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What does postpartum OCD look like and what can you do if you’re struggling?

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May 19, 2020

By Nicole Arzt, LMFT

In the past few decades, many health experts have concentrated on learning about women’s health during both pregnancy and postpartum recovery. Today, most people are aware of the symptoms related to postpartum depression or psychosis.

However, women are also at risk for developing postpartum anxiety disorders, such as OCD. While research on this condition is fairly limited, studies show that 1-3% of new mothers experience postpartum obsessive-compulsive disorder (OCD).

Let’s get into the risk factors, symptoms, and treatment options you need to know.

What Does Postpartum OCD Look Like?

All parents experience fear and uncertainty over the well-being of their babies. Many mothers lament about sleepless nights spent checking on their infant. That said, postpartum OCD is a chronic, persistent pattern of being controlled by obsessions and compulsions.

These obsessions refer to disturbing and intrusive thoughts typically related to harming or neglecting the baby. Some examples of these thoughts include:

  • Baby dying in their sleep (SIDS)
  • Dropping the baby
  • Choking the baby
  • Smothering the baby with a blanket or pillow
  • Stabbing the baby with a knife or other sharp object
  • Drowning the baby during a bath
  • Shaking or throwing the baby
  • Recurrent images of the baby dying or dead

Related: What does it mean if I’m having scary or intrusive thoughts?

To cope with these distressing thoughts, mothers with postpartum OCD engage in compulsive rituals. These rituals temporarily relieve some of these thoughts manifesting. Such compulsions might include:

  • Chronically checking the baby
  • Spending hours reading or researching symptoms
  • Seeking continuous reassurance from others that their thoughts or behaviors are normal
  • Avoiding the baby or avoiding certain tasks (like bathing or changing diapers) for fear of “acting out” on the obsessions
  • Removing all sharp objects from the house and checking obsessively for anything that could harm the baby
  • Excessively scanning over the daily events to ensure nothing bad has happened to the baby
  • Continuously assessing self when it comes to inappropriate or intrusive thoughts about the baby
  • Excessively praying over the well-being of the baby

Postpartum OCD symptoms may begin during the pregnancy, but they are most likely to occur within the first six weeks after childbirth. Women with a history of OCD may be more likely to develop this condition.

Postpartum OCD Vs. Postpartum Depression Or Anxiety

Postpartum OCD does share some similarities with postpartum depression and postpartum anxiety. However, it’s important to know the key differences.

Like postpartum OCD, postpartum depression may include some intrusive thoughts related to the baby’s well-being. Some mothers do experience fears about parenting, and they may feel hypervigilant in protecting their infant. That said, OCD is characterized by the presence of both obsessions and compulsions. It should be noted that mothers can have both postpartum depression and postpartum OCD.

OCD is an anxiety disorder, and postpartum OCD shares many similarities with postpartum anxiety. Women struggling with postpartum anxiety experience distress, fear, and excess worry about their child’s well-being. Even if they know the concerns are irrational, they may spend a great deal of time worrying. However, they do not engage in compulsions to ease the worry.

Related: How to recognize the signs of postpartum anxiety

Postpartum OCD Vs. Postpartum Psychosis

Postpartum psychosis is a severe condition that can affect every 1 or 2 out of 1,000 deliveries. When a woman experiences postpartum psychosis, she has a temporary break from reality, which may include delusions, hallucinations, confusion, rapid mood swings, and paranoia.

Women with postpartum OCD experience tremendous distress over committing harm. These fears drive the compulsions. However, women with postpartum psychosis cannot distinguish reality from fantasy. Their bizarre beliefs may convince them that harming the baby or themselves is logical.

In extreme cases, these women are at risk for suicide or infanticide. Therefore, postpartum psychosis typically entails hospitalization and medication stabilization.

Will Postpartum OCD Go Away On Its Own?

In some cases, symptoms may decrease over time. However, for many women, symptoms can progress and worsen. That’s why mothers need to consider seeking professional treatment if they are struggling.

Cognitive-behavioral therapy (CBT) is an evidence-based treatment that can help women change and challenge their distorted thoughts. CBT practitioners also teach practical coping skills for managing distress.

Moreover, selective serotonin reuptake inhibitors (SSRIs) can help with emotional regulation and chemical imbalances. SSRIs are the most common pharmacological approach in treating both mood and anxiety disorders. Because medication can be transferred through breast milk, women should discuss such risk factors with their primary care physician.


Nicole Arzt is a Licensed Marriage & Family Therapist with nearly a decade of experience treating women's issues related to parenting and family dynamics, complex trauma, and substance use disorders. She is the proud mama of her newborn son.

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