Postpartum OCD in New Parents
Postpartum OCD in New Parents
There’s an extensive amount of new emotions, experiences, and especially anxieties that come with being a new parent. During the postpartum period, it is common to encounter a wide range of unfamiliar thought patterns - things you may have never had to consider before start popping up! When did they last eat? Sleep?
On top of this challenging life transition, some individuals experience a subtype of OCD - postpartum OCD. While it occurs immediately after childbirth like other postpartum mental health conditions, it uniquely follows the OCD cycle (obsession - distress - compulsion - temporary relief), with a specific focus on the newborn. If a new parent already has OCD, it can worsen or shift subtypes during this time. Furthermore, research shows that people who are pregnant or have recently given birth are at an increased risk for developing OCD symptoms, even if they have never experienced them prior.
Common Intrusive Thoughts
One of the most difficult aspects of postpartum OCD is experiencing intrusive thoughts regarding your newborn. These thoughts can feel "taboo" or "disturbing," often bringing intense shame. It’s vital to remember that intrusive thoughts are ego-dystonic, meaning they deeply conflict with a parent's actual values, which is exactly what makes them so distressing. They are typically a symptom of extreme hypervigilance and anxiety.
If you are experiencing postpartum OCD, you may notice intrusive thoughts or images about:
Accidental harm (dropping the baby, leaving them in an unsafe area)
Intentional harm (harming the baby with a sharp object or inflicting pain)
Contamination (fears regarding the baby contracting a disease)
Violent sexual thoughts (images of the baby in inappropriate situations)
Postpartum OCD vs. Postpartum Psychosis
Another condition some may experience is postpartum psychosis. This differs fundamentally from postpartum OCD because it involves a complete detachment from reality. New parents experiencing psychosis do not find these intrusive thoughts horrifying; they may believe their delusions and hallucinations to be true. Because of this lack of distress, severe cases constitute a medical emergency where individuals may be compelled to act on them.
With postpartum OCD, parents do everything they can to avoid acting on these thoughts, which drives their compulsions. Now, if you’re reading this with OCD, you might ask, “But how do I know this doesn’t apply to me?” The answer is that you can never know with 100% certainty, but the question itself shows the fear and distress are present. If you are concerned about distinguishing between these conditions, it’s best to consult an OCD-informed professional.
Checking and Avoidance Behaviors
To manage the fear that their thoughts might come true, parents with postpartum OCD often engage in repetitive behaviors, including:
Checking to make sure the baby is healthy, well, or unharmed
Asking others for constant reassurance
Excessive washing to remove contaminants
Avoiding holding, bathing, or changing the baby due to distressing obsessions
Refusing to care for the baby without another person present
Like all compulsions, these behaviors provide only temporary relief until the next doubt presents and the cycle restarts. Left unchecked, the cycle reinforces itself, and compulsions can require more time and effort over time.
Fear of Disclosure
When you have OCD, sharing your thoughts with anyone, let alone a professional, can feel terrifying. Common fears include, “What if they think I want to act on this?” or “What if they think I’m a bad parent?” You might feel completely alone in this experience.
But imagine the alternative: you find an OCD-informed therapist who truly understands how these thoughts work. You leave your session feeling more understood and seen than ever before. How freeing would that be? That is the side that fear and shame block you from seeing right now.
Treatment and Support
Thankfully, that relief is closer than you think. Postpartum OCD is highly treatable through Exposure and Response Prevention (ERP), sometimes combined with other approaches.
Throughout treatment, you should experience a non-judgmental space to share your fears. Your therapist will work with you to accept intrusive thoughts as a normal, non-threatening part of your experience, gradually exposing you to feared scenarios without relying on compulsions. Medication (like SSRIs) can also be an invaluable tool to help manage the baseline stress of new parenthood while doing this work.
If you’re wanting to explore ERP further with an OCD-informed therapist, reach out to Health in Tandem today!