Understanding Postpartum OCD (PPOCD)

What Is Postpartum OCD?

Motherhood is often portrayed as a time of joy and bonding, but for many new mothers, it can also bring unexpected anxiety, distressing thoughts, and overwhelming fears. If you find yourself experiencing intrusive thoughts or feel driven to do repetitive behaviors that feel out of character or distressing, you may be dealing with postpartum obsessive-compulsive disorder (PPOCD).

Postpartum OCD is a subtype of obsessive-compulsive disorder that affects new mothers, typically within the first year after childbirth. It is characterized by intrusive, unwanted thoughts (obsessions) that cause anxiety and compulsive behaviors or mental rituals aimed at reducing distress. These thoughts often center around fears of harming the baby, contamination concerns, or an overwhelming need to do everything “perfectly.”

How Common Is Postpartum OCD?

Studies estimate that postpartum OCD ranged from 2.43 %-9 % among women and 1,7 % among men. experience postpartum OCD. However, due to stigma and lack of awareness, many cases go undiagnosed. PPOCD can affect any new parent, regardless of previous mental health history, making it crucial to recognize the symptoms early.

The Stigma of Postpartum OCD: Why It’s So Scary to Talk About

Postpartum Obsessive-Compulsive Disorder (PPOCD) is a deeply distressing condition, yet it remains one of the most misunderstood and stigmatized experiences a mother can go through. While postpartum depression has gained more awareness in recent years, PPOCD is still shrouded in silence, leaving many mothers terrified to seek help.

Why Is There So Much Stigma Around Postpartum OCD?

1. The Fear of Being Judged – PPOCD often involves intrusive, unwanted thoughts about harming the baby. These thoughts are ego-dystonic, meaning they go against a mother’s values and desires. However, many women fear that if they disclose these thoughts, they will be seen as dangerous or unfit mothers.
2. Lack of Awareness – Many people, including healthcare providers, do not fully understand PPOCD. Because the disorder is often mistaken for psychosis, mothers worry that they will be labeled unstable or have their baby taken away if they speak up.
3. Shame and Guilt – Intrusive thoughts can be horrifying for a mother who loves her baby. The fear of these thoughts leads to intense guilt and self-doubt, making it difficult to admit the struggle, even to a therapist.
4. Cultural Expectations of Motherhood – Society idealizes motherhood as a time of pure joy and fulfillment. When a mother experiences anxiety, fear, and disturbing thoughts instead, she may feel like she is failing or that she is alone in her experience.

Why Is Postpartum OCD So Scary?

• The Nature of the Thoughts – Intrusive thoughts in PPOCD often revolve around harm coming to the baby, whether from external dangers or the mother herself. This can include thoughts of dropping the baby, suffocating them, or accidents occurring. The more a mother fights these thoughts, the stronger they can become.
• Confusing Thoughts with Intent – Many mothers with PPOCD mistakenly believe that having a thought means they will act on it. In reality, these thoughts are a symptom of OCD, not an indication of intent or desire.
• Hypervigilance and Exhaustion – Mothers with PPOCD often engage in compulsions like excessive checking, avoiding certain objects (like knives or stairs), or seeking constant reassurance. This cycle of obsession and compulsion can be exhausting and isolating.
• Fear of Reaching Out – Many women suffer in silence, afraid of what will happen if they tell someone. This fear keeps them from accessing the help they desperately need.

Postpartum OCD is not a reflection of who you are as a mother. It is a treatable condition, and you are not alone. The more we talk about PPOCD, the more we dismantle the stigma and help mothers get the support they deserve. If you or someone you know is struggling with postpartum OCD, reaching out for help is a courageous and necessary step toward healing.

Could You Have Postpartum OCD? Take This Quiz:

If you answer “yes” to any of the following questions, you may be experiencing postpartum OCD, and it might be helpful to speak with a mental health professional:

1. Do you have recurrent, distressing thoughts about your baby’s safety that feel intrusive and unwanted?
2. Do you feel the need to perform rituals or repeated actions (like checking on your baby excessively) to relieve anxiety?
3. Do you avoid certain activities, objects, or situations due to irrational fears about harm coming to your baby?
4. Do you feel an overwhelming sense of responsibility to prevent harm to your baby, even in situations beyond your control?
5. Do you experience significant guilt or shame about your thoughts, worrying they mean something about your ability to parent?

Understanding the Distressing Symptoms of Postpartum OCD

Postpartum Obsessive-Compulsive Disorder (PPOCD) is a condition that causes intrusive, distressing thoughts and compulsive behaviors in new mothers. It can be terrifying to experience, especially when these thoughts feel completely out of character. Below is a breakdown of common symptoms and what they can look like in everyday life.

Intrusive Thoughts About Harming the Baby

Many mothers with PPOCD experience unwanted, graphic thoughts about harming their baby, even though they have no desire or intention to act on them. These thoughts can take different forms:

• A sudden image of dropping the baby down the stairs while carrying them.
• A thought about smothering the baby with a pillow, even though the mother would never do such a thing.
• Fear that they might snap and hurt their baby for no reason, despite having no history of violence.
• Repeated thoughts of something bad happening, like picturing the baby choking or drowning during bath time.

Because these thoughts are so disturbing, many mothers feel intense guilt and question what kind of person they are for having them. They may worry that having these thoughts means they secretly want to harm their child, which is not true—these thoughts are a symptom of OCD, not a reflection of reality.

Compulsive Behaviors: Excessive Checking, Seeking Reassurance, and Avoidance

To cope with intrusive thoughts, mothers with PPOCD may develop compulsive behaviors aimed at preventing harm. These behaviors may include:

• Excessive Checking: Waking up multiple times a night to check if the baby is still breathing, even when there’s no reason for concern.
• Seeking Reassurance: Constantly asking their partner, doctor, or family members if the baby is okay, if they are a good mother, or if their thoughts mean something terrible about them.
• Avoiding Activities: Avoiding tasks like changing the baby’s diaper or giving them a bath out of fear they might accidentally hurt the child.

While these behaviors might provide temporary relief, they ultimately reinforce the fears and make the anxiety worse over time.

Intense Anxiety and Hypervigilance Around the Baby

Many mothers with PPOCD find themselves in a constant state of heightened alertness, afraid that if they let their guard down, something terrible will happen. This can manifest as:

• Sleeping with the baby monitor on the loudest setting, even when the baby is in the next room, and waking up at every small sound.
• Feeling unable to relax while someone else holds the baby, fearing that they won’t be careful enough.
• Mentally reviewing every action throughout the day to ensure they didn’t accidentally do something harmful.
• Being hyper-aware of their own thoughts and body movements, worried they might lose control.

This level of anxiety is exhausting and can make it difficult to bond with the baby or enjoy daily life.

Avoidance Behaviors: Fear of Being Alone with the Baby or Avoiding Sharp Objects

To manage the distress of their intrusive thoughts, some mothers start avoiding certain situations, even when they logically know there is no real danger. Common avoidance behaviors include:

• Refusing to be alone with the baby: A mother might insist her partner or family member always be present, fearing she might accidentally harm the baby if left alone.
• Hiding or avoiding sharp objects: Some mothers may avoid knives, scissors, or even the kitchen entirely because they have thoughts about accidentally hurting the baby with these objects.
• Avoiding places associated with feared thoughts: A mother who fears dropping the baby down the stairs might start avoiding carrying the baby up or down, relying on someone else instead.

Avoidance may seem like a way to reduce anxiety, but it reinforces the fear and makes it even harder to function normally.

Feelings of Shame and Guilt: Worrying You Are a “Bad Mom”

One of the hardest parts of PPOCD is the overwhelming guilt that comes with it. Many mothers believe that having intrusive thoughts means something is wrong with them or that they are unfit to be a parent. They might think:

• “If I were a good mom, I wouldn’t have these thoughts.”
• “What if someone finds out and takes my baby away?”
• “I must be broken or dangerous.”

This shame can prevent mothers from seeking help, which only prolongs their suffering. The truth is that PPOCD does not mean you are a bad mother—it means you are struggling with a treatable mental health condition.

You Are Not Alone

If you are experiencing these symptoms, know that you are not the only one. PPOCD affects many new mothers, and with the right support and treatment, it is entirely manageable. Talking to a therapist who understands perinatal mental health can make a huge difference. You deserve help, and you do not have to go through this alone.

What Causes Postpartum OCD?

PPOCD is not a reflection of your ability to be a good mother. It is a treatable condition caused by a combination of factors, including:

• Hormonal changes after childbirth
• Sleep deprivation and increased stress
• A personal or family history of OCD or anxiety disorders
• Traumatic birth experiences or previous trauma

How Is Postpartum OCD Treated?

The good news is that postpartum OCD is highly treatable. If you are struggling, you don’t have to do this alone. Therapy, particularly Exposure and Response Prevention (ERP) and Acceptance and Commitment Therapy (ACT) , can help you challenge and manage intrusive thoughts without engaging in compulsions. Brainspotting & EMDR, a technique used at Light Within Counseling, may also help in processing unresolved trauma that could be contributing to your symptoms. In some cases, medication can be a helpful part of treatment but is not a requirement, it’s totally up to you. 

You Are Not Alone

If you are experiencing distressing thoughts, it’s important to remember that thoughts do not equal actions—having these fears does not mean you are dangerous or unfit to be a mother. Many women with postpartum OCD suffer in silence due to shame, but opening up to a therapist who understands can be the first step toward relief.

At Light Within Counseling, we specialize in treating OCD, including postpartum OCD. If you or a loved one is struggling, we’re here to help. Reach out today to schedule an appointment and start your journey toward healing.