Perinatal Matters – OCD
Obsessive Compulsive Disorder
Obsessive Compulsive Disorder – OCD
New baby, distressing thoughts
Obsessive Compulsive Disorder
OCD in the postnatal period
This can interfere with your ability to take care of your baby. For example, you may not attend straight away to your crying baby, as you feel compelled to complete a ritual such as cleaning or checking. Some mothers with OCD become obsessive about germs contaminating their baby and may go to great lengths to ensure the baby does not come into contact with anything considered dirty (e.g. changing their clothes many times a day, not allowing the baby on the floor, repeatedly washing the baby’s ears and nose).
Often women feel embarrassed or ashamed about their thoughts and compulsions and it can be very hard to tell someone. However, it is important to tell your doctor as OCD can be treated.
“My obsessive thoughts have ranged from being afraid of accidentally hurting others, hating that the letter M came before N, and not being able to cook a meal without being worried I’d poison someone, to fearing I’d randomly cheat on my husband without meaning to, and worrying I’d run someone over on the footpath. I had thoughts while I was pregnant – and then for at least the first 6–9 months with my first child. I didn’t have anything when my second child was born two years later, but then the thoughts came back with a vengeance when they were four and six years old.”
– Sophie* KiwiParent Magazine, June 2021. Read the full article here: Perinatal OCD – A penny for your (intrusive) thoughts?
Remember – you are not alone – what the numbers tell us
The number of New Zealanders living with OCD at any time:
50,000
1,500
Obsessive Compulsive Disorder
What are some common indications of Perinatal OCD?
Each individual’s experience of perinatal OCD is unique but there are some common symptoms. This list of common features may help a parent, friend or whānau to identify the possibility of perinatal OCD, but it requires a health professional to determine whether the condition is actually present.
- OCD symptoms that start or return during pregnancy or within the first year after the birth.
- Persistent worry of accidental harm coming to the unborn or newborn infant.
- Persistent thoughts or images of actively harming the baby, despite the mother or father knowing they don’t want to harm the baby in any way.
- Repeatedly doing actions meant to control or stop the obsessional thoughts, or to prevent fears from coming true (e.g. excessive checking on the baby, washing, mental rumination, saying prayers).
- Avoiding certain activities with the baby (e.g. holding, giving a bath, using stairs, changing nappies).
- Needing to have a partner or helper nearby to provide frequent reassurance related to thoughts and images, to carry out avoided tasks, and as an insurance against carrying out a feared action.
- Feeling overwhelmed by the obsessions and compulsions.
- Trouble sleeping because of the disturbing obsessions and time-consuming compulsions.
- Interference with taking care of the baby.
Obsessive Compulsive Disorder
If you are in mental distress because of intrusive thoughts about your baby, what should you do?
It is normal to worry about the responsibility of being a new parent, and to be careful about caring for and protecting your baby. The great majority of new parents will have unpleasant images or thoughts that pop into their head at some stage. If obsessive thoughts and compulsive behaviours are getting in the way of everyday life or causing significant distress, then it is time to seek help. It is easier to talk about mental distress if you are confident that others will understand. You could begin a conversation by giving this brochure to someone you know and trust.
Fortunately, with the right support OCD is a very treatable condition. If you have a good relationship with your midwife or GP you should talk to them about what is happening. You could show them this leaflet. If you don’t feel comfortable with this, contact the maternal mental health services in your area. Alternatively if you can afford it, contact a psychologist with experience in treating OCD. They can help you to understand why the unwanted intrusive thoughts and emotions are happening and, importantly, how to manage them.
“There were swirling tensions as a father wanting to do the best for my child while at the same time all these horrible thoughts flooded my mind”
– David, Dad
Obsessive Compulsive Disorder
Is it common for people to keep quiet and not tell others that they are experiencing OCD?
Contamination is a common perinatal OCD theme. This obsession is about a parent seeking complete certainty that they will keep their baby safe from illness. The parent may feel compelled to repeatedly clean or to be extremely careful about food, even though they know their concern about germs is excessive. The person may keep this private as they recognise that other people might not understand and might judge them.
Harm is another common perinatal OCD theme. A mother or father may have obsessive thoughts or images related to accidentally or actively hurting their baby. Because OCD is not about desire or intention to harm they may feel deeply ashamed and so may find it difficult to confide in others.
Intrusive thoughts are like junk mail of the mind. Usually they are hardly noticed, and quickly forgotten.
Obsessive Compulsive Disorder
Do people who experience Perinatal OCD have signs before they become parents?
Sometimes OCD emerges for the first time in the perinatal period. However, often when they look back, a parent sees signs of OCD from their childhood or adolescence. The content of the obsessive thoughts and nature of the compulsions may have changed. As a child they might have felt a need to perform rituals such as ‘checking’ to keep people safe whereas as a young adult they might have experienced intrusive sexual thoughts. In hindsight, the person may recognise an underlying pattern: wrestling with unwanted thoughts and uncomfortable emotions, and seeking relief by doing mental and/or physical actions.
Rather than intrusive thoughts, some people have an unsettling sense that something doesn’t feel right. Sometimes people feel compelled to arrange objects again and again or balance sensations on one side of the body by achieving exactly the same sensations on the other side of the body.
Obsessive Compulsive Disorder
Can Perinatal OCD be treated?
Fortunately, with the right support OCD is a very treatable condition. A clinical psychologist experienced in OCD treatment can help you to understand why the unwanted intrusive thoughts and emotions are happening and, importantly, how to manage them.
Treatment options for Perinatal OCD include:
- Exposure Response Prevention (ERP) therapy in which the person changes how they respond to their obsessional thoughts, gradually building up tolerance of uncomfortable emotions and reducing the use of compulsive behaviours.
- Mindfulness can be a useful complement to ERP therapy because it helps you to notice intrusive thoughts without engaging with them.
- Selective serotonin reuptake inhibitor (SSRI) medicine. This medication helps to decrease the intensity of obsessive thoughts and so makes it easier to undertake ERP therapy. It can be helpful to have a psychiatrist’s guidance when establishing the optimal medication for you. Some medicines used to treat OCD are probably safe to use for pregnant and breastfeeding women, and it’s important to check with your doctor about which medicines are safest for you.
Obsessive Compulsive Disorder
How can I help a friend or family member with Perinatal OCD?
When a parent has perinatal OCD, often the first instinct of family and friends is to do whatever they can to ease the person’s distress. This may mean giving frequent reassurance that a feared event will not happen, or making adjustments to everyday living so that feared situations can be avoided.
In the short-run, these accommodations might put the person at ease. Although well intentioned, these types of ‘help’ don’t work in the long-run because they unintentionally reinforce the obsessive-compulsive thought cycle.
Rather than make abrupt changes, which would likely be very distressing, be guided by the advice of a therapist about the best way to address feared situations. You could offer practical support to keep the household running. It can be helpful to learn about OCD, but it is mainly love, warmth and encouragement that is needed.
Obsessive Compulsive Disorder
Perinatal OCD Resource
Obsessive Compulsive Disorder
PADA Popup chat video #20 Perinatal OCD with Marion Maw from Fixate
The following video was from our Popup chat #20, featuring Marion Maw from Fixate. Check out our full series of PADA Popup chats and vignettes on our Video page.
Obsessive Compulsive Disorder
Fixate – OCD Online Community
A Facebook community group for friends and families of people with Obsessive Compulsive Disorder
Perinatal OCD – a father’s perspective
An informative, moving interview which includes a father’s experience of Perinatal OCD.
Obsessive Compulsive Disorder
Living with Perinatal OCD by Catherine Benfield
“If you had told me 5 years ago that at some point in the future I would be talking to midwives about the nature of my intrusive thoughts, I would be amazed. Amazed and terrified. That’s because 5 years ago I was unknowingly experiencing perinatal obsessive compulsive disorder (OCD). I was having the most intensely graphic, unwanted, recurring intrusive thoughts about harming my newborn son and, as lovely as I’m sure you all are, you were the last people I wanted to tell about it. I was worried that if I did, you’d begin the proceedings to have my son taken out of my care.”
Catherine runs the blog Taming Olivia, where she blogs about her experiences with OCD, focusing on perinatal and postnatal OCD. You can also listen to a podcast where she talks about her experience with Perinatal and Postnatal OCD.