Knowledge is Power: My Fight Against Postpartum OCD

The phrase, “Knowledge is power,” has become more real to me since becoming a mom. After giving birth to my first child, I fought against unwanted obsessive and compulsive thoughts of harming her—symptoms that were part of a disorder I had never heard of called Postpartum OCD.

The worst obsessive thought I experienced was the mental image of me throwing my daughter down the stairs or over the balcony. Disgust and fear filled my heart every time I came to a staircase, so I avoided staircases as much as possible. When I did have to carry her down the stairs, I would squeeze her tightly, fearing that if I didn’t, the horrible image in my brain would possess my body, and I would be incapable of stopping myself. As she graduated to walking down the stairs with assistance, the intrusive thought graduated to shoving her hard, and I would look away from her while holding her hand. I gained some level of relief when I could finally let her walk down by herself, but I still had to go down first with enough distance between us so as to not imagine pushing her. 

In 2017, after a couple years of struggling with my disturbing thoughts alone, I stumbled across an article that described several different women with the same symptoms that I was experiencing, and my world suddenly changed. I was 28 weeks pregnant with my second child at the time. The first thing I did was tell my husband what I had been hiding from him and, thankfully, he was supportive. After also telling my midwife, I was told that all I could to cope with Postpartum OCD was to take anxiety medication.

What is Postpartum OCD?

Postpartum OCD is a rapid onset subtype of OCD that involves obsessive thoughts of infant-related harm and/or compulsive behaviors that a parent engages in to lower anxiety levels associated with the obsessive thoughts.

From my experience, there is a lack of information about Postpartum OCD, both in terms of what we know and the availability of that limited knowledge for those who are affected by it. A search for publications on this topic in 2018 resulted in only a handful of blog posts, an article in Cosmopolitan magazine, and several academic journal publications that are only available with a subscription. Many of these sources shared personal stories and described the mistreatment, misinformation, and misdiagnosis of parents struggling with Postpartum OCD. The lack of knowledge about Postpartum OCD is an issue for healthcare providers as well as parents, and we need to be doing more to provide information.  

Learning About Postpartum OCD

Since my midwife did not offer me more information, I took it upon myself to learn what I could. Here is some of what I learned through eight months of therapy and further research:

My symptoms had a name. In war, it is considered to be a sign of power and courage to use the correct name for your enemy. Being able to say to health care providers and therapists, “I think I have Postpartum OCD. What do you know about that condition and how can you help me?” is far less scary than saying, “I have no idea what is wrong, but I’m having thoughts of hurting my child.” Knowing and saying the name put me in charge of asking for help.

It is normal and even common for new parents to have unwanted thoughts of infant-harm. Perhaps if I had known that other new mothers had experienced similar negative thoughts about their babies, I could have avoided the development of obsessions altogether. 

Parents who struggle with Postpartum OCD are at little-to-no risk of actually harming their children. Intrusive thoughts of child harm are not the same as feeling desire to harm a child. Most unwanted thoughts of child-harm are “ego-dystonic,” meaning the thoughts go against the parent’s core beliefs and desires for his or her child. This misunderstanding may lead to the unnecessary involvement of the police or social services for parents seeking help. While there are some severe postpartum conditions, such as Postpartum psychosis, that may require such extreme measures to prevent a parent from harming a child, that is less likely to be the case with Postpartum OCD. As UNC-Chapel Hill clinical psychology professor Dr. Jonathan Abramowitz explained: 

“Women with postpartum OCD resist their obsessional thoughts; meaning that they try to dismiss the obsessions or neutralize them with some other thought or behavior. The thoughts seem as if they are against every moral fiber of their being. Consequently, the risk of someone with postpartum OCD acting on their violent obsessions is extremely low (one can never say with absolute certainty that the chances are 0%, but in this case, it’s pretty close).”

Treatments are highly effective.  Behavioral Therapy (CBT) and Exposure and Response Prevention (ERP) are known to be highly effective treatments, just like with regular OCD. CBT involves sharing the specifics of negative thoughts (such as interpretations, triggers, and responses) with a therapist, accepting that negative thoughts are normal for new parents and challenging the parent’s misinterpretation of negative thoughts. ERP involves parents exposing themselves to triggers “while simultaneously refraining from compulsive behaviors.” Medication is not necessary but may be helpful in some cases, especially if immediate relief is needed. 

We have much to learn about Postpartum OCD, and I can contribute by talking about my experience. Like many Postpartum OCD parents, I was scared to tell anyone about what I was going through. Had it not been for the courage of the women in that first article I read, I may never have been able to get help. Researchers and society as a whole will learn more about Postpartum OCD if individuals who struggle with it can find a safe place to share their experiences. 

Spreading knowledge is an important first step in providing caregivers with the power to successfully diagnose and treat Postpartum OCD, helping individuals to feel safe in seeking treatment, and helping direct health care providers towards questions that can provide needed information for these families. The lack of knowledge needs to end, but that can only happen if we are willing to talk about it openly without judgment. Those who may struggle with Postpartum OCD can learn more about this condition by visiting reliable websites, searching in their areas for OCD support groups, and seeking help from knowledgeable caregivers and medical professionals. In the struggle with Postpartum OCD, hope, happiness, and victory are within reach, and a little bit of knowledge just might be the right beginning.

Sammi Trujillo is a senior undergraduate student in the Family Studies program at Brigham Young University, and currently interns with and directs the weekly e-news for the National Association for Relationship and Marriage Education. *The author wishes to thank Julie Haupt and Alan Hawkins for their suggestions and careful reviews of this blog.