Postpartum Anxiety and Postpartum Obsessive-Compulsive Disorder

By Beth Huss Secrist

Many people are familiar with Postpartum Depression, but there are other perinatal mood disorders that can impact new mothers. Postpartum Anxiety (PPA) and Postpartum Obsessive-Compulsive Disorder (PPOCD) are two of these. These are often misunderstood, and misdiagnosed, or missed altogether by health professionals. Postpartum Support International (PSI) reports that about 10% of new mothers will experience PPA, and 3-5% will experience PPOCD.

You might have PPA or PPOCD if you have had a baby in the past 12 months and you are experiencing some or all of the following:

  • Racing thoughts
  • You can’t settle down or relax
  • You have to be doing something at all times
  • You feel really worried all the time, especially about baby’s health and development or your ability to be a good parent
  • You have disturbing thoughts that you know aren’t right (particularly thoughts related to “what if” you hurt the baby). These thoughts are persistent, repetitive, and not something you’ve thought about before. You feel horrified or very scared by these thoughts. (Please note, moms with PPOCS are VERY unlikely to act on these thoughts because they are so horrified by them.)
  • You are afraid to be alone with baby because of the scary thoughts or worries
  • You feel you need to check things constantly (did I lock the car? Is the oven off? Is the baby breathing?)
  • You have physical symptoms such as stomach cramps, rapid heartbeat, headaches, shakiness, nausea, or even panic attacks
  • You often feel restless, on edge, or moody
  • You have a loss of appetite
  • You have trouble sleeping despite being extremely tired
  • You have a feeling of dread that something awful will happen
  • You know something is wrong and are afraid you’ve lost the “old you”
  • You fear that reaching out for help will result in people judging you or your baby being taken away

While some anxiety is a normal response to the huge life change of becoming a new parent or adding to your family, when anxiety becomes out of control, it’s time to seek treatment or support. Your anxiety may be out of control if:

  • You know the worries are irrational but you cannot stop thinking about them
  • You dread or avoid everyday situations (such as driving with baby or bathing baby) because of your anxious thoughts
  • Your ability to function is compromised (you are checking on him constantly throughout the night and so cannot function during the day).

Women may be more likely to experience PPA or PPOCD if they have a history of: depression or anxiety, eating disorders, OCD, weepiness or agitation related to menses, miscarriage or stillbirth, or have a more anxious personality (Type A).

Luckily, there is help and support. The process for managing PPA and PPOCD involves: Self-Care, Flexible Thinking, and Facing Fears.  

Self-Care can mean many things and is an individual taste. It is allowing yourself to put on your oxygen mask first so that you can care for others. Self-Care activities may include:

  • Relaxation techniques: mindfulness, meditation, calm breathing, progressive muscle relaxation. Practice staying present in the moment and using your 5 senses to experience each moment fully. These are skills that take time to develop and practice.
  • Accepting help (meals, childcare, etc) from others who offer, or asking people for help
  • Healthy eating (frequent small meals throughout the day to maintain consistent blood sugar)
  • Participating in life by spending time with people we care about. If you want to meet other new parents you could attend groups for young parents, such as “mommy and me” playgroups or storytimes, Postpartum support groups (see, breastfeeding groups, or babywearing meetings.
  • Sleeping, as much as is possible
  • Spending time doing pleasurable or soothing activities
  • Asking for help and treating yourself kindly
  • Exercise, especially resistance training or aerobic exercise. It can be helpful to combine exercise with spending time with others (dancing with a partner, walking with friends) or mindfulness (taking a walk in nature and being fully present in your surroundings). You can wear your baby in a carrier while you exercise (walking, dancing, etc).

For many women, self-care alone is not enough, and it is important to develop strategies for thinking flexibly and facing fears. These are not easy things to do (mothers often set lofty goals for themselves and it can be difficult when they aren't reached) but they are extremely helpful. These may be accomplished with the support of a professional such as a counselor. It is helpful to find a professional who is familiar with treating perinatal mood disorders specifically. Taking the step of talking to a professional can be intimidating, but it is worth it! Many women report that learning skills and strategies with a counselor are crucial to their daily management of anxiety and OCD symptoms.




(If you feel you identify with Postpartum Anxiety or Postpartum Obsessive-Compulsive Disorder, please speak with a healthcare professional and where possible, a mental healthcare professional.)

Beth Huss Secrist is a mental health counselor who specializes in maternal and infant mental health. She lives in Illinois with her husband and two young daughters, where she leads babywearing and gentle parenting groups.