How Does Pregnancy and Childbirth Affect Obsessive-Compulsive Disorder Symptoms?

What you need to know

• For most women with pre-existing OCD, pregnancy and the postpartum period do not significantly change their OCD symptoms.
• A small subset of women may experience some variability in symptoms during this time, but overall severity does not tend to increase.
• Women with OCD can be reassured that pregnancy and childbirth are unlikely to worsen their condition for most patients.

Understanding Obsessive-Compulsive Disorder

Obsessive-compulsive disorder (OCD) is a mental health condition characterized by recurring, unwanted thoughts (obsessions) and repetitive behaviors or mental acts (compulsions) that a person feels driven to perform in response to the obsessions. Common obsessions include fears of contamination, concerns about order or symmetry, or unwanted aggressive or sexual thoughts. Compulsions may involve excessive cleaning, checking, counting, or arranging things in a particular way.

OCD can significantly impact a person’s daily life, relationships, and overall wellbeing. For women with OCD who are considering starting a family, there may be concerns about how pregnancy and childbirth could affect their symptoms.

The Peripartum Period and Mental Health

The peripartum period refers to the time during pregnancy and shortly after childbirth. This is known to be a high-risk time for the onset or worsening of various mental health conditions. Hormonal changes, sleep disruption, and the major life transition of becoming a parent can all contribute to increased vulnerability.

While much research has focused on conditions like postpartum depression, less was known about how the peripartum period specifically impacts pre-existing OCD. Some previous studies suggested OCD symptoms could worsen during this time for some women, while others found no significant changes. However, many of these studies relied on women’s memories of their symptoms rather than tracking them in real-time.

About the Study

To better understand how OCD symptoms change during pregnancy and postpartum, researchers conducted a study following women with pre-existing OCD over many years, including through pregnancies and childbirth.

The study included 19 women who were part of a larger long-term study on OCD. These women all had OCD before becoming pregnant and were followed for an average of about 9 years. Importantly, the researchers collected data on the women’s OCD symptoms every week throughout the study period.

This allowed them to compare each woman’s symptoms during pregnancy and postpartum (the peripartum period) to her symptoms at other times. They defined the peripartum period as starting 4 weeks before the first day of the month when a pregnancy was documented and ending 12 weeks after the first day of the month when a birth or miscarriage occurred.

Key Findings

The main finding was that for most women (13 out of 19, or 69%), OCD symptoms remained stable during pregnancy and postpartum compared to other times. Their symptom severity did not significantly change.

A smaller group of women (6 out of 19, or 31%) showed some variability in their symptoms during the peripartum period. However, even for these women, the overall changes in symptom severity were not statistically significant when comparing peripartum to non-peripartum times.

In other words, while a few women experienced some fluctuations in their OCD during pregnancy and postpartum, there was no clear pattern of symptoms getting worse overall during this time.

What This Means for Women with OCD

These findings are reassuring for women with OCD who are pregnant or considering becoming pregnant. The results suggest that for most women, pregnancy and the postpartum period are unlikely to cause a significant worsening of OCD symptoms.

This is valuable information for several reasons:

1. Reducing anxiety: Women with OCD may worry that pregnancy will exacerbate their condition. This study provides evidence that such worsening is not common, which may help alleviate some of those fears.

2. Treatment planning: Knowing that OCD symptoms are likely to remain stable can help women and their healthcare providers make informed decisions about continuing or adjusting treatment during pregnancy and postpartum.

3. Support for family planning: Some women with OCD might delay or avoid pregnancy due to concerns about their mental health. This research suggests that for most, OCD itself should not be a barrier to starting a family if they wish to do so.

4. Focus on other aspects of perinatal mental health: While OCD symptoms may remain stable, pregnancy and new parenthood can still be challenging times. This knowledge allows women and their care providers to focus on other aspects of mental health and well-being during this period.

Limitations and Future Research

It’s important to note that this study had a relatively small sample size of 19 women, all of whom were seeking treatment for their OCD. The participants were also predominantly white. These factors limit how widely the results can be applied to all women with OCD.

Additionally, the study did not control for the effects of ongoing treatments like medication or therapy. It’s possible that some women’s symptoms remained stable because they were receiving effective treatment throughout the study period.

Future research with larger, more diverse groups of women could provide even more insights. It would also be valuable to specifically study the effects of different treatments for OCD during pregnancy and postpartum.

Conclusions

• For most women with pre-existing OCD, pregnancy and the postpartum period do not significantly worsen symptoms.
• While some women may experience fluctuations in their symptoms, major exacerbations of OCD during this time appear to be uncommon.
• Women with OCD who are considering pregnancy can be reassured that their condition is likely to remain stable, though individual experiences may vary.

This research provides valuable information for women with OCD, their families, and healthcare providers. It supports the idea that with proper care and support, women with OCD can navigate pregnancy and early parenthood without expecting a significant worsening of their symptoms.