Pregnancy and OCD (perinatal and postpartum)

We recognize that the birth of a newborn can be extremely overwhelming. Many women during these times can experience difficulties with intrusive thoughts around their newborn’s health. New mothers are also more likely to admit that they’ve checked from time to time to see if their newborn is still breathing. Sometimes the thoughts about the health and safety of a newborn can become intrusive and overwhelming. The checking behaviours themselves can also become debilitating. At times, some individuals who experience difficulties with OCD are likely to identify the onset of their symptoms to begin during a specific biological event that may trigger a hormonal change (menarche (a period), pregnancy, postpartum). These individuals may experience an increase in intrusive thoughts and feel compulsed to reduce the anxiety by carrying out a specific act or safety behaviour (seek reassurance, reduce the anxiety by completing a behaviour, or through avoidance).

What we know about pregnancy specifically is that it’s the only life event that has been identified as potentially influencing the onset of OCD symptoms. According to a study conducted by Uguz et al., 1.7-4% of women are likely to experience their first onset of OCD (obsessive compulsive disorder) symptoms after childbirth, while those who have a history of OCD are 25-75% more likely to experience a flare-up of OCD symptoms.

Most women during pregnancy describe their symptoms to be more aggressive in nature. These symptoms typically align with what we refer to as harm OCD (harming the baby, harming self, or sexually abusing the baby).  However, not all OCD thoughts during pregnancy are related to harm OCD and can be related to other sub-themes such as contamination or questioning decisions.

What is important to remember is that treatment has been shown to be effective in managing OCD symptoms. Treatment includes identifying distorted thinking, challenging intrusive thoughts with appropriate OCD treatment modalities, and introducing exposure with response prevention. We also teach our patients how to effectively use mindfulness strategies and techniques.

Uguz et al, J Mood Disorders., 2011.
Abramowitz OCD Newsletter, 2007.
Peggy Richter, MD; Joy Burkhard; Kate, Destefano-Torres, LPC, OCD Conference 2020.