This article was published on: 01/2/25 4:24 PM

Article written by Alex Wykowski, LCPC, PMH-C

Movies and social media want everyone to believe that bringing home a new baby is filled with nothing but joy and cuddles. But the truth is that for many new parents, this time can be full of stress, worry, anxiety and even terror. This is especially true if either parent is struggling with perinatal anxiety or obsessive-compulsive disorder. Symptoms can begin at any point during pregnancy through the postpartum period (first year after birth).

While many may be familiar with the terms postpartum depression and postpartum anxiety, these terms are time limiting and do not accurately represent the entire perinatal period from conception to 1 year post birth. The new term clinicians are using is perinatal mood and anxiety disorders or PMADs.

Perinatal anxiety

Approximately 50 percent to 80 percent of new mothers experience mood swings and weepiness during the first two to three weeks after giving birth. This is often called a period of “baby blues.” The baby blues are not the same as a perinatal or postpartum mood and anxiety disorder. Baby blues go away within the first few weeks of giving birth. However, if your depression or anxiety lasts longer, professional help may be needed. Cognitive behavioral therapy (CBT) is highly effective at treating PMADS including Perinatal anxiety.

Perinatal anxiety is reported to occur in between 8.1% of pregnant women and 16% of parents during the perinatal period. Common symptoms of perinatal anxiety include racing thoughts, inability to focus, constant worry, decreased or interrupted sleep, restlessness, and overwhelm. Perinatal anxiety can affect the biological or adoptive caregivers of the infant.

Risk factors for perinatal anxiety can include being a first-time parent, a previous history of perinatal anxiety and/or depression, a family history of mental health concerns, personal history of anxiety or depression, financial strains, and lack of a support system.

Anxiety and fear are normal emotions that help us respond in adaptive and helpful ways to any potential danger or threat.  While anxiety and fear can be a good thing at times, worries, anxieties and fears can amplify during the perinatal period and make it hard to make decisions, get a restful sleep and truly enjoy the rollercoaster ride of parenting.

Perinatal Obsessive-Compulsive Disorder (OCD)

OCD is characterized by recurrent and persistent unwanted intrusive thoughts that are experienced as distressing.  Because these thoughts are so aversive and against the nature of the person, the individual attempts to ignore, suppress or neutralize them by engaging in some other thought or action.  These behaviors are referred to as compulsions or rituals.  Compulsions can be any type of behavior that the individual engages in to alleviate the distress associated with the thoughts and/or physiological symptoms.

Perinatal OCD can occur during pregnancy or after childbirth. Mothers, fathers and adoptive parents can experience Perinatal OCD. While most new parents experience some type of unwanted thoughts, particularly around some harm occurring to the new baby; in perinatal OCD these intense fears are combined with compulsions to try and ensure certainty of the child’s safety.

Common themes for perinatal OCD include but are not limited to, fear of an unwanted impulse to shake the baby, unwanted thoughts of stabbing the baby, constant worry about disease and contaminants, or unwanted thoughts of drowning the baby in the bath. These thoughts are often misconstrued as significant and meaningful therefore, attempts are made to prevent their obsessional fear from coming true by engaging in compulsions. Compulsions are not limited to but often include behaviors such as not allowing anyone to hold the child, excessively using antibacterial wipes, avoidance of changing the child’s diaper and/or of being alone with the baby, constant checking on the baby and asking others to verify that the child is alright.

While current research suggests Perinatal OCD affects between 1% and 3% of childbearing women, Perinatal Support International suggests these numbers may be higher, noting between 7.8% of pregnant individuals, and 16.9% of individuals post birth may experience OCD symptoms.

People may develop perinatal OCD due to a combination of hormonal, genetic or previous history, and environmental factors. While there is no one factor that causes perinatal OCD, there most certainly is effective treatment through Cognitive Behavioral Therapy (CBT) with exposure and response prevention (ERP).