Being a new mom—even when it’s not your first baby—can be very stressful and can leave moms feeling out of control of their mind and their circumstances. If you aren’t feeling all joy as you embark on this journey, you’re not alone. It’s natural to feel worried about the safety of your baby or experience a heightened sense of responsibility. However, in some cases, these thoughts and worries can actually become all-consuming and detrimental to your mental wellbeing. In psychology, these are described as intrusive thoughts, voices or images that often come out of nowhere. These thoughts often originate from the feelings of anxiety around being out of control.

If this resonates with you, know that while stressful, having intrusive thoughts during the postpartum period is actually very common. At least 70% of new moms report having unwanted, intrusive thoughts about infant harm, according to a study published in BMC Psychiatry. And 50% of new moms report having intrusive thoughts related to intentionally harming their baby.

Unfortunately, if a mother doesn’t know that intrusive thoughts are a common part of the postpartum experience, she might think something is deeply wrong. Thus, instead of reaching out for help, she might internalize this experience, which can lead to further isolation and mental distress. Additionally, it’s important for moms to be able to differentiate between what is actually a serious, but very treatable disorder known as postpartum obsessive-compulsive disorder (OCD) and what is just an intrusive thought.

What is postpartum OCD?

Postpartum OCD is a type of perinatal anxiety disorder that can develop after a woman gives birth. Unfortunately, due to the lack of awareness and education regarding postpartum OCD among clinicians and the general population alike, many new moms are either undiagnosed or misdiagnosed, thus leaving many mothers struggling without proper care.

One major barrier to the diagnosis of postpartum OCD is that it is often confused with postpartum depression (PPD), but they are two distinct disorders. PPD is a mood disorder, while postpartum OCD is an anxiety disorder that involves intrusive thoughts and compulsive behaviors that are difficult to control.

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

The good news is that postpartum OCD is a very treatable mental health condition. Becoming aware of the signs and symptoms may help you if you are struggling, but may also give you the tools to offer help to another mother in your community.

Signs of postpartum OCD

For a person to be diagnosed with postpartum OCD, the symptoms must develop or worsen during the postpartum period (any point within a year of giving birth), but symptoms typically come on within the first 6 weeks after a baby is born.

The symptoms of postpartum OCD generally consist of obsessive, intrusive and recurring thoughts about harming the baby and may be accompanied by compulsive behaviors as a means of coping with these thoughts.

Obsessions come in many forms, but the most common themes include:

Fear of contamination (e.g., baby getting sick)
Fear or harm to the baby or self (e.g., dropping or hurting the baby, falling down stairs)
Exactness/symmetry (e.g., cleanliness and organization)

If someone is struggling with postpartum OCD, they 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.

As a result of these unwanted thoughts, it is common for some struggling with postpartum OCD to develop compulsive behaviors as a way of coping with these unwanted and intrusive thoughts.

Compulsive behaviors may include:

Excessive hand-washing
Excessive checking of the baby (during the night or day)
Excessive praying to ensure the baby’s safety
Constantly seeking reassurance from family and friends regarding the baby’s safety

Or, people may develop avoidance compulsions as a way to cope with these fears.

Avoidance compulsions may include:

Bathing the baby
Holding the baby
Changing the baby’s diaper
Going outside
Taking the stairs
Putting the baby in the car seat
Putting the baby down at all

Additionally, a mother struggling with postpartum OCD will most likely be exhibiting related symptoms, such as trouble sleeping.

Symptoms related to the onset of postpartum OCD may include:

Trouble sleeping (falling asleep/waking at night/insomnia)
Trouble connecting with the baby
Over- or undereating
Lack of motivation or interest in activities they once enjoyed
Isolating with or without the baby

As mentioned above, motherhood can be an extremely challenging time filled with a roller coaster ride of emotions and hormones. It is normal for a new mother to feel overwhelmed, frazzled, out of sorts and downright exhausted. However, concern is warranted when these symptoms persist past the 2 to 3 week time period after birth, especially when it relates to postpartum OCD.

Once a new mother seeks help from a professional who understands postpartum OCD, it is a very treatable diagnosis.

What’s normal in new motherhood… and what’s not

A very common fear for new moms is that they will accidentally drop their baby while going down the stairs. While disturbing, if a new mom is able to recognize this phenomenon as just an irrational intrusive thought and continues taking the stairs, this fear is actually not concerning from a mental health standpoint. However, if the mom decides to alter her life so she never has to take the stairs, this is a sign that there is a larger issue at play.

In a nutshell, when intrusive thoughts begin to significantly alter the actions or behavior of a new mom, it is imperative that a new mom receives professional help from a licensed therapist or psychiatrist.

Additionally, many new moms and people struggling with OCD suffer from ego-dystonic thoughts. Ego-dystonic thoughts refers to thoughts, impulses and behaviors that are felt to be distressing, unacceptable or inconsistent with one’s self-concept.

The important piece here as it relates to new moms, is that these intrusive thoughts leave the mom feeling uncomfortable, distressed and feeling out of line with who they are as a person. We become concerned when a new mom begins to believe or feel that things might be better if they hurt the baby or themselves—or that they are actually capable of doing so.

Coping and seeking help

Whether you are struggling with intrusive thoughts or think you may be experiencing postpartum OCD, it’s important that you know how to help yourself and when to seek outside help from a professional.

1. Acknowledge your experience

The best thing struggling moms can do is acknowledge their thoughts, feelings and fears.

When we acknowledge we are struggling, it not only opens up the opportunity for us to help ourselves but it also increases the chances that we will reach out to others for help.

Being able to confide in a partner and close friends or family is imperative for a mom struggling with intrusive thoughts. Although it can be very uncomfortable to share distressing thoughts or images with even people close to you, it will both provide a new mom with the support she needs and just the act of speaking our fears actually leads to a decrease in anxiety.

2. Name your emotions

Naming your emotions not only validates our emotional experience, but it also gives us some sense of control over our emotions and allows us to examine them with logic.

As Dr. Dan Sigel, author of the whole-brain child, famously coined, when you name it, you can tame it.

3. Do a safety check

Once you have acknowledged and named your emotions, it’s important to check for safety and ensure whatever you are feeling isn’t an actual threat or true danger.

4. Take a step forward

And then you take a step forward, literally and figuratively.

It’s important that we don’t bend our lives to avoid things that make us uncomfortable or anxious but rather that we step toward them. Dr. Catherine Schmidt, who specializes in postpartum OCD, has a wonderful podcast that provides great real-life examples of this process.

You may have to repeat this process several times a day or for several days in a row, but with small steps and practice, you’ll start creating muscle memory in the brain. When this muscle memory is created, you will not only be able to acknowledge these intrusive thoughts, but these thoughts will begin to lose their power over you. More important, you’ll most likely find this thought is not going to happen.

A note from Motherly: Coping with postpartum OCD

In the event you find yourself getting stuck at the top of the stairs (literally and figuratively), and you begin altering your life in such a way that you can no longer show up for your family, your baby or yourself, it is imperative to seek help from a professional. We need to remove the stigma around receiving mental health support in postpartum. You’re not alone in this journey, mama, and there are people around you who want to support you.