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Obsessive-Compulsive Disorder and Pregnancy

Monday, December 9th, 2013

Obsessive-compulsive disorder (OCD) is an anxiety disorder characterized by unwanted, recurring thoughts or fears (obsessions) and the behaviors a person develops to try and stop the fears from coming true (compulsions). People with OCD get into cycles of obsessive thoughts which are followed by compulsive behaviors. The compulsive behavior brings temporary relief from the anxiety, but only temporary. Soon the obsession and its accompanying anxiety return, and the cycle starts all over.

For example, a person might repeatedly wash his or her hands, clean the house, or check things such as locks or light switches. Sufferers are aware that there is no need for the behavior, but they are unable to stop themselves from repeating it. OCD can be very time-consuming and cause more anxiety or stress, rather than reliving it. In severe cases, it can stop people from leading normal lives.

Pregnancy and OCD have a relationship that is not yet well understood. Sometimes, a woman experiences OCD for the first time during pregnancy or following childbirth. Also, some women who have existing OCD may find that their symptoms worsen during pregnancy or in the weeks or months following childbirth. Still other women find that their symptoms improve during pregnancy.

OCD and depression are commonly found together; new mothers with OCD may be more likely to experience postpartum depression, or they may experience postpartum depression that is more severe. Among the general population, OCD is thought to affect about one in 100 people; about twice that number are affected during pregnancy and after childbirth. 

How Do You Know if You Have OCD?

Worries and fears are normal and common among pregnant women or new mothers. Such thoughts and fears usually do not signal OCD. However, OCD could be a concern if the anxiety is overwhelming or if it leads to needless and repetitive behaviors.

Fears that the baby is in some kind of danger are common among pregnant women with OCD. A woman may be afraid that she will somehow harm her baby herself, and therefore develop compulsions to try to protect her baby. For example, she may stop eating certain foods she believes may harm her unborn baby, even if her doctor says they are safe to eat. Or, after the baby is born, the new mother may compulsively check on the sleeping baby. She may constantly clean areas the baby has contact with, or she may even avoid spending time with her baby.

Why Is OCD More Common During Pregnancy?

The reason for this is not fully understood. Often, the reason for OCD cannot be pinpointed, even when pregnancy is not a factor. In some cases, it could be that new mothers feel the added pressure of the extra responsibility having a new baby places on them. Or, it may be that a mother suppresses negative emotions because she is “supposed” to be experiencing a joyful event. It is also possible that changes in brain chemistry play a role, or that hormonal fluctuations have an effect.

If you think you may have OCD, ask your doctor about it. He or she can refer you to someone who is trained to help people with OCD. Talking to someone who understands what you are going through is usually very helpful.

– Yvonne S. Thornton, M. D., M. P. H.