Obsessive compulsive disorder in pregnancy

One in 50 people get obsessive compulsive disorder (OCD) at some point in their lives. OCD can be triggered by stressful life changes so some women develop OCD when pregnant or after birth (perinatal OCD). Perinatal OCD is more common after birth than in pregnancy.

Woman staring out of window.

Obsessive compulsive disorder (OCD) is a pattern of steps:

  • Unwanted, intrusive and often distressing thoughts or images that keep coming back (obsessions)
  • Feeling anxious, afraid, guilty or depressed because of these thoughts
  • You repeat an action (such as washing, checking or counting) to help you cope with your feelings (compulsions).
  • The repeated action brings a short term relief, but then the cycle starts again.

If you get OCD in pregnancy or after birth it is known as “perinatal OCD”. The obsessions and compulsions may focus on your baby, although this is not always the case. It is completely normal to have some worries about your baby, but if you have OCD you may spend many hours being preoccupied by these thoughts.  Here are some examples:

  • You may have obsessional thoughts about your baby being harmed by contamination. You may spend a long time cleaning or sterilising things.
  • You may have obsessional thoughts about your baby stopping breathing. You may feel you need to check your baby constantly.
  • You may have an image or thought about harming your baby. This can be very frightening – but we know that women with OCD do not act on these thoughts.

How common is it?

One in 50 people get OCD at some point in their lives. OCD can be triggered by stressful life changes so some women develop OCD when pregnant or after birth (perinatal OCD). Perinatal OCD is more common after birth than in pregnancy. About two to three in every 100 women are affected by perinatal OCD in the first year after birth.

What should I do?

Tell your midwife or GP if you have ever had OCD in the past, or you have the symptoms now. You may feel embarrassed about the thoughts you have and the repeated actions you do to control your anxieties or fears, but OCD is not your fault. The midwife or doctor won’t criticise you or judge for having these thoughts –they will discuss and organise treatments so you can get better.

It can be difficult to talk about your thoughts and repeated actions.  You may want to write down what you want to say first, or you may want to have someone with you.  The important thing is to let someone know so that the right help can be found as soon as possible. 

What are the risk factors?

Anyone can develop OCD, but you are more likely to get OCD if:

  • you have a relative with OCD
  • you have have OCD before
  • you are under a lot of stress
  • you are a neat, organised person with high standards and these become exaggerated.

Treatment options

Your doctor will discuss the options available with you.

If you have mild OCD you may not need treatment.

If you do need treatment, the first treatment offered is normally Cognitive Behavioural Therapy (CBT) with exposure and response prevention (ERP). This is a therapy that lets you face your fear and allows the thoughts to occur without your normal compulsive response. It can be offered at different intensities depending on the severity of your condition. 

If CBT doesn’t work and the OCD has a big impact on your life the doctor or mental health service might discuss medication.  In this case the doctor will discuss any potential risks of the medication on your baby.

How can I help myself?

  • Talk to your partner, family or a friend about how you are feeling.
  • Try not to feel guilty or embarrassed. These thoughts are not your fault and you are not ‘going mad’.
  • Instead of trying to avoid or ‘fix’ your obsessive thoughts with a compulsive action, face them. Spend half an hour a day writing them down and reading them.
  • Don’t use alcohol or smoke to calm yourself down
  • Use a self-help book. You can find some recommendations below.

More reading

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

  • Understanding Obsessions & Compulsions: A self-help manual by Frank Tallis, Sheldon Press.
  • Overcoming Obsessive-Compulsive Disorder: a self-help book using cognitive-behavioural techniques by David Veale and Robert Willson, Constable and Robinson.
  • Break Free from OCD: Overcoming Obsessive Compulsive Disorder with CBT by Fiona Challacombe, Victoria Bream Oldfield and Paul Salkovskis, Vermillion.

More information and support

Maternal OCD provides information about OCD during pregnancy and after birth

OCD Action Helpline: 0845 390 6232. Provides telephone advice, online chatroom, local support groups

OCD-UK  Helpline: 0845 120 3778. Provides telephone advice, online chatroom, local support groups

MIND Helpline: 0300 123 3393. Mental health charity providing information, support, local groups and an online chatroom

Click here to find out more about different treatment options

Other resources

Read more

Sources

  1. NHS Choices [accessed 7/5/2015] Symptoms of obsessive compulsive disorder, http://www.nhs.uk/Conditions/Obsessive-compulsive-disorder/Pages/Symptoms.aspx, Next review due: 22/04/2017
  2. RCPSYCH (2014) Obsessive-Compulsive Disorder http://www.rcpsych.ac.uk/healthadvice/problemsdisorders/obsessivecompulsivedisorder.aspx © October 2014. Due for review: October 2017. 
  3. Challacombe F, Wroe AL (2013) A hidden problem: consequences of the misdiagnosis of perinatal obsessive–compulsive disorder, Br J Gen Pract. 2013 May; 63(610): 275–276.
  4. RCPSYCH (2014) Obsessive-Compulsive Disorder http://www.rcpsych.ac.uk/healthadvice/problemsdisorders/obsessivecompulsivedisorder.aspx © October 2014. Due for review: October 2017. 
  5. NHS Choices [accessed 7/5/2015] Treating obsessive compulsive disorder, http://www.nhs.uk/Conditions/Obsessive-compulsive-disorder/Pages/Treatment.aspx, Next review due: 22/04/2017
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Last reviewed on February 1st, 2015. Next review date February 1st, 2018.

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