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Arch Womens Ment Health. 2020 Mar 16. doi: 10.1007/s00737-020-01026-y. [Epub ahead of print]

Health practitioners' recognition and management of postpartum obsessive-compulsive thoughts of infant harm.

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School of Psychology, Curtin University, Perth, Western Australia, Australia.
School of Psychology, Curtin University, Perth, Western Australia, Australia.
School of Psychology & Exercise Science, Murdoch University, Perth, Western Australia, Australia.
King Edward Memorial Hospital for Women, Perth, Western Australia, Australia.


The postpartum period has been associated with elevated rates of onset of obsessive-compulsive disorder (OCD) among women, with a prevalence of 2-9%. Postpartum OCD is often characterized by recurrent, unwanted, and highly distressing thoughts, images, or impulses of deliberate infant harm. This study investigated health practitioners' recognition of, and clinical management strategies for, postpartum obsessive-compulsive symptoms (OCS). Ninety-four perinatal health practitioners from a range of disciplines and professional backgrounds completed a survey comprised of a hypothetical case vignette and questions eliciting their responses to a clinical presentation of postpartum infant harming obsessions. Almost 70% of participants did not accurately identify OCS within the case. Furthermore, the majority of practitioners endorsed at least one contraindicated clinical management strategy likely to aggravate postpartum OCS. Accurate recognition of OCS was associated with the selection of fewer contraindicated strategies. Some aspects of practitioner training and experience were associated with correct OCS identification. These findings underscore the need for targeted, interdisciplinary education to improve the detection and management of women experiencing postpartum OCS.


Clinical education and training; Intrusive thoughts; Obsessive-compulsive disorder; Perinatal mental health; Postpartum; Thoughts of harm


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