Postpartum OCD: Symptoms, Treatment and How to Get Therapy to Help

What is postpartum OCD?

In recent years, we’ve learned that the changing hormones that many pregnant people and new parents experience can bring on a variety of different anxiety disorders that can impact early parenthood. You might have heard of postpartum depression or postpartum psychosis, as these conditions are fairly common and often portrayed in the media. However, postpartum obsessive-compulsive disorder (postpartum OCD) isn’t as regularly in the spotlight.

Like other postpartum disorders, postpartum OCD can greatly impact the health and wellness of new parents and can affect the bond they develop with their baby. The condition can affect many new moms and dads. It can even effect those who are caregivers of the baby, babysitters, friends of family, etc. People experiencing OCD commonly cited pregnancy and childbirth as “triggers” of OCD onset. That’s why it’s so important to understand the signs and symptoms of postpartum OCD and be able to identify when a new parent or caregiver may need additional help or support. It is important to get an accurate diagnosis, as symptoms of OCD are very different from postpartum depression and postpartum psychosis symptoms. 

Postpartum OCD Symptoms

OCD involves intrusive or unwanted obsessive thoughts that often trigger compulsions. Compulsions are actions that are often performed in an effort to calm or subdue intrusive thoughts, images, or urges. However performing compulsions may make their condition worse by triggering cycles of obsessions and compulsions. 

OCD compulsions performed by parents can include:

• Excessive visual checking on baby
• Avoiding being around the baby alone
• Online researching of unwanted thoughts and what they may mean
• Mentally repeating prayers or assertions about how much they care for the child
• Asking others if their child will be okay, or if they’re a good parent
• Having the baby sleep in same room as caregiver
• Checking for signs of breathing throughout the night
• Having other people change the baby’s diapers
• Reassurance seeking from partner or other family members that you have not done something harmful

How do I know if I’m experiencing postpartum OCD?

In postpartum OCD, intrusive thoughts can appear a little differently from someone experiencing other types of OCD. While someone with contamination obsessions might be worried about germs and have to obsessively wash their hands before doing anything, someone with postpartum OCD often experiences obsessions that center around their baby. This could manifest as recurring, disruptive fears about the baby’s life or wellbeing.

It is not uncommon for individuals who are experiencing postpartum OCD to report fears surrounding purposefully harming their child. These thoughts are ego-dystonic, meaning they are not in alignment with the persons true desires. In fact, this is why these thoughts, images, and urges cause the individual such distress. 

And while it’s perfectly normal for new parents to worry about their children, when it causes a great deal of distress and disrupts your ability to function, it may time to seek support and treatment.

For example, having a sudden thought one night that your infant may be in danger and running to their crib to check is an understandable occurrence as an isolated incident. However, if you check on your baby multiple times throughout the night, every night, because you’re constantly afraid for their safety, it could be a sign of postpartum OCD. 

Some people with postpartum OCD have reported intrusive thoughts about themselves causing harm to their babies as well, which understandably causes discomfort and concern. Some research suggests that up to 80% of all new mothers, whether they have experienced OCD symptoms or not, report unwanted or concerning intrusive thoughts similar to those experienced by mothers with known postpartum OCD. The difference is, however, that new mothers with postpartum OCD are so terrified by their intrusive thoughts (oftentimes the fear of violent or sexual harm) that they try to neutralize those thoughts with other thoughts or compulsive actions.

According to Dr. Jonathan Abramowitz, Professor of Clinical Psychology at the University of North Carolina at Chapel Hill, common violent thoughts include:

• The idea that the baby could die in their sleep (S.I.D.S.)
• An image of the baby dead
• Thoughts of the baby choking and not being able to save them
• Unwanted impulses to shake the baby to see what would happen
• Thought of stabbing the baby
• Thoughts of drowning the baby during a bath

Examples of postpartum OCD sexually intrusive thoughts include:

• What if I’m sexually stimulated by breastfeeding my child?
• I get a tingling sensation around my groin when I’m around my newborn 
• I can’t stop staring at my child’s genitals
• What if I molest my baby while changing its diaper?

Does postpartum OCD go away?

OCD is considered a chronic condition, meaning that symptoms can persist and may never go away entirely. Even in subtypes like postpartum OCD which may develop over a short period of time, OCD may often persist in various forms if left untreated. As developmental stages of your child changes, your obsessions may become attached to other areas of their life that you feel responsible for, or to other aspects of their safety and well-being. If OCD remains untreated, you may also experience persistent intrusive thoughts and anxiety about the same obsessions you had soon after giving birth—e.g., “I had those intrusive thoughts years ago—does that mean I am a bad parent?”

While OCD is a chronic condition, that doesn’t mean that you will suffer from it forever. In fact, relief from the suffering caused by OCD can be achieved relatively quickly, with significant results often occurring within 12-25 sessions of exposure and response prevention (ERP) therapy. Many people living in recovery from any theme of OCD report that their symptoms no longer interfere with their lives and that intrusive thoughts no longer cause significant anxiety or distress. 

How is postpartum OCD treated? 

Like many forms of OCD, postpartum OCD is sometimes treated with medication such as selective serotonin reuptake inhibitors, but — more often than not — the most effective form of treatment involves exposure and response prevention therapy (ERP therapy), a highly effective form of cognitive behavioral therapy (CBT). 

ERP therapy works by exposing the person with OCD to potentially triggering situations or circumstances so that they can learn to live with and control their responses in a safe environment. The goal of ERP therapy is to help the person with OCD understand that they don’t have to act on their compulsions. ERP therapy is the gold standard of treatment for OCD and has been proven effective in treating many OCD subtypes, and studies suggest that it is likewise effective for those with postpartum OCD. 

How to get therapy for postpartum OCD

When searching for a therapist to help with postpartum OCD, look for a provider that has specific experience with ERP therapy. You can search for therapists who have completed clinical internships, fellowships or residencies focused on ERP, and you can also search for providers who are members of the International OCD Foundation (IOCDF) or the Association for Behavioral and Cognitive Therapies (ABCT). Both sites allow you to filter searches for therapists in your area who specialize in or have experience with ERP therapy.

You can now also find ERP-trained therapists online through services like NOCD. NOCD has a nationwide network of therapists with specialized experience in ERP therapy. NOCD therapists can see you via one-on-one video therapy sessions or teletherapy, and you’ll be able to get started quickly, with more than 90% of people seen by a therapist within two weeks of booking their first appointment.

This online therapy option is not only accessible, but it’s one of the most affordable OCD therapy options on the market today. It’s easy to get started working with an NOCD therapist to treat postpartum OCD — simply schedule a free call with a member of the NOCD clinical team, and they’ll help find the right therapist for you.  You can also join our Postpartum OCD community and get 24/7 access to personalized self-management tools built by people who have been through OCD and successfully recovered.