Obsessive compulsive disorder in pregnancy

What is OCD?

OCD is a mental health condition that can affect anyone. You may have had OCD before getting pregnant, or it can start during or after pregnancy.

People with OCD have:

• unwanted thoughts or pictures in their mind (obsessions)
• anxiety
• compulsive behaviour, where they repeat a thought or action to try to lessen their anxious thoughts.

Perinatal OCD

If you get OCD in pregnancy or after childbirth it is known as perinatal OCD. Perinatal OCD symptoms are often about the baby, but not always.

Having a baby changes your life and can be very stressful. It’s normal to have some worries about your baby’s wellbeing. You will also want to protect them from risks, so you will do things to reduce their risk of harm, such as sterilising feeding bottles or sometimes checking on them as they sleep. Some fleeting intrusive thoughts are common. It doesn’t always mean you have OCD.

But you may have perinatal OCD if you:

• spend a lot of time thinking about these worries or they cause you a lot of distress, and 
• develop obsessive thoughts and compulsive behaviours because of them.

For example, you may worry about your baby being harmed by germs, so spend a lot of time cleaning or sterilising things over and over again. 

After the birth, you might have a picture in your mind of hurting your baby in some way. This can be scary and upsetting, but we know that mums with OCD do not act on these thoughts

“I kept thinking that something was going to happen to my baby son if I went to sleep. I panicked about any little movement he made, thinking it might be a seizure. I started taking his temperature every hour and I was too afraid to leave the house in case he caught a bug.”

Sarah

How common is perinatal OCD?

OCD is more common during and after pregnancy than it is among people who aren’t pregnant. About 1 in 50 mothers have it during pregnancy.

Perinatal OCD is more likely to happen to first-time birthing people, but you can have it during or after any pregnancy.

What causes perinatal OCD?

It’s not clear just what causes perinatal OCD, but you are more likely to have it if you have a relative with OCD or you have had OCD before.

I think I may have OCD. What should I do?

Make sure you tell your midwife or GP if you are having symptoms now or if you’ve had OCD before. They can offer you treatment to help stop OCD or help prevent it from getting worse.

Remember that OCD is common and is not your fault. Your midwife or doctor will not judge you. They are there to help you find the best treatment so you can get better.

It can be hard to talk about. It may help to write down what you want to say, or take someone with you to your appointment. The main thing is to let someone know so you can get treatment. 

Treatment options

Your doctor will talk to you about which treatment is right for you.

The two main treatments are:

Talking (psychological) therapy

This tends to be cognitive behavioural therapy (CBT). This helps you face your fears and obsessive thoughts while resisting the urge to act on them (compulsive behaviour). 

Medication

Antidepressants are the main drug treatment for OCD. Your doctor will talk to you about the risks and benefits of taking these while you’re pregnant. 

How can I help myself?

As well as getting support from a professional, there are things you can do to manage your symptoms:

• Talk to your partner, family or a friend about how you are feeling.
• Do not feel guilty or ashamed. These thoughts are not your fault.
• Get as much rest as you can and accept offers of help.
• Do not use alcohol, or smoke  to calm yourself down. Both can harm you and your baby.
• Use a self-help book – see the list below.

Information for partners  

Pregnancy can be a worrying time for partners, especially if you’re concerned about your partner’s wellbeing. Talk to your GP or midwife if you’re worried about your pregnant partner. You can also learn more about how your partner’s emotions can change in pregnancy and get more support for dads and partners.

More reading

The books below are recommended by the Royal College of Psychiatrists. You may be able to get them prescribed from your GP through the Reading Well Agency: Books on Prescription scheme.

• Overcoming Obsessive Compulsive Disorder: a self-help book using cognitive-behavioural techniques by David Veale and Robert Willson.

• Break Free from OCD: Overcoming Obsessive Compulsive Disorder with CBT by Fiona Challacombe, Victoria Bream Oldfield and Paul Salkovskis.

• Understanding Obsessions & Compulsions: A self-help manual by Frank Tallis.

More information and support

Maternal OCD is a charity that provides information about OCD during pregnancy and after birth

OCD Action is the largest UK charity focusing on OCD. They provide support and information. 

OCD-UK provides advice information and support to anyone affected by OCD.

MIND provides advice and support to empower anyone with a mental health problem.