How women with established obsessive compulsive disorder experience pregnancy and postpartum: an interpretative...

Objective: To describe the lived experience of pregnancy and postpartum for women with established obsessive compulsive disorder (eOCD); clarify the nature of exacerbation when it occurs.Background: Little is known about the effects of pregnancy on women who have eOCD, except some women report symptom 'exacerbation'. Previous studies have failed to define 'exacerbation' beyond an 'increase in severity'.Methods: An interpretive phenomenological analysis (IPA) study of five women with eOCD, who had given birth within the past three years, using semi-structured interviews. The participants self-reported a clinical diagnosis of OCD. Dimensional Obsessive Compulsive Scale scores were used to triangulate this information.Results: Four superordinate themes emerged: exacerbation, responsibility, trust and control. Four women who experienced 'exacerbation' reported an increase in severity and distressing new symptoms or changes in symptoms. This related to a sudden increase in responsibility, feelings of loss of control and isolation. Lack of trust affected support networks and created barriers to accessing health care.Conclusion: Exacerbation involved an increase in symptom severity as well as distressing changes in symptoms. Strategies are required to identify and support women with eOCD prior to, during and after pregnancy to enable women who experience exacerbation of OCD symptoms to access healthcare.