Congratulations mamma! As this fresh chapter of motherhood unfolds before you, you will begin to notice how unique your own experience is. Yet, everyone seems to have opinions to share with you once you announce that you are expecting. By now, you have likely experienced many conflicting comments from friends and family, such as, "you are going to be so happy", or "better get your sleep in now". You might have tried to express worry about this new role to loved ones, only to be dismissed with the all too common, “your instincts will kick in, don't worry"; but what if they don't? Is that okay?
For some of us, these might be comments of reassurance, and for others, small annoyances that are easy to brush off. However, for mamas with OCD, these types of comments can trigger already existing feelings of doubt, fear, and uncertainty; and the unsolicited comments just keep coming!
What is Postpartum OCD?
First, let's clear some things up. Women can experience OCD prior to pregnancy, during pregnancy, and after the birth of their baby. For a woman with pre-existing OCD, pregnancy and postpartum can change the themes of obsessions and compulsions and increase the level of distress they experience.
We often hear about postpartum depression, but what is Postpartum OCD? Postpartum OCD is when an individual who has or hasn't had pre-existing OCD develops the onset of OCD after the birth of their baby. Typically, their obsessions and compulsions involve concern for their baby. Although it is called Postpartum OCD, you can develop this disorder during pregnancy as well.
Many women struggling with OCD worry about how their OCD symptoms will change during pregnancy. Some women worry about passing on their 'OCD genes' to their children and can experience anxiety around the decision to have a baby. Others experience fear around taking medication during pregnancy and the list goes on... Let’s take a deep breath and acknowledge where we are at today. You may already be pregnant, deciding to get pregnant or you might already be holding your baby. Regardless of where you are at today, symptoms of OCD are manageable with the appropriate support and tools in place.
Signs and symptoms
Nine months is a long time to ruminate over doubts, fears, and uncertainty about motherhood. It can feel isolating to have intrusive thoughts during such a vulnerable time in your life. You may even feel scared to tell anyone what you have been experiencing for fear of judgement.
Here are some examples of intrusive thoughts and compulsions an expectant mother may experience:
Thoughts about harming yourself or your baby.
Excessive reassurance seeking i.e. calling your doctor or family member often.
Excessive research regarding the health, development etc. of the baby.
Avoidance i.e. of baby, certain environments, or people.
Rumination over future scenarios.
Intrusive thoughts and compulsions can feel like they could be anything and everything and there truly are no strict criteria for their content.
Prevention and treatment
If you are not already working with a counsellor then now would be a good time to start. Having mental health support will be invaluable to you throughout pregnancy and motherhood. Being a parent is full of uncertainty and you will likely face natural exposures daily that may help to challenge your OCD thoughts.
There are medications that are safe during and after pregnancy that you can talk to your doctor about. The combination of medication and counselling is highly effective for managing OCD symptoms.
Let your support people know what you're dealing with and how to respond. Your support people do not need to know specific details of your thoughts or compulsions. You can be broad and share that you are struggling with thoughts and compulsions regarding pregnancy, baby, parenting etc. You can let your support people know what kinds of responses you need from them when you are experiencing anxiety regarding the themes you have shared.
Here are some helpful responses from your support people:
"Let’s write a note of that and ask your doctor at your next visit."
"Is this an emergency?"
"That is not something we can have control over; let's go for a walk."
If you are someone who has already gone through OCD treatment and is experiencing the onset of new symptoms, you might find benefit in working through our Exposure and Response Prevention Worksheet.
Hopefully, some of these things help normalize what you might be going through, give you perspective, and a tangible starting point for taking care of your mental health.
Remember mamma, all your thoughts are valid but not necessarily true. So be gentle with yourself and embrace the uncertainty.