A large-scale study at Northwestern University reveals that new mothers are much more likely than their peers to display obsessive-compulsive behavior.

A new mother has plenty to worry about, but some mothers’ fretting may go beyond natural protective instincts and into the realm of obsessive-compulsive disorder (OCD). A recent study from Northwestern University found that new mothers are five times more likely than their peers to experience OCD as long as six months after their child is born.

The National Institute of Mental Health estimates that about three percent of the general population has OCD, an anxiety disorder marked by uncontrollable thoughts and fears and repetitive behaviors.

The Northwestern researchers found that 11 percent of new mothers experience significant OCD symptoms, including fear of injuring the baby and worry about proper hygiene and germs. Some of these are normal feelings a woman experiences with a newborn, but researchers said that if the compulsions interfere with a mother’s duties it could indicate a serious mental health issue.

Senior study author Dr. Dana Gossett, chief and assistant professor of obstetrics and gynecology at Northwestern University’s Feinberg School of Medicine, experienced similar worry after she gave birth.

She began her study, which was published in The Journal of Reproductive Medicine, with 461 new mothers. Of the women who reported OCD symptoms, about half said their symptoms improved six months after giving birth, but some women actually developed OCD later.

“It may be that certain kinds of obsessions and compulsions are adaptive and appropriate for a new parent, for example those about cleanliness and hygiene,” Gossett said in a press release. “But when it interferes with normal day-to-day functioning and appropriate care for the baby and parent, it becomes maladaptive and pathologic.”

Previous research has shown that OCD can be triggered by stress, which is why pregnant women and new mothers may experience a greater incidence of OCD.

Dr. Emily Miller, study co-author, said that when she gave birth to her first child she regularly worried she would drop the baby while walking down the stairs or that her child would fall out of bed.

“It comes into your mind unbidden and it’s frightening,” she said.

A majority of women—up to 80 percent—experience what’s known as “the baby blues,” or a temporary period of anxiety, fear, or sadness after giving birth. This is believed to be related to normal hormonal changes, but it can lead to postpartum depression, a serious form of depression that affects up to 13 percent of new mothers.

The Northwestern researchers said that about 70 percent of women who experience OCD symptoms also experience depression, prompting researchers to question whether “postpartum OCD” is simply an unrecognized or not fully understood mental illness.

“There is some debate as to whether postpartum depression is simply a major depressive episode that happens after birth or its own disease with its own features,” Miller said. “Our study supports the idea that it may be its own disease with more of the anxiety and obsessive-compulsive symptoms than would be typical for a major depressive episode.”

Another serious concern for new mothers is that postpartum depression can escalate into postpartum psychosis, a rare but serious mental illness in which a new mother experiences serious depression, hallucinations, and paranoia. Unlike postpartum OCD or depression, mothers experiencing postpartum psychosis can lose their grip on right and wrong and may actually harm their children.

In light of the difficulties facing new mothers, it’s important to be mindful of any behavior that is out of the ordinary. While hormonal changes are typical for a few days after labor, lasting behavioral changes could be sign of depression, OCD, or psychosis.

Symptoms to be aware of include:

  • obsession with cleanliness or the child’s safety
  • checking and rechecking tasks
  • excessive cleaning or washing
  • crying for no reason
  • irritability
  • anger
  • anxiety
  • feelings of mania or paranoia
  • recurring thoughts of harming the child

If you or a new mother you know are experiencing these symptoms, contact your doctor or emergency services for help.