To learn more, contact our team at MothersStudy@partners.org.
Traumatic Childbirth: A Physiological Approach to Study Maternal Posttraumatic Stress Disorder
In this study we are examining the validation of maternal PTSD. To this end, we are using the same experimental methods that have been developed to establish the recognition of combat-related PTSD. We ask whether the memory of childbirth can trigger heightened physiological responses, similarly to the well-documented physiological reactivity seen in veterans diagnosed with PTSD. This study may call for expanding the formal DSM definition of postpartum conditions to include disorders of traumatic stress. Clinical Trial
International Study of Childbirth Characteristics and Subsequent PTSD
We recently completed a study of nearly 700 postpartum women from around the globe, targeting posttraumatic stress symptoms following childbirth. We have found that as much as 12% of women are expected to experience PTSD symptoms at a clinical level after giving birth to a healthy baby at term. Women who have an unscheduled Cesarean are three times more likely to suffer from PTSD.
Overall, our findings show that objective stressors in birth such as mode of delivery and obstetrical complications as well as the woman’s subjective traumatic experience of childbirth predict the development of subsequent PTSD. Socioeconomic disadvantage also increases vulnerability. Furthermore, having symptoms of PTSD can interfere with the mother’s ability to bond with her baby.
Sharon Dekel, PhD | Principal Investigator
Dr. Sharon Dekel is an assistant professor of Psychology of Harvard Medical School. She earned a PhD in Clinical Psychology from Columbia University and completed her clinical internship training at Columbia Medical Center followed by a research postdoctoral fellowship in a lead international trauma lab. Dr. Dekel is also a licensed clinical psychologist.
Dr. Dekel has been studying biological and psychological factors associated with ways of coping with stressful events. Her work on the positive outlook of traumatic stress is considered pioneering in the field. Rather than viewing trauma outcomes as exclusively negative, her studies have increased our understanding of the human capacity to thrive in the wake of trauma (see Dekel’s publication record).
Since joining Massachusetts General Hospital in 2013, Dr. Dekel has expanded her research with the investigation of childbirth as a potentially traumatic event. This represents a new frontier in trauma studies. She developed a multidisciplinary research model involving both the Mass General Psychiatric and OB/GYN Departments that has allowed her to study over 4,000 postpartum women. Dr. Dekel is defining the overlooked condition of childbirth-related post-traumatic stress disorder and working to better understand the transmission of the disorder’s effects to the offspring. By studying childbirth as a model of traumatic stress, she hopes to translate the knowledge gained to improve clinical care of trauma-exposed individuals.
Dr. Dekel is a two time recipient of the Brain and Behavior Research Foundation’s Young Investigator Award, Mass General’s Claflin Distinguished Scholar Award for Women in Science, the MGH’s Executive Committee On Research ISF funding, the Harvard Mind Brain Behavior Faculty Award, and a recent recipient of Postpartum Support International Susan A. Hickman Memorial Research Award for excellence in scientific work on postpartum mental health. She has been continually supported by the National Institutes of Health.
Dr. Dekel is on the Editorial Board of PLOS ONE, Frontiers in Psychology, where she edited a special volume on childbirth-PTSD, and Journal of Psychological Trauma, the American Psychological Association’s lead traumatic stress journal. Dr. Dekel is also Chair of the Postpartum Trauma Special Interest Group of the International Society of Traumatic Stress Studies, which is the largest professional organization in the field.
Zohar Berman, PhD | Postdoctoral Research Fellow
Cecilia Hinojosa | PhD student
Sabrina Chan, BS | Clinical Research Coordinator
F. Vanessa Alvarenga
Gabriella Dishy, BS
- Roger Pitman, MD, Massachusetts General Hospital, Harvard Medical School
- Scott Orr, PhD, Massachusetts General Hospital, Harvard Medical School
- Anjali Kaimal, MD, Massachusetts General Hospital, Harvard Medical School
- Elizabeth Lawson, MD, Massachusetts General Hospital, Harvard Medical School
- Linda Mayes, MD, Yale University
- Lauren Hanley, MD, Massachusetts General Hospital, Harvard Medical School
- Sara Bates, MD, Massachusetts General Hospital, Harvard Medical School
- Ahmed Tawakol, MD, Massachusetts General Hospital, Harvard Medical School
- George Bonanno, PhD, Columbia University
- Peter Tsvetkov, PhD, Broad Institute
- Lisa Shin, PhD, Tufts University
- Zahava Solomon, PhD, Tel Aviv University, Israel
- Ruth Feldman, PhD, Interdisciplinary Center, Israel
- Tsachi Ein Dor, PhD, Interdisciplinary Center, Israel
- Rachel Yehuda, PhD, Mount Sinai School of Medicine
- Jeffery Rosen, PhD, University of Delware
We have ongoing research opportunities in our lab. To learn about postdoctoral and research fellowship positions, please contact Dr. Sharon Dekel at email@example.com
Research Volunteers: We are seeking student volunteers to assist with the operation of ongoing clinical research studies in our lab. Primarily responsibilities will involve screening candidates and recruiting subjects, data entry, and assisting with conducting the biological and psychological assessments of subjects as needed. Ideal candidates will be highly motivated with the strong interpersonal skills necessary to interact with patients and succeed in a dynamic work environment. If you are interested, please send your cover letter and resume to our clinical research coordinator, Ms. Sabrina Chan at SCHAN27@mgh.harvard.edu.
News and AchievementsLab Achievements:
- Great news! Our lab has received Harvard’s 2020-2021 Mind Brain Behavior Research Relief Faculty Award!
- Dr. Dekel was awarded an NIH grant entitled “Neural underpinnings of postpartum adaptation following traumatic delivery and implications for infant development"
Dr. Dekel was awarded an NIH grant entitled “Predictive modeling of peripartum depression”
Dr. Dekel has been awarded the Harvard’s 2020 Mind Brain Behavior Interfaculty Initiative faculty award!
- Congratulations to Dr. Dekel for receiving Mass General's Executive Committee On Research Award, 2019 Deliberative Interim Support Funding
- Congratulations to Dr. Dekel for receiving the 2019 CFD Award
- Congratulations to Dr. Dekel on being named the 2018 Recipient of the Susan A. Hickman Memorial Research Award by Postpartum Support International!
- Congratulations to Dr. Berman for receiving Harvard’s 2018 Mind Brain Behavior Young Investigator Award!
Highlighted mentions in news articles:
Women with COVID-19 more likely to suffer acute stress during childbirth (coverage of recent COVID-19 maternal wellness project’s finding) on Medical News, December 2020
Postpartum Depression Common in Women with Childbirth-Related PTSD on MGH Psychiatry News, November 2020
Postpartum mental health in the face of the pandemic on Boston Globe, May 2020
Dr. Dekel explains the notion of psychological growth following trauma on The American Lawyer, May 2020
The ‘fourth trimester’ and plight of new mothers during a pandemic on Boston Globe Magazine, May 2020
Dr. Dekel talks about her research on COVID-19 and maternal mental health on Mass General Research Institute Blog, April 2020
Dr. Dekel talks about her research on Psychology Today, December 2019
"It's a Battle Scar": The Emotional Toll of C-Sections No-one Talks About on Harper's Bazaar, October 2019
What Is Postpartum PTSD? Interview with Dr. Dekel on Goop
Depression Screening Needed in Peripartum Period to Detect Delayed Onset and Fluctuating Symptoms on Mass General Advances in Motion, July 2019
Why #Metoo Matters in the Delivery Room on The Establishment, March 2019
Featured interview with Dr. Dekel on the Mass General Research Institute Blog, February 2019
Dr. Dekel Interviewed As Featured Member of Postpartum Support International, Postpartum Support International
Q&A with Dr. Sharon Dekel: Understanding Postpartum PTSD, Advances in Motion
Nearly Dying In Childbirth: Why Preventable Complications Are Growing In U.S., NPR
Mass General Awards and Honors, Mass General News
The Mothers Who Can’t Escape the Trauma of Childbirth, The Atlantic
Selected Publications (Most recent first)
COVID-19 is associated with traumatic childbirth and subsequent mother-infant bonding problems. Mayopoulos GA, Ein-Dor T, Dishy GA, Nandru R, Chan SJ, Hanley LE, Kaimal AJ, Dekel S. Journal of Affective Disorders. 2021; DOI: 10.1016/j.jad.2020.12.101
Traumatic memories of childbirth relate to maternal postpartum posttraumatic stress disorder. Thiel F, Berman Z, Dishy GA, Chan SJ, Seth H, Tokala M, Pitman RK, Dekel S. Journal of Anxiety Disorders. 2021;77: 102342. DOI: 10.1016/j.janxdis.2020.102342.
Maternal psychological growth following childbirth. Berman Z, Thiel F, Dishy GA, Chan SJ, Dekel S. Archives of Women’s Mental Health. 2020. DOI: 10.1007/s00737-020-01053-9.
Risk factors for developing posttraumatic stress disorder following childbirth. Chan SJ, Ein-Dor T, Mayopoulos P, Mesa M, Sunda R, McCarthy B, Kaimal A, Dekel S. Psychiatry Research. May 2020;290: 113090. 10.1016/j.psychres.2020.113090
Beyond postpartum depression: Posttraumatic stress-depressive response following childbirth. Dekel S, Ein-Dor T, Dishy G, Mayopoulos P. Archives of Women’s Mental Health. 2020;23: 557-564. DOI:10.1007/s00737-019-01006-x. PMID: 31650283
Peritraumatic dissociation in childbirth-evoked posttraumatic stress and postpartum mental health. Thiel F, Dekel S. Archives of Women’s Mental Health. 2019; 23: 189-197. PMID: 31115689. DOI: 10.1007/s00737-019-00978-0
Delivery mode is associated with maternal mental health following childbirth. Dekel S, Ein-Dor T, Berman Z, Barsoumian I, Agarwal S, Pitman RK. Archives of Women’s Mental Health. 2019; 22: 817–824. PMID: 31041603. DOI: 10.1007/s00737-019-00968-2
Dynamic course of peripartum depression across pregnancy and childbirth. Dekel S, Ein-Dor T, Ruohomäki, A, Lampi J, Voutilainen S, Tuomainen TP, Heinonen S, Kumpulainen K, Pekkanen J, Keski-Nisula L, Pasanen M, Lehto SM. Journal of Psychiatric Research. 2019; 113:72-78. PMID: 30921631.
Is childbirth-induced PTSD associated with low maternal attachment? Dekel S, Thiel F, Dishy G, Ashenfarb A. Archives of Women’s Mental Health. 2019; 22:119-122. PMID: 29786116. DOI: 10.1007/s00737-018-0853-y
Examining symptom clusters of childbirth-related posttraumatic stress disorder. Thiel F, Ein-Dor T, Dishy G, King A, Dekel S. The Primary Care Companion for CNS Disorders. 2018; 20(5). PMID: 30277674.
Differences in cortisol response to trauma activation in individuals with and without comorbid PTSD and depression. Dekel S, Ein-Dor T, Rosen JB, Bonanno GA. Frontiers in Psychology. 2017; 8:797. PMID: 28572779.
Childbirth induced posttraumatic stress syndrome: A systematic review of prevalence and risk factors. Dekel S, Stuebe C, Dishy G. Frontiers in Psychology. 2017; 8:560. PMID: 28443054. DOI: 10.1007/s00737-018-0853-y
Peripartum depression, traditional culture, and Israeli society. Dekel S, Stanger V, Georgakopoulos ER, Stuebe CM, Dishy GA. Journal of Clinical Psychology. 2016; 72(8):784-94. PMID: 27487164.
PTSD symptoms lead to modification in the memory of the trauma: a prospective study of former prisoners of war. Dekel S, Solomon Z, Ein-Dor T. The Journal of Clinical Psychiatry. 2016; 77(3):e290-6. PMID: 26796992.
Posttraumatic stress disorder and depressive symptoms: joined or independent sequelae of trauma? Dekel S, Solomon Z, Horesh D, Ein-Dor T. Journal of Psychiatric Research. 2014; 54:64-9. PMID: 24703578.
Cortisol and PTSD symptoms among male and female high-exposure 9/11 survivors. Dekel S, Ein-Dor T, Gordon KM, Rosen JB, Bonanno GA. Journal of Traumatic Stress. 2013; 26(5):621-5. PMID: 24030869.
Changes in trauma memory and patterns of posttraumatic stress. Dekel S, Bonanno G. Psychological Trauma: Theory, Research, Practice and Policy. 2013; 5(1):26-34.
Secondary salutogenic effects in veterans whose parents were Holocaust survivors? Dekel S, Solomon Z, Rozenstreich E. Journal of Psychiatric Research. 2013; 47(2):266-71. PMID: 23168139.
Self-enhancement among high-exposure survivors of the September 11th terrorist attack: resilience or social maladjustment? Bonanno GA, Rennicke C, Dekel S. Journal of Personality and Social Psychology. 2005; 88(6):984-98. PMID:15982117.
Pioneering Psychiatry Research
The integration of patient care and clinical research has been a hallmark of the Department of Psychiatry for more than 30 years. Today, the department has the largest clinical research program in the hospital, with studies at the forefront of neuroscience, molecular biology and genetics.