Thoughts of harming a baby part of postpartum: study

While many new mothers may experience troubling thoughts about harming their babies, those thoughts don’t appear to signal chances a newborn will be hurt, a new UBC study says.

The researchers note that those thoughts should be discussed with mothers as a normal, albeit unpleasant, postpartum experience. 

The findings, published March 1, is the first large-scale study to investigate the relationship between postpartum-occurring obsessive compulsive disorder (OCD) and maternal aggression towards the infant. It confirms findings from an earlier pilot study.

“What we now know is that when the thoughts are unwanted and intrusive — the mother is no more at risk of hurting their infant than the women who are just reporting accidental harm thoughts, because those thoughts are really normal and happen all the time,” said Dr. Nichole Fairbrother, a clinical associate professor with UBC’s department of psychiatry and the Island Medical Program.

The research did find evidence that, among vulnerable women, these kinds of thoughts may lead to the development of OCD.

OCD is an anxiety-related condition characterized by the recurrence of unwanted, intrusive and distressing thoughts. Left untreated, it can interfere with parenting, relationships and daily living.

The study stressed a need to make a distinction between perfectly normal thoughts, those possibly indicating a need for treatment and those that might signal a threat to the baby.

That, researchers said, could encourage better communication between health-care workers and new mothers.

“My concern right now is that there is so little understanding and education about this, that disclosures may trigger responses that are unhelpful,” Fairbrother said. “We have examples of people who were suffering from postpartum obsessive-compulsive disorder and nevertheless had their child removed from their care because the understanding of this was very poor.”

Out of 763 surveyed postpartum participants in B.C., a total of 388 provided data through questionnaires and interviews in order to assess “unwanted, intrusive thoughts” (UITs) of infant-related harm, OCD and maternal aggression towards the infant.

Among the 151 women who reported UITs of intentional harm, four reported behaving aggressively towards their infant — resulting in an estimated prevalence of 2.6 per cent — compared to 3.1 per cent in women who did not report such thinking.

Simply put, there was a less than one per cent difference between the two groups.

The findings build on a recent study by Fairbrother and her UBC team, the University of Victoria, the Women’s Health Research Institute and King’s College London. That research found OCD among those who have recently given birth is more common than previously thought, often attributed to thoughts of harm related to the baby.