Perinatal obsessive compulsive disorder (OCD)

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Click above to watch a video from Best Beginnings with Dr Alain Gregoire on perinatal Obsessive-compulsive disorder (OCD)

Contact information for your local maternity service

East and North Hertfordshire (The Lister Hospital): 01438 284 124

West Essex (The Princess Alexandra Hospital): 01279 827286

South and West Hertfordshire (Watford General Hospital): 01923 217 343

Contact information for your local health visiting service

Hertfordshire health visiting service: 0300 1237572

West Essex health visiting service: 0300 247 0122

Perinatal 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 or maternal OCD (although parters can get it too).

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) revolved around significant fear of harm coming to your baby, with the worries often focused on accidentally or deliberately harming your baby or the baby becoming ill. It is important to note that this is completely normal and very common to occasionally experience these worries. However, some people find themselves so distressed that they will 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 behavioural patterns of OCD:

Obsessions - are intrusive thoughts , ideas or urges that repeatedly appear in your mind. An example of this could be thinking that dirt and germs have contaminated you. Or, it could be worrying that you might hurt someone.
Compulsions - are repetitive activities that you feel you have to do. This could be something like repeatedly washing your hands to make sure they're clean, 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:

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 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

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 they are able to support you and your family.

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

Self help - Reading well books are available from most libraries, they promote the benefits of reading for health and wellbeing. Here is another good book on anxiety that you may find useful.

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. Women (and partners) 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 proved very effective. You should receive your treatment within 6 weeks of the initial referral (NICE 2014). Contact the local talking therapy service in Hertfordshire or West Essex for support.

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. Bumps provide further advice. It is not generally recommended that you take holistic medication without speaking to your GP in the first instance.