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When a Mom’s Worry Goes Too Far: Pregnancy and OCD

I wanted to have a baby. The time was right, my fourth book finished, the debt on my house paid down, my middle age approaching. Thirty-three, thirty-four, still young enough to touch the toes, but not so young that the future is forever, the way an adolescent sees it, time stretching out, blue and hazy as any horizon.

So one night my husband and I lobbed my diaphragm out the bedroom window, where it sailed through the air, shaped like a small spaceship. I remember that night, early spring, the air frosty in a bracing sort of way. The diaphragm landed there, in the garden, a brittle thorn hooking its underside.

Was that an omen? I didn't believe in omens, frankly still don't, but there was that thorn right in the gut of the rubber flesh. Three months later, I missed my period. I stood in a dawn-dark bathroom and peed in a pleated cup, watched the test window turn inky and blue, watched the first line appear, the second line then, straight and unambivalent: a definite yes.

I have a mental health history, but by the time I got pregnant, by the time I stood on the wood floor that morning, clutching the plastic stick, it was behind me, years ago. Of course I thought it would stay that way. And for a while it did. The first few weeks of the pregnancy were good. I was good. No, amend that. I was great. I was elated, my belly light and bright as a balloon, or so it seemed, holding me aloft. I floated.

Then, at week eight of the pregnancy, I found a little brown spot of blood on my underwear. It was such a strange spot, so precise, like a punctuation point: the end. "It's probably fine," my obstetrician said to me. "Fifty percent of women bleed in their first trimesters, and the blood isn't red, it's brown blood, old blood. I'm sure you're fine." But I wasn't fine. I was scared, on the edge, surreptitiously slipping my fingers beneath the elastic rim of my underwear, checking to see if they came back smeared. Again and again I did this. I got an ultrasound and saw the heartbeat, fast, the little baby curled like a cashew, all there. It didn't comfort me. It comforted me for maybe five seconds, and then anxiety set in again. The blood stopped, but the anxiety didn't. There were a million ways for a fetus to die; the slippage of a single cell, kaput. Was my progesterone stable? Was my HCG on the upswing? I went back to see the doctor again and again, demanding tests, ultrasounds, measurements, means. Though I was perfectly healthy, by the end of the first trimester, my pregnancy had turned into a techno-numerical nightmare. I was weeping, lying in bed with a calculator in hand, computing the complex rise of my HCG, my progesterone, and God knows what other chemicals I was insisting that my doctor measure daily.

I had, it turns out, what clinicians call gestational OCD. Obsessive-compulsive disorder. I needed to check and count and tap, whereas before getting pregnant, I'd been normal. There has been a lot of discussion about gestational and postpartum depression, the disease that caused Marie Osmond to leave her kids with the nanny and just drive away. Everyone knows, it seems, that depression is part and parcel of the pregnant and postpartum state; fewer people know that the anxiety constellation of OCD is also a frequent uninvited guest during this period.