What is Postpartum OCD?
Postpartum OCD is an obsessive compulsive disorder that develops within the first two to three months after giving birth. Postpartum OCD affects approximately 3-5% of new mothers with obsessive and compulsive symptoms similar to those seen in other forms of OCD.Postpartum OCD differs from other types of OCD as it specifically focuses upon the fear of causing purposeful or accidental harm to the newborn baby.
This fear typically manifests in compulsive checking behaviours to ensure the baby is well or may involve compulsive praying or reassurance seeking in the form of research to investigate whether it is ‘normal’ to have bad thoughts about the baby. It is notable that it has been found that up to 80% of all new mothers experience unwanted nasty and unacceptable thoughts similar to those seen within Postpartum OCD, with Postpartum OCD involving a further significant distress and impairment associated with obsessive thoughts.
Furthermore, it is notable that those experiencing Postpartum OCD do not desire to harm their baby but rather, are terrified by these thoughts and the idea of harm coming to their baby. Research has also suggested that Postpartum OCD may also develop in new fathers who may report similar, negative thoughts about their newborn.
What are the symptoms?
The common symptoms associated with Postpartum OCD are as follows:
- Fear and images of the newborn passing away in their sleep, or choking and being unable to save them.
- Fear of accidentally harming by the baby by dropping them from a height or giving them a disease.
- Unwanted thoughts or impulses about harming the baby such as through shaking them, drowning them, yelling at them or stabbing them.
- Repeatedly checking on the baby to ensure they are well.
- Praying repeatedly in the hope of ensuring the health and wellbeing of the baby.
- Hiding or throwing out sharp objects.
- Repeatedly reviewing daily tasks to ensure that one has not harmed the baby.
- Avoidance of child for fear of harming them.
Why does it occur?
It is difficult to definitively pinpoint the cause of Postpartum OCD, however, there are a number of factors that may contribute to the development of Postpartum OCD. It has been suggested that the biological changes that occur during pregnancy may contribute to the development of OCD. In particular, it has been suggested that it is imbalances in levels of oxytocin and serotonin that contribute to the development of Postpartum OCD. it has further been suggested that Postpartum OCD may develop as a result of mistakenly misinterpreting, what research suggests are quite normal thoughts for a new parent, as something that is significant and threatening which may then be compounded by the added sense of responsibility a new parent feels to their child.
What treatments are available?
The treatment of Postpartum OCD is similar to the treatment of other forms of OCD. A specific facet of Cognitive Behaviour Therapy (CBT) called Exposure and Response Prevention (ERP) has been found to be highly effective in the treatment of Postpartum OCD and involves creating a hierarchy of fears from least to most challenging such that the client is exposed to their hierarchy of fearful obsessions over time without performing their compulsive behaviours.
Another facet of CBT called Cognitive Restructuring has also been found to be highly effective in treating Postpartum OCD and involves challenging the validity of the unwanted, disturbing thoughts and images that are experienced. Mindfulness-based CBT has also been found to be effective in the treatment of Postpartum OCD and involves the acceptance of unwanted thoughts in a non-judgemental manner in an effort to decrease the compulsion to eliminate discomfort.
Dr Emily O’Leary
- Clinical Director of Anxiety House and OCD Clinic since 2010
- Ten years’ experience with clients with OCD and anxiety
- Clinical supervisor and STAP trained
- Worked in public and private sectors for many years
- Worked in acute inpatient and outpatients units
- Regular speaker on radio and social media
- Researcher and presenter at international conferences