Postnatal depression and perinatal mental health

Explains postnatal depression and other perinatal mental health problems, including possible causes, treatments and support options. Also has information for friends and family, including support and advice for partners.

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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.

This page covers:

Signs and symptoms of perinatal OCD

OCD has two main parts: obsessions and compulsions.

Obsessions are unwelcome thoughts, images, urges, worries or doubts that repeatedly appear in your mind. They can make you feel very anxious, although some people describe it as 'mental discomfort' rather than anxiety.
Compulsions are repetitive activities that you do to reduce the distress and anxiety caused by obsessions. It could be something like repeatedly checking that you locked a door or repeating a specific phrase in your head. Repeating compulsions is often very time-consuming, and the relief they give doesn't usually last very long.

It's normal to worry about your child's wellbeing and want to protect your baby while you are pregnant and after giving birth. But if you start to experience obsessive and compulsive symptoms that affect your daily life and wellbeing, you may be experiencing perinatal OCD.

The obsessions and compulsions you may experience are likely to relate to feelings about being a parent and your baby.

Common obsessions

Examples of common perinatal obsessions include:

intrusive thoughts about hurting your baby, during or after pregnancy
disturbing thoughts of sexually abusing your child
fear of being responsible for giving a child a serious disease
fear of making the wrong decision – for example, about vaccinations or medical treatment.

These thoughts can be very upsetting and frightening. It's important to remember that they are not your fault. Having an intrusive thought doesn't mean that you want to act on it, or that you will act on it.

Common compulsions

Examples of common perinatal compulsions 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
constant checking on the 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 harmed your baby.

It can be very hard to open up and talk to someone about your obsessions or compulsions. But there are treatments and support options which may help.

"I spent the first few months of my daughter's life consumed with anxiety that I would somehow contaminate her. My hands were raw from constant washing. I got the help I needed and am finally enjoying being a mummy."

Treatments for perinatal OCD

There are various treatments that you may be offered for perinatal OCD. Your doctor should discuss these options with you, so you can make a decision together about the best treatment for you:

Talking therapy

The main types of talking therapy offered for OCD are:

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.

ERP is only available in certain areas of the country.

Medication

You may also be offered medication to treat any symptoms of anxiety.If you have any concerns about taking medication, you can talk to your doctor or pharmacist. This includes discussing any concerns about taking medication during pregnancy or while breastfeeding.

See our page on talking to your GP if you're worried about having this conversation.

A combination of talking therapy and medication

Some people find that taking medication alongside a talking therapy can help them get the most out of their therapy.

If there are long waiting lists for talking therapies in your area, your doctor may recommend that you explore an alternative to therapy. These can help you manage your mental health while you are on the waiting list.

See our page on treatments for OCD for more information.

"During my second pregnancy, I had an experience seeing blood on a public toilet seat which led onto a severe obsession with the irrational thought that I had contracted HIV. This irrational thought took over my life. It turned into what felt like a huge monster."

Self-care for perinatal OCD

Experiencing perinatal OCD can be very difficult, but there are steps you can take to help yourself cope. Here are some ideas to help manage your OCD:

Contact specialist organisations

Charities like OCD UK and OCD Action have resources to help you understand and cope with your OCD. They also run peer support groups and online forums where you can talk to other people living with OCD. Maternal OCD also offers specific support for perinatal OCD.

Try self-help resources

See our page on self-care for OCD for a list of self-help resources that you might find helpful.

Talk to someone you trust

Having the support of those around you can make a big difference to how much you feel able to cope with your obsessions and compulsions.

If you feel comfortable, you could talk to them about your obsessions and compulsions. And you could talk about how you'd like them to respond and support you.

For more ideas, see our page on ways to look after your mental health when becoming a parent.

"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."