New mothers apparently have a much higher rate of obsessive-compulsive symptoms than the general population, according to new research.
The study from researchers at Northwestern Medicine found that 11 percent of postpartum women experience significant obsessive-compulsive symptoms compared to just 2 to 3 percent in the general population.
The symptoms, which include fear of hurting the baby and worrying about germs, are usually temporary, according to the researchers.
Researchers speculate the obsessiveness could result from hormonal changes or manifest as an adaptive response to caring for a new baby.
But if the obsessive compulsions interfere with a new mother’s functioning, they may indicate a psychological disorder, the researchers warn.
“It may be that certain kinds of obsessions and compulsions are adaptive and appropriate for a new parent, for example those about cleanliness and hygiene,” said study senior author Dana Gossett, M.D., chief and assistant professor of obstetrics and gynecology at Northwestern University Feinberg School of Medicine. “But when it interferes with normal day-to-day functioning and appropriate care for the baby and parent, it becomes maladaptive and pathologic.”
The researchers noted that their own obsessive and upsetting thoughts after giving birth led them to investigate if the experience was universal.
For postpartum women with obsessive-compulsive symptoms who otherwise are functioning normally, “it would be reassuring to hear that their thoughts and behaviors are very common and should pass,” Gossett said.
Obsessions are unwanted and repeated thoughts or images that create anxiety, the researchers explain. A compulsion is a response to those obsessive thoughts, described as “a ritualistic behavior that temporary allays the anxiety but can’t rationally prevent the obsession from occurring,” said Emily Miller, M.D., lead study author and a clinical fellow in maternal fetal medicine at Feinberg.
The women in the study reported that their most prevalent thoughts were about dirt or germs, followed by compulsions to check that they did not “make a mistake,” Miller said.
For example, new mothers may check and recheck baby monitors are working, the baby’s crib side is properly latched or bottles are properly sterilized.
Some women reported intrusive thoughts that they would harm the baby, according to the researchers.
“That can be emotionally painful,” Miller said. “You don’t intend to harm the baby, but you’re fearful that you will.”
Gossett recalled that after she gave birth to her first child, she routinely worried about falling down the stairs with her baby or that the baby would fall out of bed.
“It comes into your mind unbidden and it’s frightening,” she said.
The women in the study were recruited while hospitalized after delivering their babies at Northwestern Memorial Hospital. They completed screening tests for anxiety, depression and OCD two weeks and six months after going home. According to the researchers, 461 women completed the surveys at two weeks and 329 completed them at six months. Symptoms were self-reported and the women did not receive a clinical diagnosis by a psychologist, the researchers note.
About 50 percent of the women reported an improvement in their symptoms by six months, according to the researchers. However, some women who had not experienced symptoms at two weeks developed symptoms at the six-month mark, the researchers reported.
“If those symptoms are developing much later after delivery, they are less likely to be hormonal or adaptive,” Gossett said. The risk for psychological disorders persists for up to a year after delivery, she added.
About 70 percent of the women who screened positive for obsessive-compulsive symptoms also screened positive for depression. That overlap and the subset of obsessions and compulsions could indicate postpartum OCD represents a distinct postpartum mental illness that is not well classified, according to Miller.
“There is some debate as to whether postpartum depression is simply a major depressive episode that happens after birth or its own disease with its own features,” she said.
“Our study supports the idea that it may be its own disease with more of the anxiety and obsessive-compulsive symptoms than would be typical for a major depressive episode.”
The study will be published The Journal of Reproductive Medicine.
Source: Northwestern University