Perinatal OCD and Intrusive Thoughts: A Troublesome Secret to Many

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By Catharine McDonald

This blog was inspired by a dear friend of mine (who shall remain nameless) that shared her very personal story after reading my first MotherWoman blog. We'll call her Jane. Jane and I were on a play date with our similarly aged children last week and she mentioned the blog, and then asked if I ever had a client with intrusive thoughts. Normally I shy away from mixing my professional knowledge with personal interactions; however it was apparent she had something important to share. Jane went on to tell me that in her pregnancy she had graphic images of harming her belly, she complained to her husband of constant nausea so he didn't notice she was avoiding the kitchen--they ate out often and she felt safe by keeping herself from sharp objects. After the baby was born Jane told her husband that bath time was a good time for them to bond since she was nursing and got to bond over mealtimes. Jane's husband enjoyed his nightly routine with their son and Jane rarely had to bathe the baby. Jane opted not to share with her husband that she had terrifying, graphic images of harming the baby in the bath, whether it be water temperature or in another manner. As she told me this, tears welled up in her eyes, her guilt was palpable and I could do nothing but offer her a hug. What's particularly heartbreaking for me is that our children are approaching two. Jane struggled with these thoughts for most of her son's first year of life, hid this experience for another year. She never felt safe telling anyone- she hid her terrifying fears from the world, because we don't talk about these things. She feared she was losing her mind or thought she was a terrible person, so she remained silent.

2013-05-30-Depressedmom.jpgIf only two years ago, Jane had a local group like MotherWoman in those pre-baby and postpartum months. MotherWoman provides an additional, very important form of care and support in their monthly group gatherings. Women suffering similar anxiety and stress come together and can share their experiences in a safe place, normalizing their fears and learning about how to cope and where to get help. Similar organizations may have monthly support meetings in your area. At these support meetings, mothers are reminded that their disturbing thoughts are not by any means a reflection of their parenting, their ability to love and mother their child, or an indication of what the mother-child relationship will be like in the future.

In my experience in mental health, the average person tends to have a basic understanding of depression and anxiety. We have all felt sad or worried at some point in our lives- to a degree we can relate. When that anxiety manifests into something more, something alarming or disturbing, people stop discussing their experiences openly.

Suddenly a person can feel alone, wondering if they are the only person who experiences alarming thoughts... when intrusive thoughts center on a baby, the degree of anxiety is exponentially amplified. Perinatal OCD and intrusive thoughts are much more common than we hear about--- some researchers estimate as many as 11% of women experience these disorders (Miller, Chu, Gollan, & Gossett, 2013), and almost all parents have a fleeting intrusive thought at some point in the perinatal period (pregnancy through early postpartum). MotherWoman strives to normalize this perinatal emotional complication and educate women about intrusive thoughts and how to work through them.

Perinatal OCD can start in pregnancy with unwanted, intrusive thoughts about harm coming to the baby, miscarriage, or even the mother intentionally causing harm to the baby herself. After delivery, a mother may experience anxiety about failing to care properly for her baby or harm coming to her baby whether it is by her or someone else. Images can come into a mother's mind in a gruesome or graphic nature--in Jane's case she experienced intrusive thoughts in both pregnancy and motherhood.

Women may be tormented by appalling or ominous thoughts and images, disturbing much needed, precious sleep in those early weeks of motherhood. Sometimes these thoughts can take a disturbing, sexual nature and a parent may fear the child will be abused. Describing other common thoughts in detail can serve only to fuel an anxious mother's mind or give her additional ideas to worry about, so I will refrain from additional examples, but please know, anxious moms- your thoughts are yours, but you are not the first woman to have them. There may be a compulsion component to this perinatal emotional complication as well, mothers may complete repetitive tasks in hopes of protecting the baby or quieting the anxiety. For example, a mother may bathe or change a diaper excessively. She may lay awake at night replaying the activities of the day checking to make sure she did not accidentally harm or neglect the baby in any way. She may not sleep at all because she is constantly checking on her infant.

The key to intrusive thoughts is in the name--they are intrusive, unwanted. The mother does not see the baby as a sexual object, she does not desire to harm the baby or think that she should hurt her child. She finds the thoughts distressing and upsetting. She does not want to act on them and may feel disgusted with herself for having these thoughts. This mom may avoid objects, places, or even her baby for fear of acting on intrusive thoughts. Bottom line: Perinatal OCD is not psychosis. If a woman believes that she should harm her belly or her baby, it's time to seek help, now.

One of my favorite resources is a book titled "Dropping the Baby and Other Scary Thoughts," by Karen Kleiman and Amy Wenzel ( This book is not only a good read but also conveniently available on Kindle and NOOK so you can conveniently read them without fearing book store checkout judgment. Other articles are available online and can be helpful to bring along to a provider. These symptoms are more common in individuals who have dealt with anxiety prior to a pregnancy and may be more common after a traumatic birth. Perinatal OCD and intrusive thoughts are both very treatable. With counseling and supports, women can learn to manage and overcome intrusive thoughts, and enjoy mothering with less worry.

Miller, E., Chu, C., Gollan, J., & Gossett, D. (2013). Obsessive-Compulsive Symptoms During the Postpartum Period: A Prospective Cohort. The Journal of Reproductive Medicine.

Catharine McDonald, MS, NCC, LPC works as a Senior Clinical Therapist and Access Specialist in Crisis and Behavioral Health at a community hospital. Her clinical interests include trauma, family therapy, and maternal mental health. Catharine is also active in La Leche League and Holistic Moms Network in supporting pregnant and postpartum mothers in her area. She lives in Connecticut with her husband, daughter, and their two spoiled dogs.

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