Understanding Perinatal OCD
Welcoming a new baby is often portrayed as a joyful time filled with love, cuddles, and excitement. But for some new parents, it can also come with unexpected mental health challenges—one of which is perinatal obsessive-compulsive disorder (OCD). While it’s common to feel anxious about your baby’s safety or your ability to care for them, perinatal OCD goes beyond normal worries. Understanding what it is, how it differs from other mental health conditions, and what treatments are effective can make a huge difference in getting help early.
What Is Perinatal OCD?
Perinatal OCD is a mental health condition that can occur during pregnancy or within the first year after giving birth. It is characterized by intrusive thoughts—unwanted, often disturbing thoughts or images—that are difficult to control. Common examples include:
Worrying that you might accidentally drop your baby while holding them.
Fear that you could forget to feed or care for your child properly.
Thoughts of accidentally leaving the baby in a dangerous situation, like in the car or near water.
Imagining yourself hurting your baby, even though you would never act on these thoughts.
Excessive fears that germs or dirt could harm your baby, leading to repeated cleaning or handwashing.
In response to these thoughts, individuals often engage in compulsive behaviors, which are repetitive actions aimed at reducing anxiety. Examples include:
Constantly checking that the baby is breathing or sleeping safely.
Rewashing bottles or sterilizing pacifiers multiple times.
Asking your partner over and over if everything is “okay” with the baby.
While these behaviors temporarily reduce stress, they can take up significant time and energy, interfere with daily life, and sometimes make intrusive thoughts worse in the long run.
How Common Is Perinatal OCD?
Perinatal OCD is more common than many people realize. Research shows that the perinatal period is a high-risk time for both new cases of OCD and worsening of existing OCD (Hudepohl et al., 2022).
For parents who have never experienced OCD before, studies suggest that new-onset OCD occurs in about 2–22% of pregnancies and can be slightly higher in the postpartum period, affecting 2–24% of parents after birth.
For those who already have OCD, the perinatal period can make symptoms worse, with 8–70% experiencing an exacerbation during pregnancy or after childbirth.
A recent study that carefully used strict diagnostic criteria found that 7.8% of pregnant individuals and 16.9% of postpartum individuals met criteria for OCD during these periods (Hudepohl et al., 2022).
These numbers highlight that perinatal OCD is not rare, and experiencing intrusive thoughts does not mean you are a “bad” parent. It is a recognized mental health condition, and with proper support, parents can manage symptoms successfully.
Recognizing the Signs
It can be difficult to know whether what you are experiencing is normal anxiety or perinatal OCD. Here are some common signs:
Intrusive thoughts. These are unwanted, repetitive thoughts about harming the baby or fears that something terrible might happen. Some concrete examples include:
Imagine accidentally shaking the baby while trying to soothe them.
Fear that you might forget to secure the car seat properly.
Persistent worries that you could leave the baby in a dangerous position while napping.
These thoughts are intrusive because they pop up uninvited and cause significant distress, even though the parent knows deep down they would never act on them.
Compulsive behaviors. Actions taken to reduce anxiety, like repeatedly checking on the baby, cleaning excessively, or seeking reassurance. For example:
Spending hours washing baby bottles or sanitizing the nursery.
Repeatedly checking locks, windows, or baby monitors.
Asking your partner, friend, or family member multiple times if the baby is safe or healthy.
Distress and interference. These thoughts and behaviors can consume a significant amount of time, disrupt daily life, and hinder bonding with your baby. Some parents report feeling exhausted, guilty, or isolated because they worry their thoughts are “abnormal.”
How Is Perinatal OCD Different from Other Perinatal Mental Health Conditions?
It’s important to differentiate perinatal OCD from other conditions because each requires slightly different approaches:
Perinatal Depression. Characterized by persistent sadness, loss of interest in activities, fatigue, and sometimes feelings of worthlessness. Unlike OCD, depression doesn’t usually involve repetitive, intrusive thoughts about harm.
Example. Feeling consistently sad and withdrawn, unable to enjoy cuddling or playing with your baby.
Perinatal Anxiety. Involves excessive worry and tension about the baby’s health or your parenting abilities, without the ritualistic behaviors seen in OCD.
Example. Worrying about whether the baby is getting enough sleep or nutrition, but not repeatedly checking or performing specific rituals to prevent harm.
Postpartum Psychosis. A rare but serious condition that may involve hallucinations, delusions, or confusion. This is distinct from OCD, which does not include losing touch with reality.
Example. Believing your baby is in danger due to supernatural forces or hearing voices instructing you to act, which is not typical in OCD.
The main distinction is that perinatal OCD revolves around unwanted thoughts and compulsive behaviors, whereas other conditions may involve mood changes or more general anxiety.
When to Seek Help from an Individual Therapist
Suppose you notice that intrusive thoughts or compulsive behaviors are causing distress or interfering with your ability to care for yourself or your baby. In that case, it is important to reach out for help. You should contact a mental health professional if you experience:
Persistent, unwanted thoughts about harming the baby.
Compulsive behaviors that take up a lot of time or disrupt daily life.
Intense anxiety, guilt, or shame about these thoughts.
Difficulty bonding with your baby due to fear or anxiety.
Example. You spend hours each night repeatedly checking the baby’s breathing or washing bottles, leaving little time to eat, rest, or enjoy time with your partner. This is a clear sign to seek support.
Evidence-Based Treatments
The good news is that effective treatments exist. Evidence-based approaches include:
Cognitive Behavioral Therapy (CBT)
CBT helps identify unhelpful thoughts and behaviors and develop strategies to manage them. A specialized form called Exposure and Response Prevention (ERP) is particularly effective for perinatal OCD. ERP involves gradually exposing individuals to feared situations and preventing the accompanying compulsive response.
Example. If a parent fears harming their baby during bath time, therapy may involve supervised exposure to bathing routines without performing the usual compulsive checks.
Medication
In some cases, selective serotonin reuptake inhibitors (SSRIs) may be prescribed to reduce intrusive thoughts and anxiety. Decisions about medication should always be made in consultation with a healthcare provider, especially during pregnancy or breastfeeding.
Supportive Measures
Connecting with other parents who have experienced perinatal OCD, joining support groups, and involving partners or family members in treatment can provide practical and emotional support.
Overall, it’s important to find resources that emphasize early recognition, individualized treatment, and combining therapy with social support. Tailoring treatment to each parent’s needs can improve outcomes and reduce the distress caused by OCD.
Getting Support for Perinatal OCD in Individual Therapy
Experiencing perinatal OCD can be frightening and isolating. Many parents feel ashamed or worry that these thoughts make them a “bad parent,” but it is crucial to understand that these thoughts do not reflect your true intentions or character. With proper support at Manas Cor Psych, parents can manage symptoms effectively and maintain strong, healthy connections with their babies.
If you or a loved one is experiencing symptoms of perinatal OCD, reach out to a mental health professional who specializes in perinatal care. Early intervention is key, and treatment can significantly improve the quality of life for both parent and baby.
Remember: Intrusive thoughts and compulsive behaviors are symptoms of a treatable condition. Seeking help is a sign of strength, not weakness. With the right support, recovery is possible
Take the First Step Toward Supportive, Compassionate Care
At Manas Cor Psych, our therapists understand the unique challenges that can arise during pregnancy and the postpartum period. We know how heavy these thoughts can feel, how isolating they can be, and how hard it is to reach out when you’re already stretched thin. Individual therapy can give you the support, tools, and clarity you need to feel grounded again.
Whether you’re deep in the newborn stage, preparing for your baby’s arrival, or months into parenthood and still struggling quietly, there is help — and real healing — available to you.
Reach out today to schedule your first session and take a meaningful step toward feeling more like yourself again.
Explore our blog posts for more resources on perinatal OCD and individual therapy.
Your well-being matters — and support is here when you’re ready.
Other Services We Offer In Washington, DC & Online
Alongside individual therapy for perinatal mental health care, we also offer group therapy for parents and individuals seeking connection and shared support. Additionally, psychological testing and assessment to help you better understand your needs and map out next steps in care.
