OCD in the Perinatal Period

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OCD affects about 1% of the general population. Amongst the perinatal population, some researchers have found that up to 11% of women meet criteria for OCD. Recent studies suggest that OCD is more common during the perinatal time period more than any other time in one's life.

What is OCD?

Obsessive Compulsive Disorder (OCD) is an anxiety disorder that is characterized by persistent, repetitive and intrusive unwanted thoughts, images, and ideas (obsessions) accompanied by behavioral and/or mental actions (compulsions) that work to reduce and/or neutralize acute anxiety that is caused by intrusive thoughts. People with OCD are often very distressed and sometimes even confused by their obsessions and recognize that their obsessions and compulsions may be irrational. However, insight does not reduce anxiety or reduce the urge to use their compulsion. We use compulsion like behaviors all time- we may know rationally that knocking on wood doesn't increase/decrease the likelihood of something happening but we do it anyway. For someone with OCD, they feel this way about their compulsion but much more intensely.

How is Perinatal OCD different?

OCD symptoms that emerge in the perinatal period almost always involve thoughts about the baby. This may include anxiety provoking and intrusive obsessional thoughts about miscarriage, the baby's health, morbid images of the baby that are often quite detailed and graphic, and unwanted intrusive thoughts about harming the baby, (such as accidentally dropping the baby or suffocating the baby).  Compulsions that accompany these thoughts also connect to the baby- they may involve frequent checking on the baby's breathing, attending many doctor's appointments and/or avoiding tasks that have to do with the baby, such as bathing, holding and feeding the baby.

Moms report that these thoughts are very distressing and contrast greatly with how they actually feel about their infant. Research shows that these thoughts are driven by anxiety and do not pose an actual threat to the baby. In fact, some researchers theorize that OCD may have an evolutionary basis that has worked to help parents remain hypervigilant and protective of their baby.

We need to support moms with OCD by educating them about their diagnosis, help them learn ways to cope and tolerate their symptoms through therapy and medication, and nurture the mom-to-baby bond.
— Catherine Boutwell, Clinical Psychologist, Ph.D.

Many moms with OCD can feel very alone and ashamed of their intrusive thoughts. But truth is, most parents will experience morbid intrusive thoughts about their child from time to time- it's just that with OCD the thoughts are overwhelmingly persistent, convincing and interpreted as more meaningful than they actually are. For example, the intrusive image of the baby being smothered is interpreted as "I will smother the baby." A mom with OCD is more likely to avoid holding their baby or may go to great lengths to ensure safety over intentionally harming the baby. Instead, we need to support moms with OCD by educating them about their diagnosis, help them learn ways to cope and tolerate their symptoms through therapy and medication, and nurture the mom-to-baby bond.
 

Dr. Catherine Boutwell
Clinical Psychologist
The Motherhood Center

Want to learn more and meet Dr. Catherine Boutwell?

If you would like to learn more about OCD in the Perinatal Period, make sure to register for the next monthly provider seminar at The Motherhood Center on Thursday, June 14th from 6:30 – 7:30 PM EST.