Obsessions, compulsions, and intrusive thoughts in the perinatal period

Perinatal intrusive thoughts, obsessions, and compulsions are often neglected or misidentified, compared to postpartum depression and anxiety. These symptoms have a unique presentation and progression during the perinatal period. Both mothers and fathers of newborns may experience intrusive thoughts particularly in the early postpartum phase. New mothers may feel guilty and ashamed about having such thoughts especially if they are related to intentions of harm to their baby. While many have intrusive thoughts alone, some mothers may develop a perinatal obsessive compulsive disorder (OCD). The detrimental effects of perinatal obsessions and compulsions may extend beyond the mother’s quality of life and functioning, also affecting mother-infant bonding and consequently the infant’s development. Clinicians need to assess these thoughts sensitively and provide multidisciplinary care that takes into account the mother, the infant and the family.