Postpartum OCD is a treatable mental health condition that typically occurs within 6 weeks after the birth of a child. Becoming aware of the signs and symptoms may help you cope.

After the birth of their newborn child, birthing individuals may notice they’re more cautious and aware of their surroundings in hopes that they can protect their infant.

Some may even experience a mix of emotions, such as worry or fear, as they adjust to caring for their baby and the physiological changes that naturally occur during the fourth trimester.

But sometimes, those worries and fears can become more severe and persistent — and when they do, it could be a sign of postpartum obsessive-compulsive disorder.

Postpartum OCD is a condition that typically affects a parent following the birth of their child, usually within 6 weeks, though it can also occur during pregnancy. During pregnancy, it’s usually called perinatal OCD.

Postpartum OCD can affect someone who has never been diagnosed with obsessive-compulsive disorder (OCD) and someone who’s had a previous diagnosis of OCD, often worsening existing symptoms.

While estimates vary, up to 4% of birthing parents have their first onset of OCD after childbirth, and between 25-75% of birthing parents with OCD will have a recurrence after delivering their baby.

OCD is a well-known, though often misunderstood, chronic mental health condition that affects around 2.3% of U.S. adults at some point in their lives.

Someone living with OCD will experience two types of symptoms:

  • obsessions: intrusive and recurring thoughts, images, or urges
  • compulsions: actions or things you do repeatedly in response to the obsessions you experience

Postpartum OCD symptoms generally arise much faster than OCD typically does, and they can last at least 6 months.

But if you experience postpartum OCD, your obsessions will be related to the baby in some way. And it can also affect the non-birthing parent.

Postpartum depression and postpartum OCD

It’s important to note that postpartum OCD and postpartum depression (PPD) are two separate disorders, but PPD can co-occur with postpartum OCD.

Also known as peripartum depression, PPD is a severe mental health condition that affects about 1 in 8 people who give birth in the United States. It can show up in pregnancy, within days of the baby being born, or within 1 year.

Birthing individuals living with PPD may notice symptoms, such as:

  • intense sadness or hopelessness
  • feeling disconnected from your partner
  • not connecting or bonding with the baby
  • loss of interest in activities you once enjoyed
  • feeling worthless, guilty, or like a bad parent
  • trouble concentrating or making decisions
  • fear of harming yourself or your baby

Like postpartum OCD, non-birthing parents can also be affected by PPD. But there are differences in the signs and symptoms that may help further distinguish both disorders.

Signs and symptoms of postpartum OCD can include obsessive fears of:

  • dropping the baby
  • drowning the baby
  • putting the baby in a strange place
  • harming the baby intentionally or unintentionally
  • the baby dying of SIDS
  • the baby getting sick
  • telling people how you feel for fear of being called “crazy” or being hospitalized

If you live with postpartum OCD, you might also have intrusive, disturbing images of the baby’s death or violent acts toward the baby, even if the idea of those acts is unpleasant to you.

As a result of these unwanted thoughts, you might find yourself developing compulsive behaviors, such as:

  • repeatedly checking that the baby is still breathing
  • staying up to watch the baby sleep
  • repeating prayers for the baby’s safety
  • asking others for assurances that the baby is okay or healthy

Someone living with postpartum OCD might also develop avoidance compulsions as a result of these fears, such as avoiding:

  • bathing the baby
  • holding the baby
  • changing the baby’s diaper
  • going outside
  • talking the stairs
  • putting the baby in the car seat
  • putting the baby down at all

Researchers aren’t exactly sure what causes postpartum OCD. This is most likely because there isn’t just one cause.

It’s important to remember that postpartum OCD is not your fault, and experiencing these symptoms does not mean you are a “bad” parent.

Like with PPD though, postpartum hormonal changes, such as changes in estrogen, are believed to play a role in activating the mental health condition.

For example, hormones can affect neurotransmitters in the brain — including serotonin — and serotonin disruption might be related to OCD.

Other possible risk factors for postpartum OCD include:

  • a personal or family history of OCD
  • a personal history of depression
  • a personal or family history of anxiety, substance use, or mood disorders
  • giving birth for the first time
  • complications during pregnancy or delivery
  • high stress levels
  • lack of sleep

Postpartum OCD appears to be related to PPD, but researchers aren’t sure whether one necessarily causes the other.

While postpartum OCD can lead to disturbing thoughts and images, it’s unrelated to postpartum psychosis (which is also significantly rarer).

However, sometimes people can mistake postpartum OCD for postpartum psychosis (or worry their thoughts are a warning sign), which may cause them to feel shame and fear. As a result, they’re less likely to share their feelings, which can delay treatment.

If you have any of these symptoms, consider talking with a primary care provider, OB-GYN, or a mental health professional. They can help you get diagnosed to get the treatment you need.

Cognitive behavioral therapy (CBT)

Treatment for postpartum OCD generally includes psychotherapy, otherwise known as talk therapy, which is a big part of treatment for postpartum OCD. In particular, cognitive behavioral therapy(CBT) is a popular technique used.

With CBT, your therapist will help you identify negative, unhealthy, disturbing thinking patterns and learn skills to challenge and replace them.

Treatment will likely involve exposure to the things that frighten you — but in a safe setting — to help you realize that you are unlikely to harm your child and help you learn how to prevent your compulsions.

Serotonin Reuptake Inhibitors (SSRI)

Serotonin reuptake inhibitors (SSRI), an antidepressant, are also sometimes prescribed to treat postpartum OCD.

Since SSRIs transfer through breast milk — and there is limited research on the long-term effects of SSRI exposure through breast milk in babies — talk therapy is often tried first if you’re nursing.

Like PPD, living with postpartum OCD can affect your bond with your baby and partner. But with treatment, it’s possible to learn how to cope with your thoughts and learn coping skills.

It’s also beneficial to take good care of yourself while undergoing treatment. Some tips that can help include:

  • sleeping as much as you can
  • self-care, including remembering to shower and taking time for a little “me time.”
  • remembering to eat
  • asking or accepting help from friends and family if you can
  • meditation

It can be difficult to welcome a new baby into the world — especially when your sleep routine changes, you experience shifts in your hormone levels, or you don’t feel like you know what you’re doing.

If you feel your fears and anxieties are “taking over,” causing you significant distress, or are interfering with your ability to care for your baby (or yourself) effectively, you’re not alone. Consider speaking with a mental health professional for help because postpartum OCD is treatable.

If you’re unsure where to find a therapist, you can check out our Find a Therapist page. Other helpful resources include: