Postpartum OCD
Postpartum OCD
By Justin La Rose, RP, M.Psy · Registered Psychotherapist (CRPO) · Clinical Director, The OCD Clinic
Evidence last reviewed: October 2026
Postpartum OCD is obsessive-compulsive disorder that starts or gets worse in pregnancy or after a baby arrives. The obsessions are usually about the baby being harmed, by accident or by you, and the compulsions are what you do to escape them: checking, avoiding, hiding the knives, asking for reassurance. The thoughts are the opposite of what you want, and it is treatable.
At its heart, OCD is a phobia of your own thoughts. A baby raises the stakes on every thought overnight. So the scariest ones get treated like warnings, and you start building your days around keeping them quiet.
The short answer
- How common it is: One large Canadian study found 7.0% of women met criteria for OCD in the postpartum period (Fairbrother et al., 2021).
- What the obsessions are about: Obsessional thoughts in postpartum OCD tend to concern fears of harm coming to the infant, according to a review of the research (Abramowitz et al., 2003).
- Harm thoughts and behaviour: In a study of 388 new mothers, those with unwanted thoughts of harming their infant, and those with OCD, were not more likely to report aggression toward the baby (Fairbrother et al., 2022).
- Who gets stuck: Stronger obsessive beliefs during pregnancy predicted a higher chance of an OCD diagnosis 6 months after birth (Abramowitz et al., 2025).
What are the symptoms of postpartum OCD?
The symptoms of postpartum OCD are unwanted, intrusive thoughts about the baby, plus the things you do to make them stop. The thoughts usually look like this:
- Images of dropping, drowning, stabbing or smothering the baby
- Fears of the baby dying because you missed something
- Unwanted sexual thoughts or images during a bath or diaper change
- Fear of contamination: germs, chemicals, making the baby sick
And the compulsions usually look like this:
- Avoiding baths, diaper changes or being alone with the baby
- Hiding knives, scissors or cords
- Checking the baby's breathing again and again
- Asking your partner or searching online whether parents who think this are dangerous
- Replaying the day in your head to prove nothing happened
The full picture of the harm thoughts, including what the research says about them, is on intrusive thoughts about harming your baby.
Why does OCD show up after a baby?
OCD shows up after a baby because responsibility jumps overnight, and the brain starts scanning for every way things could go wrong. OCD usually builds gradually, but a 2026 BMJ review notes it can start abruptly in pregnancy or after birth (Abramowitz et al., 2026). Most new parents get strange, scary thoughts. What turns them into OCD is the meaning you give them. Beliefs like “having this thought means something about me” or “I have to make sure” predicted who developed symptoms after the birth (see OCD research updates), in mothers (Abramowitz et al., 2025) and in fathers (Abramowitz et al., 2006).
It's like a bully that found your softest spot. OCD goes after what you care about most, and right now that's a seven-pound person. Do what the bully says, avoid, check, confess, and it gets louder. That's the trap.
Is it postpartum OCD, depression or psychosis?
Postpartum OCD, postpartum depression and postpartum psychosis can all involve frightening thoughts about the baby, but they're different conditions. In OCD the thoughts feel unwanted and you know they're thoughts. In depression the weight is hopelessness and exhaustion. In psychosis a person can lose touch with reality, and the thoughts may not feel wrong to them.
The side-by-side table lays out the differences. Postpartum psychosis is a medical emergency. In Canada, call or text 9-8-8 (Suicide Crisis Helpline), call 911, or go to the nearest emergency department.
Can dads get postpartum OCD?
Yes. Fathers and non-birthing parents get intrusive thoughts about harming the baby too. When researchers played recorded infant crying to parent pairs, mothers and fathers were equally likely to report harm thoughts (Fairbrother et al., 2019). In my experience, dads are the ones most likely to be told they're just tired.
How is postpartum OCD treated?
Postpartum OCD is treated with Exposure and Response Prevention (ERP), sometimes alongside medication from your doctor. ERP means you approach what you've been avoiding, the bath, the knife drawer, being alone with the baby, and drop the rituals, so your brain gets to learn what the fear keeps predicting and never testing (Craske et al., 2014).
Think of it like the gym. Nobody starts with 300 pounds. You start with what you can lift, with a plan built around your baby and your life. The postpartum OCD treatment options page compares every route in Ontario, and ERP therapy for postpartum OCD walks through one composite parent's plan week by week.
Where should you start?
Intrusive thoughts about harming your baby →
Why they're common, what the research shows, and when they become OCD.
Postpartum OCD treatment options →
Every route in Ontario compared: ERP, medication, hospital programs, private and online therapy.
Postpartum OCD therapy in Toronto →
What therapy with us looks like, what it costs, and how to start.
ERP therapy for postpartum OCD →
One composite parent, week by week, from the first session to the last.
FAQ
What Do Parents Ask About It?
Estimates vary by study. One large Canadian study found 7.0% of women met criteria for OCD in the postpartum period. Milder obsessive-compulsive symptoms are far more common than the full disorder.
Yes. Symptoms can begin or get worse during pregnancy as well as after the birth, which is why some clinicians call it perinatal OCD. If the thoughts and rituals start before the baby arrives, it's worth getting assessed then rather than waiting.
For some parents the symptoms ease as life with the baby settles. For others, avoidance and rituals keep them going for months or years. If the thoughts take up time every day or you're changing how you care for your baby, an assessment is the better bet than waiting.
Not for private therapy. You can book a free 20-minute consultation with us directly. Hospital perinatal programs in Ontario usually need a referral from a doctor, nurse practitioner or midwife.
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Book a free 20-minute consultation. No commitment, no pressure. Just a conversation about where you are and how we can help.
Book Free ConsultationHow we researched this page
This page draws on prevalence research on OCD in pregnancy and the postpartum (Fairbrother 2021), a study of harm thoughts and maternal behaviour (Fairbrother 2022), prospective studies of how beliefs about thoughts predict postpartum symptoms in mothers and fathers (Abramowitz 2006 and 2025), a study of mothers' and fathers' harm thoughts in response to crying (Fairbrother 2019), a review of postpartum OCD (Abramowitz 2003) and research on how exposure therapy works (Craske 2014), alongside what I see in my own practice. Most of these studies are regional samples that rely on self-report and include more mothers than fathers, and treatment research specific to postpartum OCD is still limited.
A note on my perspective
I run a private clinic that treats OCD with ERP, and I'm paid when people book with us. Read what I write with that in mind. Public and lower-cost routes exist too, and the Ontario OCD treatment guide lays them out next to ours.
About the author
Justin La Rose, RP, M.Psy is a Registered Psychotherapist with the College of Registered Psychotherapists of Ontario (CRPO) and Clinical Director of The OCD Clinic in Toronto. He has worked in mental health for more than 25 years and treats OCD with Exposure and Response Prevention (ERP). You can confirm his registration on the CRPO public register.
Client stories on this site are composites, with names and identifying details changed. How we write client stories
How to cite this page
La Rose, J. (2026). Postpartum OCD: Symptoms, Causes and Treatment. The OCD Clinic. https://theocdclinic.ca/postpartum-ocd