The Untold Story of the Worrying Mom

by Alexis Hershfield, PHD

As you’re bathing your newborn baby, a thought crosses your mind: What if the baby drowns? The next day, while you are bottle feeding your baby, you imagine giving your baby old formula—and your baby catching a deadly illness. Anxiety sets in.

Intrusive unwanted thoughts related to a fetus or infant are reported by 70% of new mothers. While it’s common to experience occasional intrusive unwanted thoughts during pregnancy and postpartum due to the physical, emotional, relational, hormonal and lifestyle changes that accompany pregnancy and childbirth, the challenge for some is that these thoughts become a frequent part of their day-to-day parenting life. Intrusive thoughts can lead to debilitating anxiety or depression, and can cause significant interpersonal stress, parenting challenges, and issues with child development.

According to the American College of Obstetrics Perinatal, anxiety disorders are considered the number one childbirth complication. Perinatal Obsessive Compulsive Disorder (OCD) is an anxiety related condition characterized by recurrent intrusive thoughts and compulsions, which can occur sometime during pregnancy or up to one year postpartum. Those at-risk for developing perinatal OCD include people with a history of mental health challenges, obstetric complications in pregnancy or birth, those who had a Cesarean section, or those who had an experience with the NICU.

While birthing mothers do have a unique risk profile, perinatal OCD is not a condition experienced solely by birthing mothers. Adoptive parents, foster parents and non-birthing parents, including fathers, are also at risk. Times of high stress can be a major trigger for the development of any mental health condition, and that is inclusive of perinatal OCD.

While each person with perinatal OCD can have a unique symptom profile, there are some common symptoms. These include worries that harm will come to the baby, such as dropping or throwing the baby or by unintentionally exposing the baby to toxins or chemicals, checking the baby while he/she sleeps, seeking assurance from family members, avoidance of child-rearing activities for fear that you may harm the baby, or an over-attachment/unwillingness to let others help with rearing. These symptoms often lead to clinical levels of hyper-vigilance, emotional reactivity and sensitivity, sadness, isolation and significant sleep disruption.

For those needing support, research has shown that people with perinatal OCD respond just as well to the those treatments that are recommended for the non-perinatal population. The gold standard treatment for OCD continues to be cognitive behavioral therapy with an emphasis on exposure response prevention (ERP).