Postnatal depression and perinatal mental health

Explains postnatal depression and other perinatal mental health issues, including possible causes, sources of treatment and support, and advice for friends and family.

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What is perinatal OCD?

Obsessive-compulsive disorder (OCD) is a type of anxiety disorder. The term is often misused in daily conversation – for example, you might hear people talk about being 'a bit OCD' if they like things to be neat and tidy. But the reality of this disorder is a lot more complex and serious.

Perinatal OCD is when you experience OCD during pregnancy or in the year after giving birth.

This page covers:

What are the common signs and symptoms?

OCD has two main parts:

obsessions – intrusive thoughts, ideas or urges that repeatedly appear in your mind. For example, thinking that you have been contaminated by dirt and germs, or worrying that you might hurt someone.
compulsions – repetitive activities that you feel you have to do. This could be something like repeatedly washing something to make sure it’s clean, or repeating a specific phrase in your head to prevent harm from coming to a loved one.

The aim of a compulsion is to relieve the intense anxiety caused by obsessive thoughts. However, the process of repeating these compulsions is often distressing in itself, and any relief you feel is often short-lived.

"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."

If you experience perinatal OCD, you're likely to have obsessions and compulsions that relate to your feelings about being a parent and your baby. Here are some common obssessions and compulsions:

Obsessions

intrusive thoughts about hurting your baby, by suffocating them or throwing them down the stairs, for example
disturbing thoughts of sexually abusing your child
intrusive thoughts of accidentally harming your baby while you're pregnant by eating dangerous foods or taking the wrong medication
fear of being responsible for giving a child a serious disease such as HIV
fear of making the wrong decision – for example, about vaccinations or medical treatment

Compulsions

excessive washing of clothes, toys or bottles
avoiding changing soiled nappies out of fear that you might accidentally touch 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
mentally going over what happened each day to reassure yourself that you've not been responsible for harming your baby

These thoughts can be very upsetting and frightening, but it's important to remember that having an intrusive thought doesn't mean that you'll act on it. It can be very hard to open up and talk to someone about these type of thoughts, but you can get treatment and support.

"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."

What are the treatments?

The main treatment for OCD is cognitive behavioural therapy (CBT), particularly a specific form of CBT called exposure and response prevention (ERP). This is a talking treatment 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.

You may also be offered medication to treat your anxiety. Some people find that taking medication alongside a talking treatment can help them get the most out of their therapy. If there are long waiting times in your area for talking treatments, your doctor might suggest that you try medication while you wait.

See our pages on CBT and 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."

How can I help myself cope?

Here are some ideas to help you look after yourself and manage your OCD:

Contact specialist organisations. Charities like OCD UK and OCD Action have resources to help you understand and cope with your OCD, as well as running peer support groups and online forums where you can talk to other people living with OCD. Maternal OCD 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 your loved ones. 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, talk to them about your obsessions and compulsions and how you'd like them to respond and support you.

For more ideas, see our page on how you can look after your mental health in general when becoming a parent.