It is common for expecting and new parents to experience intrusive thoughts and anxiety, as well as to be very protective of their pregnancy and/or newborn. For many parents, these intrusive thoughts and anxiety are temporary and do not get in the way of daily functioning or a parent’s ability to care for their baby. However, if these intrusive thoughts, anxiety, and protective behaviors are beginning to impact your life in a more intense, upsetting, and/or ongoing way, it may be perinatal OCD (often called “postpartum OCD” or “maternal/paternal OCD”).
OCD stands for obsessive compulsive disorder, and when we add “perinatal” (or “postpartum” or “maternal/paternal”) we are specifically talking about OCD that takes place during the pregnancy period and/or after the baby is born. Just like “garden variety” OCD, perinatal OCD consists of a cycle of obsessions (unwanted thoughts, images, or impulses that occur over and over again, feel outside of the person’s control, and cause them intense and uncomfortable feelings such as fear, disgust, and/or doubt) and compulsions (repetitive behaviors or thoughts that a person uses to try to get rid of or counteract their obsessions). With perinatal OCD, these obsessions and compulsions tend to focus on the unborn or newborn baby, and may fall into different categories (or “subtypes”):
Common Obsessions in Perinatal OCD
Common Compulsions in Perinatal OCD
Perinatal OCD by the Numbers
- Perinatal OCD is present in about 2 to 3% of all parents, though recent studies believe the number may actually be higher.
- Rates of perinatal OCD are higher among women who had an OCD diagnosis prior to giving birth.
What Causes Perinatal OCD?
Perinatal OCD is caused by a mix of hormonal/medical factors, as well as influenced or triggered by environmental factors. Current research (while still somewhat sparse), suggests that perinatal OCD is caused by 1) the change in hormones (mainly oxytocin, which is related to the neurotransmitter serotonin, a main neurotransmitter involved in OCD), as well as 2) the change in responsibility when having a child. Because of both of these factors, perinatal OCD can occur in all parents, including fathers, same sex partners, adoptive parents, etc., regardless of whether or not they are a childbearing parent.
What ISN'T Perinatal OCD?
It is important to note that intrusive thoughts can exist outside of perinatal OCD. In fact, everyone experiences intrusive thoughts at some point! It is incredibly common for new or first-time parents to have “new parent nerves" or anxiety. These feelings are understandable and often the nerves and anxiety will disappear the more time the parent spends with their newborn. However, we begin to consider someone might be experiencing perinatal OCD when these intrusive thoughts start getting in the way of living life and/or caring for the baby and if the individual notices that they are doing things to try to make those thoughts go away.
Intrusive thoughts related to perinatal OCD are often confused with Postpartum Psychosis by patients and providers alike. Perinatal OCD-related intrusive thoughts are not the same as the delusions/hallucinations that are present during a state of psychosis. Psychosis should be treated as a medical emergency, while those suffering from perinatal OCD are generally treated in an outpatient setting (find more information about treatments). For more information about Postpartum Psychosis, please visit Postpartum Support International’s webpage on the topic.
Stories from Parents
As scary as perinatal OCD can feel, know that you are not alone - it is a common mental health condition experienced by many. Below are stories from other parents just like you who have lived through perinatal OCD:
- My Story, by Allison Livingston (check out Allison's full blog!)
- To Resist is to Persist, by Rachel Huber
- Navigating Motherhood while Living with OCD, by Brittany Bowman
Perinatal OCD is one of many mental health conditions that can happen during the pregnancy period and/or after the birth of the baby. Below are some other conditions that can occur during these periods of time that could be mistaken for perinatal OCD:
A Note on Suicidal Thoughts
The time before and after giving birth can be stressful for birthing and non-birthing parents alike. It is increasingly common for parents suffering from perinatal mental health concerns, including perinatal OCD, to have thoughts about suicide or hurting themselves, something referred to as “suicidal ideation.” These thoughts are very distressing to experience and even more distressing to think about telling someone else, for fear of what might happen to you and/or your child if you tell.
If you are living with these distressing thoughts, know that it is not your fault and you are not to blame. Suicidal ideation is treatable with professional help. Talk to your current care team about what you are going through, or find help today.