![]() Perinatal OCD is characterized by intrusive unwanted thoughts (i.e., obsessions) about aggression toward or a fear of contamination of the infant. When these thoughts don’t recede or begin to get in the way of day-to-day functioning, the presence of OCD must be considered. For others, though, the thoughts are significantly unsettling and often accompany other symptoms of anxiety or depression. For many new mothers, these thoughts go away on their own over time, with some reassurance, and extra sleep. Unfortunately, these anxious thoughts can transform into thoughts and images of harming the baby, such as “ What if I drop the baby over the railing? What if I drown or burn the baby in the bathtub? What if I shake the baby? ” Other thoughts involve harm coming to the baby such as “ What if the baby stops breathing when I’m not watching? What if the baby catches a deadly illness?” These thoughts are generally regarded as “harming infant thoughts” and are experienced by mothers as frightening, shameful, and unacceptable. It is considered normal and part of the process of adjusting to the new circumstances. Additionally, psychological factors such as a heightened sense of responsibility and increased perception of threat can lead to the obsessional anxiety that is a hallmark of OCD.Īll new mothers experience anxious thoughts. It is also thought that a rapid rise in oxytocin, a hormone that is central to the mother–infant bonding process, may trigger an exaggerated "protective" response in the form of obsessive thoughts and checking rituals. ![]() ![]() Theories suggest that some women are susceptible to the drastic changes in hormone levels that occur during pregnancy and the postpartum period, which in turn may influence brain chemical activity (the same type of brain activity we see in anxiety disorders). Major depression is the most common co-occurring disorder, and one study found that over 40% of women with postpartum major depression also experienced repetitive, intrusive, unwanted thoughts of harm befalling their infants. Additionally, women who have never been diagnosed with OCD can develop OCD symptoms following childbirth. The study of pregnant and postpartum women with OCD is relatively new, so there is not absolute clarity regarding how common this disorder is, but there is agreement that a majority of women with OCD who give birth have significant worsening of their symptoms. While screenings now commonly occur for postpartum depression, and many providers are trained to recognize this, the same providers may miss symptoms of anxiety or mistake them for signs of depression.įor reasons not fully understood, the perinatal period (from pregnancy to 12 months after childbirth) is a particularly vulnerable time for symptoms of OCD to appear, whether they be entirely new symptoms or a re-occurrence of OCD after a period of remission. In addition, many medical and even mental health providers are not adequately trained to recognize and accurately diagnose anxiety disorders in the perinatal period. First and foremost, mothers are often unwilling to disclose their symptoms due to guilt, shame, and fear of judgment by loved ones or health care providers. ![]() It is typically referred to as either Perinatal OCD or Postpartum OCD, solely due to the timing of the symptoms as occurring during pregnancy or after childbirth.ĭifficulties with recognizing and accurately diagnosing perinatal OCD are traced to several factors. This anxiety can worsen dramatically in the weeks and months after delivery and takes the form of obsessive compulsive disorder (OCD). Obsessive anxiety is a common example of this, with many mothers worrying about the safety or well-being of their infants. This article was initially published in the Winter 2014 edition of the OCD Newsletter.Īnxiety disorders in women during their pregnancies and in the months after giving birth are often under-recognized and undertreated, and can have significant impact on the health of the mother, infant, family, and mother–baby relationship. To learn more about perinatal OCD, please visit our new Perinatal OCD Resource Center! By Neha Hudepohl, MD, & Margaret Howard, PhD ![]()
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