Understanding Perinatal and Postpartum OCD: Symptoms, Causes, and Effective Treatment
Perinatal and postpartum obsessive-compulsive disorder (often called pOCD) are forms of OCD that appear during pregnancy or after giving birth. These symptoms often come on suddenly, especially as the emotional and physical demands of pregnancy and early parenthood increase. Many parents are surprised by the intensity of these thoughts and feelings, and it can be incredibly distressing—but you are not alone, and treatment is available.
What Is Perinatal and Postpartum OCD?
pOCD is a disorder marked by intrusive, unwanted thoughts and repetitive behaviors meant to reduce anxiety. These thoughts do not reflect your character, your intentions, or your ability to be a loving parent. They are symptoms of OCD, not a sign that something is wrong with you as a parent.
Both expectant and new parents can experience pOCD, and it often shows up in ways that feel shocking or out of character—which is exactly why it causes so much distress. pOCD can feel like a trap! You have intrusive, disturbing thoughts and you want to get rid of and feel so isolating, and yet what we often find is the very behaviors that we feel pulled to do to get rid of the thoughts make the thoughts come up more and more!
Common Symptoms of Perinatal and Postpartum OCD
1. Intrusive, Disturbing Thoughts (Obsessions)
Obsessions are thoughts that are unwanted, repetitive, and often feel “sticky,” meaning they’re extremely difficult to dismiss. Especially when we have very scary thoughts, it feels important to take them seriously so they don’t come true! But that’s part of the trap of pOCD– once we start treating thoughts as truth or risk, we end up reinforcing the cycle. These thoughts can be deeply upsetting and may involve themes such as:
Fear of accidentally or intentionally harming your baby
Worries about contamination, illness, or making a mistake
Disturbing images or thoughts related to violence or taboo subjects
For example, a new parent may suddenly fear, “What if I drop my baby?” even though they would never want to harm their child. These thoughts feel terrifying precisely because they go against your values!
2. Compulsions or Avoidance Behaviors
To reduce the anxiety caused by intrusive thoughts, many parents engage in repetitive behaviors or avoid certain situations altogether. Indeed, if you have thoughts you don’t want to happen, it’s only natural to try to neutralize them or avoid situations that trigger them! These behaviors bring temporary relief but ultimately reinforce OCD’s cycle.
Common compulsions or avoidance patterns include:
Excessive checking or reassurance-seeking
Avoiding holding, bathing, or feeding the baby
Mental rituals, such as reviewing memories or “checking” your intentions
Avoiding objects or situations that trigger intrusive thoughts
If you find yourself rearranging your day to avoid triggers or constantly asking others for reassurance, this may be part of the OCD cycle.
How Is pOCD Treated?
The gold-standard treatment for perinatal and postpartum OCD is Exposure and Response Prevention (ERP), a highly structured form of cognitive-behavioral therapy specifically designed for OCD.
During ERP, you and your therapist gradually face the thoughts, images, and situations that trigger anxiety—while learning how to resist the compulsions that keep OCD in control. It may sound overwhelming and scary to think about facing these thoughts, but treatment will go at your pace so you feel in control of the process. Over time, your brain learns that these thoughts are not dangerous and do not require action.
Many parents describe ERP as empowering because it helps them reconnect with their confidence, values, and sense of safety.
You Deserve Support
If you’re struggling with intrusive thoughts or fear that something is wrong, please know: having these symptoms does not make you a bad parent. pOCD is a treatable condition, and reaching out for help is a courageous first step.
If you have questions or would like support, please contact:
Dr. Jennifer Herbst
Licensed Clinical Psychologist
Email: JHerbst@richmondfamilypsychology.com
Phone: 804-214-6416
Dr. Herbst specializes in the evidence-based treatment of OCD, including perinatal and postpartum subtypes, and would be honored to help you begin the path toward healing.
