Perinatal Obsessive Compulsive Disorder (OCD): 

During pregnancy and postpartum periods, women may experience intrusive thoughts or images for the first time, or may have a resurgence of symptoms if there was a previous diagnosis of OCD.  Intrusive thoughts are often about accidental or intentional harm coming to the baby.  Obsessive thoughts can be violent or sexual in nature and are therefore deeply distressing when experienced.


It is crucial to understand the difference between Perinatal OCD and Postpartum Psychosis as symptoms may seem similar to a layperson.  The OCD sufferer is severely distressed by these disturbing thoughts and his horrified at the thought of harm coming to her baby.  She is debilitated by these "ego-dystonic" obsessions (thoughts not lining up with the character or personality of a person). Women with postpartum psychosis do not experience concern over their disturbing thoughts.  They experience a break in reality where the thoughts make sense to them and they may think they are actually saving/helping their baby by engaging in the impulse. Postpartum psychosis requires a higher level of care and a brief hospital stay is usually required.

Common Obsessions in Perinatal OCD;

  • What if I throw the baby out the window?

  • What if I accidentally stab my baby?

  • What if I forget the baby in the car?

  • What if I give my baby a disease (AIDS, Cancer, Etc)? 

As a result of these thoughts, women may experience intense guilt-shame, isolation, panic attacks and crippling anxiety. In order to cope, it is common for sufferers to avoid triggering situations and to engage in certain rituals to help dispel the disturbing thoughts. Women may be frightened to tell their partner or medical provider about their thoughts for fear they will be labeled as "crazy," or worse, have their children removed.

Common compulsions in perinatal/postpartum OCD:

  • Avoiding knives or sharp objects in the kitchen 

  • Avoiding  dressing the baby or changing diapers due to fear of engaging in sexually inappropriate behavior

  • Repeatedly asking for reassurance from friends/family members that the baby is safe and healthy

  • Repeatedly checking on the baby

There is effective treatment for Perinatal OCD that often requires a combination of counseling and medication management referrals. You are not alone, and You Are Not Your Thoughts 



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