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Maternal obsessive compulsive disorder (OCD)

Obsessive-compulsive disorder (OCD) is a form of anxiety disorder. It is often talked about in daily conversation. We hear people being described as being 'a bit OCD', in reality the disorder is far more complex and serious than someone merely wanting things to be clean and tidy.

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

You may also hear the disorder being referred to as postpartum OCD.

Until recently OCD in pregnancy and/or after having a baby had not been researched in much detail. However, this has changed in recent years. It's now said that OCD may well be more common at this time than other times in life.

Perinatal OCD often (but not always) revolves around significant fear of harm coming to your baby, with the worries often focusing on accidental or deliberate harm coming to your baby or the baby becoming ill. It is important to note that this is completely normal and very common to occasionally experience these thoughts and worries. However, some people find themselves so distressed that they feel compelled to take measures to manage their anxiety or prevent their fears coming true in the form of obsessive and/or compulsive behaviours.

These are the two primary features of OCD:

  • Obsessions - intrusive thoughts, ideas, images or urges that repeatedly appear in your mind. An example of this could be thinking that dirt and germs have contaminated your baby. Or, it could be worrying that you might hurt someone.
  • Compulsions - repetitive behaviours or actions that you feel compelled  to do to neutralise the anxiety caused by the obsessions. This could be something like repeatedly washing your hands to make sure they're clean, checking locks or repeating a specific phrase in your head to prevent harm from coming to a loved one.

Below are some examples of common obsessions and compulsions:

Watch the video above from Best Beginnings with Dr Alain Gregoire on perinatal Obsessive-compulsive disorder (OCD).

  • Intrusive thoughts about hurting your baby, by suffocating them or throwing them down the stairs, for example
  • Disturbing thoughts about 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 decisions - for example, about vaccinations or medical treatment

  • Excessive washing of clothes, toys or bottles
  • Avoiding changing soiled nappies or bathing baby due to fear that you might accidentally touch your baby inappropriately
  • Keeping your baby away from other people in case they hurt or contaminate them
  • Constant checking on the baby - for example, watching the baby monitor throughout the night or waking them up when they're asleep to check they are OK
  • 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

We know that talking about how you are feeling can often be very difficult, however, there is help out there. You do not have to feel like this. We hear that women often worry that they will be judged or seen to be 'not coping' - this is a common misconception. Health professionals are aware of how prevalent OCD can be during the perinatal period, and are here to support you and your family.

There will be a range of treatment options available to you:

Self help - offers you the option of exploring how you might be feeling through workbooks which you can download or print off. Reading well books are available from most libraries, they promote the benefits of reading for health and wellbeing.

Talking therapy is a NICE recognised therapy delivered by a therapist either face to face, over the telephone or in groups. The therapy is available wherever you live via the NHS and is completely free. Parents in the perinatal period (antenatal and up to 1 year post-birth) will be prioritised for talking therapy treatment. There are many different types of therapy available including Cognitive Behavioural Therapy (CBT), which has been demonstrated to be effective in treating OCD. You should receive your treatment within 6 weeks of the initial referral (NICE 2014).

Medication - You will need to seek the advice of your GP. For mild to moderate anxiety, talking therapy is the first choice of treatment and medication won't usually be considered until you have undertaken some therapy. If you are pregnant or breastfeeding there is still medication that you can take, but you need to discuss this with your GP. Please see further advice. It is not generally recommended that you take holistic medication without speaking to your GP in the first instance.

Consider including the bumps website here for those who want specific perinatal medication advice online: bumps - best use of medicine in pregnancy (medicinesinpregnancy.org)

Self help:

Useful services & resources:

  • Maternal OCD
  • Talking Therapies / Improving Access to Psychological Therapies (IAPT) services can support people with mild to moderate mental health issues such as anxiety or low mood. Shropshire Primary Care Psychological Therapies Service aims to improve health and wellbeing by offering a range of help, advice, life skills courses, supported self-help, other groups, and individual therapies for everyone aged 16 and over.
  • The Lighthouse Service supports women, birthing persons and support partners in Shropshire and Telford & Wrekin whose mental health has been adversely affected by their birth or maternity experience. They may be experiencing loss, grief or trauma, or have a fear of childbirth.
  • PANDAS Foundation
  • The Perinatal Mental Health Team.(PMHT) provides specialist assessment and support for women across Shropshire and Telford & Wrekin, providing both support to those women experiencing mental health difficulties, and those at risk of developing mental health difficulties up until a year after baby's birth. The service supports women experiencing moderate to severe mental health problems.​​​​​​​​​​​​​​​​​
  • Baby Buddy ​​​​​​​is the multi-award winning free app that guides you through pregnancy, birth, parenting and beyond. You can explore the web version of Baby Buddy or download the full version of the app for free on the App Store and Google Play. There is a lot of information, including videos about your physical and mental health. We know that talking about how you are feeling can often be very difficult, however there is help out there, you do not have to feel like this. We hear that women often worry that they will be judged or seen to be 'not coping', this is a common misconception. Health professionals are aware of how common anxiety is during the perinatal period, and are able to support you and your family.

Content adapted from MIND