Perinatal / Postpartum OCD – Symptoms and Treatment
Perinatal / Postpartum OCD is a significant problem that can affect expectant and new mothers. Perinatal refers to the period of time from approximately 4-5 months prior to giving birth to one month after giving birth. Postpartum refers to the first 2-3 months after giving birth. Perinatal and postpartum mental illnesses range from the relatively benign “baby blues” to the most severe, postpartum psychosis. It is estimated that anywhere from 60%-80% of new mothers will experience the depressed mood often called the “baby blues”. These symptoms often ameliorate within a week of onset, and do not warrant treatment. Postpartum depression, which afflicts approximately 10%-20% of new mothers, is more severe and lasts for a longer period of time. Postpartum OCD affects approximately 3-5% of new mothers and has symptoms similar to those seen in others with OCD. In mothers with Perinatal / Postpartum OCD, the focus of the obsessions is often on the fear of purposely harming the newborn or somehow being responsible for accidental harm.
Symptoms of Perinatal / Postpartum OCD
Symptoms of Perinatal / Postpartum OCD vary widely from mother to mother. Some examples of common obsessions seen in Perinatal / Postpartum OCD are:
- Horrifying, intrusive thoughts of stabbing or suffocating a newborn child
- Unwanted images of throwing or dropping a baby
- Disturbing thoughts of sexually abusing a child
- Fear of accidentally harming a child through carelessness
- Intrusive thoughts of accidentally harming the fetus or child by exposure to medications, environmental toxins, germs, chemicals, or certain foods
- Fear of being responsible for giving a child a serious disease
- Fear of making a wrong decision (i.e., getting inoculations, feeding certain foods, taking antidepressants) leading to a serious or fatal outcome
Some common examples of compulsions seen in Perinatal / Postpartum OCD include:
- Hiding or throwing out knives, scissors, and other sharp objects
- Avoiding changing soiled diapers for fear of sexually abusing a child
- Avoiding feeding a child for fear of accidental poisoning
- Repeatedly asking family members for reassurance that no harm or abuse has been committed
- Avoidance of certain foods, medications, or normal, everyday activities for fear of harming the fetus
- Monitoring self for perceived inappropriate sexual arousal
- Avoiding news articles and TV shows related to child abuse or infanticide
- Repeatedly and excessively checking in on a baby as he/she sleeps
- Mentally reviewing daily tasks and events in an attempt to get reassurance that one has not harmed a child or been responsible for harm to a child
Unfortunately, Perinatal / Postpartum OCD is quite often misdiagnosed as being depression. The reason for this appears to be three-fold. First, many women with Perinatal / Postpartum OCD also have depression. While some experts estimate that as many as 30% of new mother with postpartum depression also have postpartum OCD, one recent study found that 57% of new mothers with postpartum depression also had symptoms of Postpartum OCD. Second, many pediatricians, obstetricians, psychiatrists and psychologists do not fully understand the nature of Perinatal / Postpartum OCD, and thus misunderstand the symptoms being reported. And third, Perinatal / Postpartum OCD is often a very secretive condition. New mothers are often reluctant to tell anyone of their obsessions for fear that they will be seen as “crazy” or a danger to the child.
