The overwhelming defining symptom of postpartum OCD, according to the OCD Center of Los Angeles, is incredibly distressing thoughts about one's new infant. Their list includes "horrifying, intrusive thoughts of stabbing or suffocating a newborn child; unwanted images of throwing or dropping a baby; disturbing thoughts of sexually abusing a child; fear of accidentally harming a child through carelessness; intrusive thoughts of accidentally harming the fetus or child by exposure to medications, environmental toxins, germs, chemicals, or certain foods", and other terrors revolving around accidental or intentional harm. (If you want to know more about intrusive thoughts, IntrusiveThoughts.org has the rundown.)
People with "regular" OCD will recognize these intrusive thoughts by their type, if not their content. OCD is an anxiety disorder, and the anxiety response of the body in OCD is worked to fever pitch by unwanted and extremely upsetting thoughts that sufferers will do virtually anything to banish. A case study of postpartum OCD in 1999 suggested that "postpartum OCD may be a distinct clinical entity with features that include early postpartum onset; repetitive, intrusive thoughts about harming the baby; avoidant behavior; anxiety; panic attacks; secondary depression; and disruption of the mother-infant relationship."
"Having lived with Pure OCD since I was just a little girl," Jordaine Chattaway tells Bustle, "postpartum OCD was always a risk for me. For parents, harm obsessions and sexual obsessions are especially common in Postpartum OCD. For me, despite spending my entire pregnancy and a good three weeks post-baby (and the trauma of giving birth) in a blissful baby bubble, all it took was a single sleep-deprived intrusive thought to sucker-punch me and boom, I was on the floor crying."
Figuring out how common postpartum OCD might be is difficult, because women who experience thoughts of harming their children are often, understandably, not willing to disclose them, even to medical professionals. But it may be more common than you'd think; in a study of 400 women who had given birth in 2009, 39 percent met the criteria for postpartum OCD.
Certain factors, doctors have discovered, seem to raise the likelihood of developing postpartum OCD symptoms. It's more common after first children than after subsequent births, and it's more likely if you've had previous psychiatric disorders (particularly anxiety), had significant complications during pregnancy or delivery, and experience postpartum depression.
Some theorists believe that, particularly for first infants, some women (and men) may become overwhelmed with the idea of their responsibility and the helplessness of their babies, experience extreme stress, and begin to see threats everywhere. Protective behavior for babies is a good evolutionary strategy, but when someone has postpartum OCD, the impulse becomes more stressful than helpful. The organization OCD UK explains:
"During pregnancy women will read and hear many guidelines encouraging them to be more careful about their diet and behaviour, and frequent messages about the safety of various activities for their baby in the short- and longterm. Most women become a lot more concerned about protecting their baby and about how their actions can impact on their unborn child. It is also a time of increased stress, major physical change and transition to a new role which can increase vulnerability to developing difficulties."
"For mothers and fathers," Chattaway says, "a new baby is the most precious gift in the world. A parent's obsessive intrusive thoughts about harming their baby or harm coming to their baby [are] the flip side of their core value: protecting their child. OCD takes that primal love and protection and attacks it. Unfortunately, many parents are too afraid to speak up about their situation for fear of judgement, ridicule or worse." It's no accident that the compulsive behaviors associated with postpartum OCD are often related to hygiene and health, like refusing to use certain foods in case of poisoning or obsessively cleaning surfaces. Other symptoms include aggression towards people who "might harm" the baby and repeated reassurance-seeking from others that the baby's OK.