Parenthood is often portrayed as a joyful and fulfilling experience and while that is true, there’s an often-overlooked obsessive compulsive disorder (OCD) that affects how some individuals deal with parenting. This condition is called perinatal OCD and is more common than most people realize, yet is often misunderstood and rarely discussed. This blog will shine a light on perinatal OCD, and if you’re experiencing symptoms, know that support is available and you’re not alone.
What Is Perinatal OCD?
Perinatal OCD is characterized by intrusive, distressing thoughts and repetitive behaviors that a parent may feel compelled to perform to prevent imagined harm. This is a specific form of harm OCD that occurs during pregnancy or within the first year after giving birth. A study by the National Center for Biotechnology Information (NCBI) at the National Library of Medicine reported that “between 70 and 100% of new mothers report unwanted, intrusive thoughts of infant-related harm.” Although these thoughts can be distressing, they are egodystonic, meaning they do not represent a person’s desires or intentions; in fact, they are scary because they are unwanted and not an accurate representation of their true self.
Perinatal OCD is characterized by two key features: obsessions and compulsions.
- Obsessions are persistent, intrusive, and unwanted thoughts, images, or urges that cause significant distress and anxiety. In perinatal OCD, these obsessions often center on the baby’s safety and well-being. A parent might have recurring fears of accidentally or intentionally harming their child, worries about contamination, or an overwhelming need for things to be perfect.
- Compulsions are repetitive behaviors or mental acts that a person feels driven to perform in response to an obsession. The goal is to reduce anxiety or prevent a feared event. This could look like constant cleaning, repeatedly checking on the sleeping baby, mentally replaying actions to ensure no harm was done, or avoiding certain activities with the infant altogether.
What Causes Perinatal OCD?
Pregnancy and postpartum involve dramatic shifts in hormones like estrogen and progesterone. These changes can influence brain chemistry⎯especially serotonin, which plays an important role in OCD and anxiety disorders. New parents also are usually sleep deprived, are dealing with heavy emotions, and are feeling overwhelmed about the responsibility that comes with caring for a newborn. Since there are multiple factors that can cause perinatal OCD, there isn’t one cause that correlates to whether you’ll develop it or not.
Can Fathers Have Perinatal OCD?
New fathers can experience perinatal OCD just like new mothers do. According to numerous studies in the Journal of Contextual Behavioral Science, “the transition to new parenthood is a risk factor for the development of OCD in both mothers and fathers.” Fathers also experience unwanted, intrusive thoughts about their baby that feel scary and disturbing, even though they would never act on them.
Why Perinatal OCD Is Challenging To Diagnosis?
Perinatal OCD often goes undiagnosed for a variety of reasons. Parents often feel shame and guilt about their intrusive thoughts, fearing that admitting them will lead to judgment or in a worst-case scenario, having their child taken away. They may not realize that these thoughts are a symptom of perinatal OCD and instead believe they are a “bad parent.”
Another reason it can be difficult to diagnose is that friends, family, and even healthcare providers may see these symptoms as typical stress, or “baby blues” that often comes with a newborn and adapting to new periods. This can make parents feel alone in what they’re experiencing and feel that they must navigate this process on their own so as to not be judged.
What Risk Factors Could Make People More Susceptible To Perinatal OCD?
Perinatal OCD can affect anyone, though some people may be more susceptible to developing obsessive patterns of thinking. Potential risk factors include:
- A history of depression, including postpartum depression
- Already struggling with general anxiety, OCD or other fear related disorders
- Family history of OCD or anxiety disorders
- Breastfeeding
- High levels of stress both during and after pregnancy
- Sleep deprivation
- Perfectionism and a high desire to do right by your child
- A difficult pregnancy, birth complications, or a NICU stay
What Are Symptoms Of Perinatal OCD?
Perinatal OCD involves a cycle of distressing intrusive thoughts (obsessions) and repetitive behaviors or mental rituals (compulsions) that are meant to reduce anxiety. Symptoms of perinatal OCD can vary, but often include:
Intrusive Thoughts
- Fear of accidentally harming the baby like dropping them or making a mistake while caring for them (”What if I walk down the stairs with them and I trip?” “What if I don’t hear them crying and they stop breathing?”)
- Fear of intentionally harming the baby, even though the parent has no desire to do so (“What if I walk into the kitchen and put them in the oven by accident thinking it was something else?” “I don’t want to hurt my baby but what if I don’t realize how fragile they are.”)
- Graphic or violent mental images involving the baby. Images may include baby drowning, mother leaving the baby, or the baby being kidnapped.
- Fear of contamination or germs harming the baby (obsessive worry about wiping them, sanitizing their hands, not letting them or loved ones get too close, constantly worried about sickness)
- Constant, overwhelming fears that the baby will stop breathing or suddenly die
- Religious or moral fears about being a “bad” parent
Parents with perinatal OCD are typically horrified by these thoughts and try hard to push them away.
Repetitive Behaviors or Mental Rituals
Compulsions are attempts to reduce the anxiety caused by obsessions. These may include:
- Repeatedly checking on the baby (i.e. are they breathing, reviewing monitors, checking crib safety manuals)
- Excessive cleaning, sterilizing, or handwashing
- Avoiding being alone with the baby
- Avoiding areas that the baby could be harmed (kitchen, bathroom)
- Constantly seeking reassurance from others (“I fed the baby, right?” “I didn’t hurt them, did I?”)
- Mentally reviewing events to make sure no harm occurred
Seeking Help For Perinatal OCD
If you are experiencing symptoms of perinatal OCD, it’s important to remember that you’re not alone, and you aren’t a bad parent. Our therapists at Georgetown Psychology are here to help you navigate perinatal OCD and give you tools and strategies to work through your thoughts and feelings. If you have any questions or would like to schedule an in-person appointment in Georgetown (DC), Bethesda (MD), McLean (VA), and Alexandria (VA), contact Sarah Smathers, our Director of Client Services, at sarah@georgetownpsychology.com or (301) 652-5550. We also offer convenient telehealth appointments across 43 states.
Our clinics also offer psychoeducational evaluations, psychological testing, adult ADHD testing, autism assessments, independent school admissions testing, developmental assessments, cognitive baseline testing, and neuroaffirming evaluations.
