What is Postpartum OCD and how is it treated?

You have a new baby, which of course means a slew of responsibilities. And naturally you’re tired all the time. Add to that swirl of emotions relentless “what if” fears about something happening to your kid, and it can become entirely debilitating. 

You’ve probably heard of postpartum depression, but there’s another condition that can be triggered by your pregnancy or right after. It’s called postpartum obsessive-compulsive disorder, or postpartum OCD. 

“It can cause a lot of confusion and anguish to go from ‘We’re so excited that our baby is here!’ to ‘But now I’m having all these weird thoughts that don’t make sense to me’,” says April Kilduff, MA, LCPC, LMHC, a clinician at NOCD, the leading provider of specialized OCD treatment. But here’s the good news: This condition is highly treatable, and you are not alone. Keep reading to learn more about the symptoms of postpartum OCD and how it’s treated. 

Scared of your postpartum intrusive thoughts? Our OCD specialists can help. Book a free call to get started.

What is postpartum OCD

Postpartum OCD describes a type—or theme—of OCD that focuses on your newborn. Maybe you experienced OCD before your pregnancy, and that it’s just shifted focus to your baby. But it’s also possible for OCD to be triggered by pregnancy or giving birth. The content of postpartum OCD obsessions can center around your baby’s health and safety, fears about them getting lost or kidnapped, and sexual obsessions, like what if I touch my baby inappropriately? These obsessions are then followed by compulsive, even ritualistic, physical or mental behaviors. Postpartum OCD is exhausting and, often, downright debilitating. 

“A certain amount of worry is a normal part of being a new parent. But when those fears cause a great deal of distress that disrupts your ability to function, it may be a sign to get help,” says Patrick McGrath, PhD, NOCD’s Chief Clinical Officer. 

Symptoms of postpartum OCD

As with most mental or physical conditions, the exact symptoms of postpartum OCD can vary from person to person, which is why it’s always best to be assessed by a licensed professional. However, all cases of OCD tend to follow this general pattern of symptoms: 

• Repetitive, unwanted intrusive thoughts, images, or urges. OCD specialist Alegra Kastens explains, “It can be terrifying to think about telling another person about these scary thoughts and images that you’re having. A lot of people fear that if they tell a therapist, that therapist is going to have to report them.” But don’t worry, OCD specialists know the truth about intrusive thoughts, and they’ve heard it all. Intrusive thoughts might sound like:
  • What if my baby dies in their sleep? 
  • Maybe I accidentally gave them the wrong kind of milk in their bottle. 
  • Maybe I’m not a fit parent. 
  • Do I want to harm my baby? 
  • When I give them a bath, what if I’m harboring some secret desire to touch them inappropriately?
  • I can’t leave my baby with a sitter—something bad might happen if anyone but me takes care of them.
  • I could take this kitchen knife and stab my baby.
• Extreme distress over intrusive thoughts This can look like anxiety, worry, fear, panic, guilt, shame, or embarrassment. You become desperate to “solve” your intrusive thoughts, to make sure they don’t really mean anything—and doing this feels extremely urgent.
• Mental or physical behaviors These are compulsions done with the intent to solve intrusive thoughts, relieve distress, and/or prevent a bad thing from happening. Compulsions can look like:
  • Excessively checking on your baby
  • Avoiding being around your baby alone
  • Doing exhaustive online research about your fears 
  • Mentally repeating prayers or assertions about how much you care for your child
  • Asking others if your child will be okay, or if you’re a good parent
  • Repeatedly checking for signs of breathing throughout the night
  • Seeking reassurance from a partner or other family members to be sure that you haven’t done something harmful
  • Hiding all the knives in your house

The tricky thing about OCD is that it’s cyclical. Meaning, compulsions feel like they’re going to help, when in fact, they just make your obsessions seem more legit. The result? Your obsessions continue to feel urgent, and your brain thinks compulsions are the only thing that will bring relief. Unfortunately, the relief brought by compulsions is only temporary. As long as you’re stuck in the cycle, no amount of compulsions or reassurance will ever be enough.

Does postpartum OCD mean you’re a bad parent?

Having postpartum OCD—and specifically, the scary intrusive thoughts that come with it—does not make you a bad parent. Or a bad person. OCD doesn’t say anything about who you are. Rather, it’s a debilitating mental health condition that you’re experiencing. Remember, part of the definition of intrusive thoughts is that they are unwanted and unenjoyable. “OCD goes after things you really value,” Kilduff says.

Dr. McGrath adds that, “What’s important to know is that these thoughts are ego-dystonic, meaning they are not in alignment with your true desires. In fact, this is why these thoughts, images, and urges cause so much distress.” In other words, you’re having these terrifying thoughts because of how much you love and care about your baby—not the opposite.

And you’re not alone in having these thoughts. In fact, research has shown that 80% of new mothers—whether they have OCD symptoms or not—experienced unwanted, disturbing, or uncomfortable thoughts, including ones that were violent or sexual in nature. There’s also evidence that 94% of people—across 13 countries and six continents—experienced at least one intrusive thought in the last three months.

Everyone has thoughts they don’t like. OCD just makes you worry that the thoughts mean something, and tells you you have to figure it out. The good news is you can get effective treatment to manage your distress and stop engaging in compulsions.

What’s the best treatment for postpartum OCD?

There is an evidence-based type of therapy designed specifically for OCD, and it works for all themes of the disorder, including postpartum OCD. It’s called Exposure and Response Prevention therapy (ERP). 

ERP works by gradually exposing you to situations, words, images, places, or anything else that triggers your intrusive thoughts and, importantly, teaches you how not to respond with compulsions. For example, you may begin by looking at a photo of a baby. The fear thoughts about your own baby may arise. But instead of turning to rumination, or research, or reassurance-seeking to relieve your distress or make the thoughts go away, you will practice sitting with the discomfort. Your therapist will give you concrete tools for how to do this, and be by your side the whole time.

Over time, as you work your way up to more challenging exposures, you’ll actually become desensitized to your intrusive thoughts. You’ll be able to recognize them for exactly what they are: thoughts, and nothing more. Rather than so much of your time and energy being consumed by obsessions and compulsions, you’ll be able to enjoy time with your baby, and be more present.

For some people, medication can also be an effective complement to ERP. You can chat with your therapist about whether that might be the right choice for you. 

Take it from NOCD member Amy, who struggled with perinatal and postpartum OCD and successfully went through ERP treatment: “I’ve referred others to NOCD and have watched them heal and finally get the specialized treatment they need. My husband has a happier wife and my children have a happier mother. My family gets the best version of me now, the one that OCD didn’t get to take from me. I will never say that I’m glad that this all happened. But I will say that God graced me and restored me in more ways than I can describe.”