A mother experiencing postpartum OCD with intrusive thoughts visualized as dark clouds.

Postpartum OCD: When New Motherhood Brings Intrusive Thoughts

Reese Marlowe in Health & Wellness November 2025 • 5 min read.

"Understanding the Link Between Postpartum Depression, OCD, and a Rare Case of Infanticide"

The arrival of a new baby is often celebrated as a joyous occasion. However, for some women, the postpartum period can bring unexpected challenges, including mental health issues like postpartum depression and obsessive-compulsive disorder (OCD). While postpartum depression is relatively well-known, postpartum OCD often goes underrecognized, despite affecting approximately 4% of women within 6 weeks of giving birth. This article delves into the complexities of postpartum OCD, its relationship with postpartum depression, and the importance of seeking help.

Postpartum OCD involves intrusive, repetitive thoughts and compulsions that can be highly distressing for new mothers. These obsessions often center around the newborn, with common themes including fears of harming the baby, either intentionally or unintentionally. While the idea of violence in women with postpartum OCD has historically been considered low, this article sheds light on a rare and critical case that challenges this assumption.

This article examines a case report that explores the potential link between postpartum depression, OCD, and infanticide, emphasizing the need for increased awareness, research, and support for women experiencing mental health challenges during the postpartum period. Understanding the nuances of these conditions is crucial for early diagnosis, intervention, and prevention of tragic outcomes.

The Case: When Postpartum Depression and OCD Converge

A mother experiencing postpartum OCD with intrusive thoughts visualized as dark clouds.

Mrs. A, a 32-year-old woman, was admitted to the emergency room after the death of her 2-month-old infant. She was charged with murder after allegedly slashing her baby's neck with a knife. Her history revealed a struggle with depressive symptoms throughout her pregnancy, including low mood, loss of interest, weight changes, sleep disturbances, and feelings of hopelessness.

Adding to her challenges, Mrs. A's postpartum period was marked by several medical and psychosocial stressors. She experienced gestational diabetes, an induced labor complicated by a retained placenta, and difficulties with breastfeeding and formula feeding. Her infant also developed a persistent cough, further exacerbating her distress.

Within a month of delivery, Mrs. A began experiencing:

Repetitive, intrusive thoughts of harming her infant.
Recognition that these thoughts originated from her own mind and were irrational.
Distress caused by the intrusive thoughts.
"Commanding voices" telling her to harm her infant (though she denied other psychotic symptoms).

On the day of the alleged offense, Mrs. A reported being particularly disturbed by the "voices" commanding her to kill her infant. She asked her husband and children to leave the house. Subsequently, she described a trance-like state where she smothered her infant with a pillow and slashed its neck with a knife. She repeatedly stated that she did not want to kill her infant and called her husband to return home immediately. She had no prior psychiatric or family history of mental illness.

Understanding the Intersection: OCD vs. Postpartum Psychosis

It's crucial to differentiate between postpartum obsessional thoughts and postpartum psychosis, as the latter carries a significantly higher risk of infanticide. In Mrs. A's case, the ego-dystonic nature of her infanticidal thoughts, her distress, and her acknowledgement of their irrationality pointed towards obsessive-compulsive symptoms. However, the presence of "command auditory hallucinations" and acting on those voices suggested psychotic features.

Existing research suggests that infanticidal obsessions in mothers, in the absence of other psychotic features, are unlikely to lead to violence. Mrs. A's case highlights the diagnostic complexities and the potential for overlapping symptoms of OCD and postpartum psychosis.

More research into postpartum OCD is needed to fully understand its symptomatology and associated risks. Increased awareness and improved diagnostic accuracy can help healthcare professionals provide timely and effective interventions, ultimately safeguarding the well-being of mothers and their children. Seeking help is a sign of strength, and early intervention can make a significant difference in managing postpartum mental health challenges.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.1016/j.ajp.2018.11.004, Alternate LINK

Title: Postpartum Obsessive-Compulsive Symptoms In A Case Of Peripartum-Onset Depression And Infanticide

Subject: Psychiatry and Mental health

Journal: Asian Journal of Psychiatry

Publisher: Elsevier BV

Authors: Kenneth Ken Siong Lee, Badiah Yahya

Published: 2019-01-01

Everything You Need To Know

What is Postpartum OCD, and what are its common symptoms?

Postpartum OCD involves intrusive, repetitive thoughts and compulsions that can be highly distressing for new mothers. These obsessions often revolve around the newborn, with common themes including fears of harming the baby, either intentionally or unintentionally. The article highlights that while violence in women with Postpartum OCD has historically been considered low, it's crucial to recognize this condition and its potential for serious outcomes. The significance lies in the need for increased awareness, research, and support for women experiencing mental health challenges during the postpartum period, which can affect 4% of women within 6 weeks of giving birth.

How does Postpartum Depression relate to other mental health conditions in new mothers?

Postpartum depression is a mental health condition that can affect new mothers, often co-occurring with other conditions like Postpartum OCD. The case of Mrs. A illustrates a complex interplay of symptoms, including low mood, loss of interest, weight changes, sleep disturbances, and feelings of hopelessness. The relationship is important because Mrs. A experienced depressive symptoms throughout her pregnancy and struggled with several medical and psychosocial stressors. The implications of this overlap are significant because it highlights the need for a comprehensive approach to diagnosis and treatment, considering the potential for severe outcomes when these conditions converge.

What does the term "infanticide" mean in this context, and why is it significant?

In the provided case, the term infanticide refers to the act of a mother killing her infant. This tragic event underscores the severity of mental health challenges during the postpartum period. In Mrs. A's case, she was charged with murder after allegedly slashing her baby's neck with a knife. The importance of recognizing this tragic outcome emphasizes the critical need for early diagnosis, intervention, and support for new mothers. The implications are far-reaching, highlighting the potential for severe consequences when mental health issues like Postpartum OCD and Postpartum Depression are left untreated or inadequately addressed.

Why is it important to differentiate between postpartum obsessional thoughts and postpartum psychosis?

It is crucial to differentiate between postpartum obsessional thoughts and postpartum psychosis because the latter carries a significantly higher risk of infanticide. In Mrs. A's case, the ego-dystonic nature of her infanticidal thoughts, her distress, and her acknowledgement of their irrationality pointed towards obsessive-compulsive symptoms. However, the presence of "command auditory hallucinations" and acting on those voices suggested psychotic features. Understanding this difference is important because the treatment and management strategies will vary greatly depending on the specific diagnosis. Recognizing the potential for psychosis is a key element in preventing further harm to the mother or the infant. The implications highlight the need for a comprehensive evaluation and appropriate psychiatric intervention.

Can you describe the main events in Mrs. A's case and how they relate to Postpartum OCD?

Mrs. A, a 32-year-old woman, was admitted to the emergency room after the death of her 2-month-old infant. She was charged with murder after allegedly slashing her baby's neck with a knife. She experienced gestational diabetes, an induced labor complicated by a retained placenta, and difficulties with breastfeeding and formula feeding. Within a month of delivery, Mrs. A began experiencing: repetitive, intrusive thoughts of harming her infant; recognition that these thoughts originated from her own mind and were irrational; distress caused by the intrusive thoughts; and "commanding voices" telling her to harm her infant. This case underscores the importance of early intervention and support for new mothers experiencing mental health challenges. The implications are that it highlights the need for a comprehensive approach to mental health care during the postpartum period.