Women experience OCD, anxiety after childbirth
March 4th, 2013
03:01 PM ET

Women experience OCD, anxiety after childbirth

Women may experience more symptoms of anxiety or obsessive compulsive disorder following childbirth than previously thought, according to two studies published today.

One study, published in the March/April issue of The Journal of Reproductive Medicine, found postpartum is a high-risk time for women to develop these symptoms. More than 400 study participants completed screening tests for anxiety, depression and OCD at 2 weeks. At 6 months, 329 of the women completed the survey again. (The women in the study did not receive a clinical diagnosis by a psychologist.)

"Postpartum women may experience obsessive compulsive symptoms at much higher rates than at other times in their lives," said senior study author Dr. Dana Gossett, assistant professor of obstetrics and gynecology at Northwestern University Feinberg School of Medicine.

OCD is a sub-type of depression. In this study, researchers found the most common symptoms were being concerned about dirt or germs, and checking behaviors for fear of harming the baby. While it's not unusual for new mothers to be concerned that they are doing everything with their new baby correctly, the real question, Gossett said, is how it's affecting the mother's daily life.

The researchers found 11% of new moms have symptoms after childbirth, half will get better by six months, and there is an additional 5.4% that will develop new onset symptoms at 6 months.

"I think we've traditionally felt that the main mental health complication after delivery was depression and have characterized women has having this or not having this," said Dr. Emily Miller, fellow study author and a clinical fellow in maternal fetal medicine at Feinberg. "But we haven't explored other health concerns."

Another study published today in the American Journal of Pediatrics found postpartum anxiety to be more common than postpartum depression, at least through the first 6 weeks after the baby is born.

"We found stronger associations between anxiety and breast-feeding outcomes than depression," said lead study author Dr. Ian Paul, who is a professor of pediatrics and public health sciences at Penn State College of Medicine.

Woman who have postpartum anxiety are more likely to stop breast-feeding, Paul said. This can create a negative cycle because trouble breast-feeding causes anxiety and vice versa.

Paul and his team found anxiety affects more than 1 in 6 women, about 17% of the women in the study. Anxiety in the study was defined as an acute phenomena in response to a perceived stressful, dangerous or threatening situation.

Study participants were asked 20 questions during a postpartum stay in person within the first 2 to 3 days after delivery. They were re-asked the questions at two weeks over the phone, then again at 2 months and 6 months. Statements were included on the survey such as: I am jittery, I feel indecisive and I feel strained. Patients had to answer as to how much they agreed with each statement.

More than 17% of the women met the cut off for having anxiety, compared to the 5.5% screened positive for depression. At 2 weeks, 6.9% screened positive for anxiety, while 5.5% screened positive for depression. The results followed a similar trend at 2 months.

Paul said having a positive screen test doesn't mean you have this diagnosis, so a clinical interpretation is needed.

Dr. Jennifer Shu, a pediatrician in Atlanta, said knowing these symptoms are common can help new moms get through the rough period. While it's normal to be concerned and have compulsive thoughts sometimes, she said, if it's starting to interfere with your life or how you take are of baby, it's best to get medical help.

Shu said it's different for a first-time parent; once you go through childbirth and become a mom, it kind of paves the way for people to feel more confident the second time around. She said she struggled herself as a new mom, despite the fact that she is a pediatrician and she cares for babies and children everyday at her practice.

"As a new mom I found I worried a lot of whether I was going to drop the baby or fall down stairs with the baby," she said. "So that kind of concern can be a good thing, because you will be more careful. But if you are so anxious you can't leave the house then that's a problem. Now that we know that anxiety is an issue and a common one, we can help new moms get through it."

Shu said it's also helpful for moms to have someone to lean on for support so they can work through the stress that happens postpartum.

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    New research shows how we should also be aware of postpartum anxiety. Read the whole story at http://www.dailyrx.com/postpartum-anxiety-more-common-postpartum-depression-among-moms

    March 4, 2013 at 18:16 | Report abuse | Reply
  2. Lisa Gannoe

    Women experience OCD and anxiety after childbirth

    March 5, 2013 at 12:37 | Report abuse | Reply
  3. Psych

    Ugh, OCD is not a subtype of depression. One is an anxiety disorder, the other is a mood disorder. Another MD speaking out of turn and place.

    March 5, 2013 at 23:12 | Report abuse | Reply
  4. Janet (ocdtalk)

    I have never heard of OCD described as a "sub-type of depression." It is, in fact, a neurologically based anxiety disorder. We already know that childbirth can exacerbate OCD in those who have been previously diagnosed. It is not surprising to me that during this time of upheaval and stress that those who are also prone to the disorder might develop OCD, though hopefully it will be temporary.

    March 6, 2013 at 16:35 | Report abuse | Reply
  5. No sleep

    I just had a baby, and a lot of those feelings can be attributed to lack of sleep! My son is finally sleeping through the night, and I feel like a whole new woman.

    March 13, 2013 at 08:32 | Report abuse | Reply
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    Psychological interventions such as behavioral and cognitive-behavioral therapy as well as pharmacological treatment can lead to substantial reduction of OCD symptoms for the average patient. However, OCD symptoms persist at moderate levels even following adequate treatment course and a completely symptom-free period is uncommon.,:;-

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    Postpartum psychosis is a separate mental health disorder which is sometimes erroneously referred to as postpartum depression. It is less common than PPD, and it involves the onset of psychotic symptoms that may include thought disturbances, delusions, hallucinations and/or disorganized speech or behavior. The prevalence of postpartum psychosis in the general population is 1—2 per 1,000 childbirths,*^'*

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