Postpartum Obsessive-Compulsive Disorder can be an emergency crisis situation.
If you are having thoughts of harming your baby, call your doctor or 911.
Postpartum Obsessive-Compulsive Disorder (also known as Postpartum OCD or Postpartum and Perinatal Obsessive-Compulsive Disorder) is a mental disorder with a rapid onset (often within the first week postpartum) in which the mother develops scary obsessions and compulsions involving harm that may happen to the new baby. These postpartum obsessions can involve actual or unintentional harm occurring to the new baby.
What Are Postpartum Obsessions?
Postpartum obsessions are very upsetting, highly intrusive, persistent, repetitive thoughts or mental images relating to the baby. These thoughts may include (but are not limited to):
- Unshakeable belief that the baby will die of SIDS (sudden infant death syndrome)
- Visualizing images of the baby, dead
- Thoughts of dropping the baby from a tall building
- Thoughts of the baby choking and being unable to save him or her.
- Unwanted impulses to shake the baby to "see what happens."
- Thoughts of poking the baby's fontanel (soft spot)
- Thoughts of stabbing the baby
- Thoughts of the baby drowning in the bath
What Are Postpartum Compulsions?
Postpartum Compulsions are repetitive acts done to reduce fears and obsessions, like needing to clean everything top to bottom, count or reorder things. These acts may include (but are not limited to):
- Obsessively checking on the baby overnight to make sure he or she is still alive
- Throwing away any sharp items
- Avoiding feeding a child due to fear of choking or poisoning the baby
- Avoiding dirty diapers for fear of sexually abusing the child by accident
- Monitoring self for perceived inappropriate sexual arousal around child
- Obsessive reassurance-seeking (from the internet or elsewhere), to make sure that feelings are normal
- Mental compulsions like constant prayers to prevent disasters
- Avoiding being left alone with the baby, for fear of harming the baby
How Is Postpartum and Perinatal Obsessive-Compulsive Disorder Diagnosed?
Postpartum OCD is often misdiagnosed as postpartum depression. A misdiagnosis may occur because:
- The mother is suffering from postpartum depression in addition to postpartum OCD.
- Clinicians are not aware of perinatal and postpartum obsessive-compulsive disorder.
- The mother is being secretive about her obsessions and compulsions, because she is afraid she will seem "crazy" or be perceived as a threat to the baby.
A thorough examination of physical, mental, and emotional postpartum symptoms will help the health care provider to make an accurate diagnosis and ensure proper treatment.
How Is Postpartum and Perinatal Obsessive-Compulsive Disorder Treated?
The good news is that there is treatment for postpartum and perinatal obsessive-compulsive disorder. Treatment typically involves a combination of cognitive-behavioral therapy (CBT) and medications.
Cognitive-Behavioral Therapies Used To Treat Postpartum OCD
- Exposure and Response Prevention Therapy: Mothers make a list of their fears and starting from the least anxiety-provoking to the most anxiety-provoking, they face their fears.
- Cognitive Restructuring: Mothers learn to challenge the validity of their fears, compulsions, unwanted thoughts and images.
Medications to Treat Postpartum OCD
- Selective seretonin reuptake inhibitors (SSRIs) have shown to be effective in treating OCD, however, their safety for breastfeeding mothers is not widely known.
Each individual case is different; you and your physician will determine what the best course of treatment is for you.
Additional Postpartum Obsessive-Compulsive Disorder Resources:
Postpartum Progress: the most widely-read resource for women suffering postpartum mood disorders on the Internet. Amazing information, stories, and support.
Postpartum Support International: a list of local volunteers and coordinators that can provide support and information for women and their families suffering postpartum mood disorders.
Postpartum Support International provides State-by-State resources for women suffering postpartum OCD or other pregnancy-related mental illnesses.