What Is Postpartum Obsessive-Compulsive Disorder?

Medically Reviewed by Smitha Bhandari, MD on February 23, 2024
4 min read

After childbirth, worrying thoughts may start to pop up in your mind. These thoughts may repeat frequently or progressively get worse. If you’re a new mom, you may feel a constant urge to make sure your baby is still breathing. You may worry about your baby catching a virus or other disease. You could find yourself washing and rewashing bottles and other baby items because you’re afraid of germs. These feelings may be the result of postpartum obsessive-compulsive disorder (OCD). 

After giving birth, you must adjust to an entirely new life and cope with a lot of related stress. Pregnancy and the postpartum period can be a trigger for OCD. 

The most common thoughts that trouble women with postpartum OCD are: 

  • Concerns about dirt and germs
  • Making sure not to make a mistake
  • The urge to check and recheck that the baby monitor is working
  • Ensuring bottles are properly sterilized

These thoughts are intrusive and make caring for your child very difficult. You don’t have the intention to harm your child, but you’re very much afraid that you will do so accidentally. 

If you’re a new mom, you’re five times more likely than other women to develop postpartum OCD. Further research has shown that up to 70% of women with postpartum OCD also have postpartum depression

Studies haven’t found an exact postpartum OCD cause but believe it to be linked to the hormonal and psychological changes that come with pregnancy and childbirth. Twenty percent of women are more likely to have mood and anxiety symptoms during birth because of rapid hormonal level changes. First-time moms are even more likely to feel overwhelmed. 

The two most prominent symptoms of postpartum OCD are fear of injuring your baby and concern about germs. These concerns can be typical, temporary fears that stem from hormonal changes or from having your first child. Once these thoughts start to interfere with your everyday functioning, they can be a sign of postpartum OCD. 

Postpartum OCD symptoms can start during your pregnancy or at delivery. They are most often uncomfortable thoughts that affect your normal daily functioning. Other symptoms include: 

  • Keeping your obsessions to yourself for fear of being diagnosed with psychosis or being hospitalized
  • Compulsions meant to prevent your fears from coming true like checking on your baby, repeating prayers, asking for reassurances, constant cleaning
  • Avoiding certain activities with your baby like bathing, carrying them up or downstairs, changing their diaper
  • Feeling overwhelmed by your obsessions and compulsions
  • Postpartum depression
  • Needing a partner or helper nearby because of fear of hurting your baby
  • Trouble sleeping because of obsessions and compulsive urges
  • Having a hard time taking care of your child

Postpartum OCD symptoms may go unnoticed at first. You or your family may not realize you have OCD compulsions until months later, though symptoms can appear in the first two to three weeks after birth.

If you’re having thoughts that overwhelm you and get in the way of your parenting, you should talk to your doctor. Many parents are dealing with similar worries, and you shouldn’t feel ashamed. Talking about your thoughts is the first step to getting help. Sharing them will not make you lose your child or get you hospitalized, though this is the main concern that keeps new mothers with postpartum OCD from talking to their doctor. 

Your doctor may go through your history to assess your thoughts and feelings. You may be asked to use a rating scale to help you track symptoms and measure obsessions and compulsions. 

After a diagnosis, you can start getting postpartum OCD treatment. The same methods used to treat other types of OCD can be used for postpartum OCD. They include:

Cognitive-behavioral therapy (CBT). This is the most commonly recommended form of treatment. You and a psychologist will talk through your obsessive thoughts. They’ll help you learn that these types of thoughts are normal and not dangerous. CBT will help you confront the situations and thoughts that you’ve been trying to avoid. The goal is to help you reduce the compulsive rituals you use to cope with your fears. 

Selective serotonin reuptake inhibitors (SSRIs). Serotonin is a hormone that plays a key role in maintaining a person’s mood and feelings of well-being. SSRIs are medications that help increase serotonin levels and reduce feelings of anxiousness and doom. Most SSRIs used for OCD are safe to take when pregnant and breastfeeding. You will nevertheless want to check with your doctor first. 

Medication. In addition to CBT, your doctor may prescribe antidepressants. These medications are commonly recommended as the first-line of treatment for OCD.