What is perinatal OCD?
Obsessive-compulsive disorder (OCD) is a type of anxiety disorder. Perinatal OCD is when you experience OCD during pregnancy or in the first year after giving birth.
On this page:
Our page on self-care for perinatal mental health problems has some tips for helping yourself.
Signs and symptoms of perinatal OCD
OCD has two main parts: obsessions and compulsions.
- Obsessions are unwelcome thoughts, feelings, images, urges, worries or doubts that keep coming into your mind. They may feel stuck in your mind, no matter what you do. You may worry what they mean or why they won't go away. And you may feel very distressed by them.
- Compulsions are repetitive things that you do to reduce the distress or uncertainty caused by obsessions. Compulsions can be things you do physically, like repeatedly checking a door is locked. Or they can be things you do in your head, like repeating a specific word to yourself. Or they may involve others, such as asking people for reassurance.
It's normal to worry about your baby's wellbeing. And to want to protect your baby while you're pregnant and after giving birth.
But if you start to experience obsessive thoughts and compulsive behaviours that affect your daily life and wellbeing, you may be experiencing perinatal OCD. The obsessions and compulsions are likely to relate to feelings about being a parent and your baby.
Examples of perinatal obsessions
These include:
- Intrusive thoughts about hurting your baby, during or after pregnancy
- Disturbing thoughts of sexually abusing your child
- Fear of being responsible for giving your baby a serious disease
- Fear of making the wrong decision – for example, about vaccinations or medical treatment
These thoughts can be very upsetting and frightening. But they're not your fault. Having an intrusive thought doesn't mean that you want to act on it, or that you will act on it.
From a runny nose, my thoughts quickly spiralled to a chest infection, hospital, intensive care and eventually my baby dying. The anxiety and panic was unbearable. I never slept with worry.
Examples of perinatal compulsions
These include:
- Excessive washing of clothes, toys or bottles
- Avoiding changing soiled nappies because you're worried about accidentally touching your baby inappropriately
- Keeping your baby away from other people in case they hurt them or contaminate them
- Constantly checking your baby – for example, waking them up when they're asleep to check on them
- Repeatedly asking people around you for reassurance that your baby hasn't been hurt or abused
- Going over what happened each day to reassure yourself that you haven't hurt your baby
It can be hard to open up and talk to someone about your obsessions or compulsions. But there are treatments and support options which may help.
Treatments for perinatal OCD
If you're worried that you're experiencing perinatal OCD, talk to your GP or health visitor. Your doctor should discuss treatment options with you, so you can make a decision together about the best treatment for you.
See our pages on seeking help for a mental health problem for more tips, including how to speak to your doctor.
Talking therapy
CBT with ERP is the most recommended talking treatment for OCD. It combines two types of therapy:
- Cognitive behavioural therapy (CBT)
- Exposure and response prevention (ERP), which is a specific form of CBT used to treat OCD
ERP is a talking therapy that helps you understand how your OCD works and what you need to do to overcome it. Your therapist will help you confront your obsessions and learn how to resist the urge to carry out compulsions.
We have more information on talking therapies, including finding a therapist.
If there are long waiting lists for talking therapy in your area, your doctor may recommend that you explore an alternative to therapy. These can help you manage your mental health while you're on the waiting list.
Medication
Your doctor may also offer you medication to treat anxiety, a common symptom of OCD. If you have any concerns about taking medication, you can talk to your doctor or pharmacist. We also have information about taking antidepressants while pregnant or breastfeeding.
A combination of talking therapy and medication
Some people find that taking medication alongside having talking therapy can help them get the most out of their therapy. But others find medication or talking therapy are more helpful on their own.
If you're already taking medication for an anxiety disorder before pregnancy, your doctor may suggest that you combine medication with a talking therapy such as CBT. Your doctor may also offer this if symptoms haven't improved with talking therapy or medication.
See our page on treatments for OCD for more information.
I thought I was a horrible failure… I'd panic that they thought I would hurt him and then take him away. After this I became so obsessed that they would, I would watch him constantly and not sleep to make sure nothing happened to him.
This information was published in March 2024. We will revise it in 2027.
References and bibliography available on request.
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