It's common to worry about your baby or occasionally have an upsetting thought about your little one's health and safety. But if you frequently experience intrusive thoughts and find yourself engaging in repetitive behaviors, you may be suffering from postpartum obsessive-compulsive disorder (OCD).
Obsessive-compulsive disorder may develop for the first time during pregnancy or after childbirth, or postpartum changes might exacerbate an already-diagnosed case.
Read on for more about this illness, including the signs to watch for and how to get treatment.
What is postpartum obsessive-compulsive disorder (OCD)?
Postpartum OCD (or perinatal OCD if it occurs during pregnancy) is a mental health condition.
Symptoms can start or worsen during pregnancy, or in the first few months after childbirth, causing women to experience a cycle of unwanted thoughts and repeated behaviors. Those habits and worries tend to focus on their newborn babies and their performance as parents, though they can encompass other fears.[1]
An example of an obsession would be an intense fear of harm coming to the baby and a compulsion might be having to wash your hands a certain number of times to prevent your baby from getting sick.
Researchers are still learning about postpartum obsessive-compulsive disorder, but around 1 to 2% of new moms are estimated to have the condition. It’s more likely to affect women who had an OCD diagnosis before they got pregnant.
Because outside or lifestyle factors can play a role in OCD, the condition may also affect new dads.
Postpartum obsessive-compulsive disorder is often misunderstood, especially because it’s not uncommon to experience some OCD-like symptoms in the postpartum period — even if you don’t have the condition.
For example, one study found that as many as 65% of new parents have had intrusive thoughts, though they were temporary for most people.[2]
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Postpartum OCD can also resemble postpartum anxiety — which is more common, affecting up to 15 to 20% of new moms and a few new dads. So it can sometimes be difficult to distinguish between the two.
What causes postpartum obsessive-compulsive disorder (OCD)?
The causes of postpartum obsessive-compulsive disorder aren’t fully understood, but experts believe that OCD in general may stem from both genetic and environmental factors.[3]
Having a personal or family history of OCD and anxiety may up your risk for developing the condition during the postpartum period.
New moms in general are more susceptible, thanks to the hormonal changes that take place during and after pregnancy. Pregnancy and the postpartum period are greatly affected by changes in certain hormones, particularly progesterone and oxytocin.[4]
Research suggests that oxytocin and the neurotransmitter serotonin have an effect on OCD, so fluctuating levels of these hormones may put new mothers at a higher risk of developing symptoms.[5]
The major physical changes and shifts in lifestyle that accompany pregnancy and parenthood can also contribute to OCD.
What are the symptoms of postpartum obsessive-compulsive disorder (OCD)?
In general, obsessive-compulsive disorder features obsessions (persistent, unwanted thoughts or visions) and/or compulsions (repetitive behaviors).
Although people with OCD usually experience both obsessions and compulsions, some may just have one or the other.[6]
Examples of obsessions that might occur during the perinatal period include:[7]
- Contamination obsessions, such as intense fear about germs
- Intrusive thoughts about something bad happening to your baby
- Perfectionism obsessions, such as needing to be the perfect parent
- Intense fear about being alone with your baby
Examples of compulsions that can happen during pregnancy and postpartum include:
- An extreme need to keep your baby's clothes and accessories tidy and symmetrical
- "Checking" behaviors, such as constantly looking in on your baby while she's sleeping
- Obsessively praying to protect your baby
- Feeling the need to count or repeat phrases relating to your baby in a certain pattern
As a result of these obsessions and compulsions, a new mom may experience feelings of excessive avoidance and shy away from giving her baby a bath, holding the baby, or changing diapers.
If you experience any of the obsessions or compulsions described above, consider talking to a health provider who specializes in OCD, especially if your symptoms are interfering with your life and the care of your baby.
Will my OCD lead me to harm my baby?
Many new moms with postpartum OCD fear they’re losing control and worry they might somehow act on the distressing intrusive thoughts they’re experiencing.
But the chance of acting on these unwanted thoughts around your baby is extremely low, according to the International OCD Foundation.[8]
Postpartum OCD is very different from postpartum psychosis, which is a serious mental break and a medical emergency that does require an immediate call to the doctor or trip to the ER.
But it’s still important to get help for postpartum OCD because the symptoms can greatly interfere with your life.
If you’re experiencing any obsessive and compulsive thoughts, reach out to your health care provider to discuss your symptoms and treatment options.
What’s the difference between postpartum OCD and postpartum anxiety?
It can be difficult to tell the difference between postpartum obsessive-compulsive disorder and postpartum anxiety.
That’s because OCD is a type of anxiety disorder, and the two conditions share many of the same symptoms like extreme fear.
It's also possible for a new mom to have both postpartum anxiety and OCD.
Here’s how to tell the difference between postpartum OCD and postpartum anxiety:
- Postpartum obsessive-compulsive disorder can include many of the same symptoms of postpartum anxiety, such as extreme worry, but OCD symptoms take the form of obsessions and/or compulsions. Obsessions may include extreme fears or disturbing, frightening thoughts related to the baby and her health, while compulsions are repeated behaviors that you feel like you "have" to do. These intrusive feelings can interfere with daily life, causing a new mom to repeatedly check on the baby or obsess about her safety (i.e., “is my baby falling, choking or drowning?”).
- Postpartum anxiety is characterized by excessive worry, fear or dread after having a baby and becoming a new parent. This condition is somewhat common: Fifteen to 20% percent of new moms experience postpartum anxiety, and women who also have postpartum depression may be more at risk. In addition to excessive worry, moms suffering from postpartum anxiety may experience racing thoughts, an elevated heartbeat, a persistent feeling of being on edge, an agitated or jittery feeling, and trouble falling or staying asleep.
Symptoms of postpartum OCD may last longer than those of postpartum anxiety. One analysis of more than 450 women found that of those with depression, 20% also had anxiety and 26% exhibited OCD signs.[9]
But by the time their child was 6 months old, anxiety symptoms had eased, while the OCD symptoms lingered.
How is postpartum OCD diagnosed?
Diagnosing an obsessive-compulsive disorder in the postpartum period can be tricky, in part because symptoms may mirror other conditions, such as postpartum depression and postpartum anxiety.
In fact, some experts believe that up to 30% of new moms with postpartum depression also have OCD.
And as with other postpartum mood disorders, moms with postpartum OCD may hesitate to open up about their symptoms. If you think you are experiencing symptoms of postpartum OCD, reach out to your practitioner right away.
Your doctor can screen you for postpartum OCD (as well as other postpartum mood disorders such as postpartum depression, anxiety, and postpartum PTSD) and refer you to a mental health care professional.
How is postpartum OCD treated?
It's important for moms with postpartum obsessive-compulsive disorder to know that they're not alone and the condition is very treatable.
Treatment options for postpartum OCD can include exposure therapy, in which unwelcome thoughts are actually triggered in a safe setting to help you face your fears.
Depending on how mild or severe your symptoms are, a combination of cognitive-behavioral therapy (CBT) and medications (often antidepressants like serotonin reuptake inhibitors, or SSRIs) may be recommended.
In general, SSRIs are considered safe to use during pregnancy and while breastfeeding, but always discuss your options with your physician.
You may also benefit from techniques like meditation, as well as relaxation exercises and mindfulness training.
Remember, there’s no need to go it alone when you’re experiencing obsessions and compulsions.
Postpartum OCD symptoms can be disruptive to your life and expend a lot of mental energy and time (already in short supply!). That’s why it’s really important to get the care treatment you need.
For more support and information on providers in your area, check out following resources:
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