-Anjan K Behera
Department of Media Studies,
Christ University.
Half a million women die each year around the world in pregnancy. It's not biology that kills them so much as neglect. -Nicholas D. Kristof
Twenty seven year old Rachael was six months pregnant with her first child. Her husband- Aaron was her college sweetheart. He had been extremely caring, supportive and understanding for the past six months. Her medical reports showed everything normal. Rachael should have been ecstatic. Her dream of a perfect family was coming true. But then she was not. Something was terribly wrong. She avoided leaving her room. Reluctant to share her feelings with anyone, she housed in herself an unnecessary fear; fear that she would trip and fall and harm her unborn child in the process. Understood that expectant mother’s need to be careful, but wasn’t this a little too much?
What Rachael was suffering from was one of the most under-reported and under-diagnosed mood disorders, ‘Pregnancy Induced Obsessive-Compulsive Disorder’. It can be extremely distressing for many women. Although experts are not exactly sure of how many women are affected by this disorder, it is estimated that between two and three percent of new mothers suffer from this disorder. Although all women have the have the potential to develop pregnancy induced obsessive-compulsive disorder, those with a family history of the disorder are in high risk. While most women develop it during or after the course of pregnancy, some report to having developed it before pregnancy occurred. Women tend to experience heightened obsessive-compulsive disorder during pregnancy. Inexperience and hormonal changes could be partly responsible for this. People affected by this are consumed with particular thoughts, impulses or images. These thoughts or impulses often cause the person a great deal of anxiety, disgust and discomfort. Women report a fear of:
1) Harming the baby by stabbing, this could result in a fear of sharp objects or the kitchen room as a whole. (postpartum)
2) Dropping the baby, which may result in fear of holding the baby (postpartum)
3) Germs, which may lead to rituals of excessive washing. (during pregnancy and postpartum).
4) Slipping a falling, which results in the fear to leave the house or walk briskly.(during pregnancy)
5) Risk of a food poisoning, resulting in constant checking of contents of diet.(during pregnancy and postpartum)
The main difference between pregnancy induced obsessive-compulsive disorder and the general obsessive-compulsive disorder that affects women is that women who tend to develop the disorder during or immediately after pregnancy tend to focus their obsessive thoughts on their baby.
This may seriously affect their daily functioning and may lead to guilt because of these unexplained fears that they do not feel confident in sharing with others. This may also lead to depression. Studies conducted by Neziroglu F, Anemone R and Yaryura-Tobias JA (1992), Uguz F, Gezginc K, Zeytinci IE, Karatayli S, Askin R, Guler O, Kir Sahin F, Emul HM, Ozbulut O and Gecici O (2007), Williams KE and Koran LM (1997),Maina G, Vaschetto P, Ziero S, Di Lorenzo R, Bogetto F (2001). report a variable course of obsessive-compulsive disorder during pregnancy. A substantial number of women date the onset of the disorder to during pregnancy or postpartum. Women with obsessive-compulsive disorder may experience a worsening of symptoms during pregnancy and postpartum. A recent study suggests that fluctuating hormones may trigger symptoms during pregnancy. Oxytocin, a hormone produced during pregnancy, may also be a factor in both the worsening of pre-existing obsessive-compulsive disorder and the emergence of the distinct new disorder.
Professor Salkovskis, a clinical psychologist at King's College London, and a world-authority on obsessive-compulsive disorder, believes that pregnancy induced obsessive-compulsive disorder may not be related to hormones; but actually to responsibility. The arrival of a baby brings new responsibility, a new set of concerns, and changes in routine. While normal reaction to a newborn may include some anxiety, postpartum obsessive-compulsive disorder features disturbing thoughts and excessive behaviour regarding the baby's well-being. Signs of pregnancy induced obsessive-compulsive disorder include-
• Intrusive, recurrent and obsessive thoughts, usually involving the baby.
• Avoidance behaviour, possibly of the baby but generally anything that will cause fear
• Establishing rituals which include-
o Repetitive behaviour
o Obsessive cleaning or washing
o Hoarding objects that could result in harming the baby- knives, high heels
o Anxiety and/or depression
o Fear
While the obsessive thoughts and fears can be especially disturbing, very few mothers with this disorder are likely to actually cause any harm to their babies.
Unfortunately, little attention has been paid to the relationship between childbirth and obsessive-compulsive disorder symptoms in other family members, for example, fathers. Some males develop rapid-onset obsessive-compulsive disorder symptoms associated with their spouse's pregnancy or the birth of a child.
A variant of an anxiety disorder, pregnancy induced obsessive-compulsive disorder too needs treatment and the absence of proper management would lead to various other problems. In severe cases, a mother may even dread going near the child out of fear that she might hurt the latter. This may give rise to severe mother-child bonding issues. Some of these totally unnecessary fears can turn pregnancy into a nightmare, destroying every bit of happiness that pregnancy is associated with. There are different treatment options available to women with this disorder. Some may be treated with anti-obsession medications. Other may receive the medication in combination with other forms of treatment including couples therapy, support groups, interpersonal therapy and cognitive behaviour therapy.
A woman who already has obsessive compulsive disorder before pregnancy can help her increase her coping skills during pregnancy. An untreated mother with pregnancy induced obsessive-compulsive disorder has a higher risk of developing postpartum depression.
A sub plot of the Michael Patrick King’s movie- Sex and the City shows an expectant mother (Charlotte, played by Kristin Davis) overcoming pregnancy induced obsessive-compulsive disorder as a a result of her motivating and understanding friends and family. The responsibilities of parenting lies on both the parents equally, who should be always there for both each other and their child. The assurance that the mother is not alone can ease these obsessions to a great extent. Mothers should be more confident about their parenting capabilities and not hesitate to approach a psychologist for help if required. I end with this quote denoting the joys that come along with motherhood, something that should definitely not be destroyed because of an untreated anxiety disorder!
“A baby is something you carry inside you for nine months, in your arms for three years and in your heart till the day you die.” - Mary Mason
