Postpartum obsessive-compulsive disorder

By Cristiano Antonino On Dec 16, 2022

What is postpartum obsessive-compulsive disorder? For some parents (mothers and fathers alike), the new parenting condition can trigger postpartum obsessive-compulsive disorder, which is a surprisingly common anxiety disorder that is associated with violent and disturbing thoughts, images, or impulses

Symptoms may begin suddenly after the newborn arrives home, or preexisting symptoms may be exacerbated by new parental responsibilities.

Postpartum obsessive-compulsive disorder, aggressive obsessions and sexual obsessions are particularly common

In particular, the former may include the fear of causing intentional or accidental harm to the infant.

Imagine that a mother of a newborn with frequent colic, frustrated by her baby’s crying, has a mental image of herself throwing the baby down the stairs or out the window.

This thought comes unexpectedly and is perceived as dangerous, significantly upsetting the woman, who may begin to think, “Why am I having this thought? Does this mean that I might hurt my baby? What would happen if I lost control and actually had to throw my baby down the stairs? Mothers should not have thoughts like this.”

In response to these thoughts, she will avoid going near the stairs while holding her baby or will start holding her baby very tightly whenever she approaches them.

Postpartum obsessive-compulsive disorder, unwanted thoughts regarding accidents

Another common symptom of postpartum obsessive-compulsive disorder is the recurrent, intrusive worry that something bad might happen to the baby.

For example, a parent may have recurring thoughts or intrusive images of the baby suffocating or choking in his or her crib and may think, “It’s my responsibility to prevent any harm that might happen to my child.

If I have such a thought, it is important that I check every time just to make sure my child is okay.

After all, that is what a good parent should do.

If I fear such things and don’t check, something bad will happen and the death of my child will be all my fault.”

In response to these thoughts, it is possible for the parent to perform numerous checkups to make sure the child is okay.

These may occur several hundred times a day.

Each time a new doubt creeps in, the parent feels compelled to check again, just to reassure himself or herself.

Postpartum obsessive-compulsive disorder, unwanted sexual thoughts

A third very common symptom of postpartum obsessive-compulsive disorder involves unwanted sexual thoughts about one’s child.

These usually occur during diaper changing or bathing and may consist of thoughts (e.g., “What would happen if I touched my baby inappropriately? What if I was aroused by it?”), sexual images involving the baby, or impulses to act in a sexually inappropriate way.

A father with these kinds of obsessions, for example, might think, “What kind of person has thoughts like this? Does this mean that I am a pedophile or that I might be able to molest my child? These are sick thoughts. I should not have thoughts like this.”

In response to such unwanted thoughts, the father may begin to avoid the child

Avoidance may be particularly evident with respect to those situations in which it is possible to see the child naked (e.g., during diaper changes, while bathing, when changing clothes).

Parents with postpartum sexual obsessions often avoid physical contact with the baby (e.g., hugging the baby, holding the baby sitting on their lap) or being alone with the baby.

Postpartum obsessive-compulsive disorder, characteristics

In the above examples, an unexpected spontaneous thought gives rise to a fear that the parent may pose a threat to the child or may act in a way that puts the child at risk.

Parents with postpartum obsessive-compulsive disorder have no desire or intention to harm the baby, however, the appearance of an unwanted or threatening thought causes them to question their own intentions, morals, or suitability for parenthood .

Despite these fears, postpartum obsessive disorder is not associated with an increased risk of harming children or infants

As with all forms of obsessive-compulsive disorder, it includes rituals and avoidance behaviors in response to obsessions, such as controlling behaviors, washing behaviors, situational avoidance behaviors, and mental rituals.

These behaviors maintain the symptoms of the disorder because they prevent the disconfirmation of erroneous beliefs related to the obsessions themselves.

Given the way postpartum obsessive-compulsive disorder works, the more intensely the parent examines the unwanted thoughts, the more they aggravate their disorder.

The more the person tries to understand why these thoughts appear, or seeks ways to make them stop, the more frequently the thought will recur.

Parents suffering from severe postpartum OCD may have unwanted thoughts concerning their child almost constantly

Symptoms can cause the parent to dread spending time with the child, and this can affect bonding and can devastate the parent-child relationship.

Because aggressive obsessions and sexual obsessions are in stark contrast to what the new parents feel they “should” feel, the symptoms of obsessive disorder often cause a great deal of guilt, shame and confusion.

Because of the nature of the symptoms, postpartum OCD often results in extreme isolation, alienation, and depression and is sometimes a trigger for parental separation or divorce.

Although many people are aware of the existence of postpartum depression, very few are familiar with postpartum obsessive-compulsive disorder, but it affects about 2.6 percent of mothers.

The symptoms of this disorder can be so disturbing that only a few can express themselves clearly about what they are experiencing.

They fear the looks of horror and disgust from loved ones, the possibility that their children may be taken away from them, or that doctors may decree that they are “crazy” and hospitalize them.

The reality is that, just like other forms of OCD, postpartum OCD is treatable. The treatment of first choice is cognitive behavioral therapy, which involves techniques designed specifically for symptoms of this type.

Some characteristic fears of postpartum obsessive-compulsive disorder

The most common symptoms of postpartum obsessive-compulsive disorder include fears of accidentally or intentionally harming one’s child.

Fear of acting on an unwanted impulse and hurting or killing one’s baby.
Fear of stabbing one’s baby.
Fear of beating one’s child to death.
Fear of choking one’s child.
Fear of shaking the child to death.
Fear of losing control and drowning the baby during bath time.
Fear of acting in a sexually inappropriate way toward the baby during diaper changing, bathing, or while dressing the baby.
Fear that one may secretly wish to molest the child.
Fear of inappropriately touching one’s baby.
Fear of being sexually attracted to one’s baby.
Fear that one’s irresponsibility will lead to the child’s death.
Fear of accidentally poisoning one’s baby by not cleaning the bottle or toys properly.
Fear of accidentally exposing the child to chemicals (e.g. , cleaning products).
Fear that if you do not supervise your baby enough, your baby may suddenly die (e.g., from SIDS)
Fear of suffocating one’s baby or that the baby will suffocate due to one’s own negligence.