Can you have OCD when pregnant or even postpartum?
When you think about obsessive-compulsive disorder (OCD), the first image that comes to mind may be someone who washes their hands repeatedly or checks the stove multiple times. But OCD can show up in many different ways—some of which feel so distressing, confusing, or taboo that people suffer in silence, especially during what is supposed to be one of the most joyful times of life: becoming a parent.
One lesser-known but incredibly impactful form is Perinatal OCD, also referred to as Postpartum OCD or Maternal OCD. This subtype deserves more awareness, more compassion, and more understanding—because many birthing people and new parents are navigating it alone.
What is Perinatal OCD?
Perinatal OCD refers to obsessive-compulsive disorder that occurs during pregnancy (prenatal) or after childbirth (postpartum). While the term “postpartum OCD” is often used, “perinatal OCD” is more inclusive, as symptoms can begin any time during pregnancy or the first year after birth.
It can affect mothers, fathers, non-birthing partners, and adoptive parents—anyone taking on the intense emotional responsibility of caring for a newborn.
Perinatal OCD is a recognized subtype of OCD and involves unwanted, intrusive thoughts (obsessions) and repetitive behaviors or mental acts (compulsions) that the person feels compelled to do to reduce distress or prevent something terrible from happening.
What Are the Symptoms of Perinatal OCD?
Like other forms of OCD, Perinatal OCD is ego-dystonic—meaning the intrusive thoughts go against a person’s values and desires. This is what makes it so painful and terrifying.
Common symptoms include:
Intrusive thoughts of harm coming to the baby—either accidental or intentional.
Fears of being a “bad” parent or making a mistake that will damage the child.
Mental images or urges related to sexual, violent, or inappropriate behavior around the baby (these are taboo, unwanted, and never acted upon).
Excessive checking on the baby (breathing, feeding, diaper changes).
Avoidance of being alone with the baby out of fear of what you “might” do.
Compulsions such as reassurance-seeking, mental review, counting, or prayers to prevent harm or neutralize thoughts.
Hypervigilance around germs or cleanliness, especially if connected to fear of infecting the baby.
These thoughts are not a reflection of intent, but rather a manifestation of OCD trying to protect the baby through fear and control.
What’s the Difference Between Perinatal OCD and General OCD?
The core mechanism—obsessions and compulsions—is the same in all OCD subtypes. What makes Perinatal OCD distinct is the content of the obsessions, which center around the safety and well-being of the infant or one’s fitness as a parent.
Here’s a breakdown:
General OCD and Perinatal OCD obsessions can involve contamination, symmetry, harm, etc. Obsessions often center around the baby (harm, contamination, intrusive sexual/violent thoughts)Compulsions may be visible (hand-washing) or mental (counting)Compulsions may include checking baby, mental reviews, prayer, or avoiding the baby can occur at any life stage specifically arises during pregnancy or after birth
The Taboo Side of Perinatal OCD
Perhaps the most painful aspect of Perinatal OCD is its taboo nature. Many new parents are horrified by the content of their thoughts and believe it means they’re unsafe, unfit, or “going crazy.” This shame leads many to hide their symptoms, fearing judgment or even losing custody.
Here are examples of taboo symptoms that are common but rarely talked about:
Imagining dropping the baby from a height or shaking them.
Intrusive thoughts of sexually inappropriate acts (these are horrifying and deeply unwanted).
Urges to avoid sharp objects, bath time, or diaper changes for fear of acting on intrusive thoughts.
Distress about not bonding “correctly” with the baby.
It’s essential to understand: having these thoughts does not mean you will act on them. In fact, people with OCD are statistically less likely to act on harmful thoughts than the general population as these obsessions (thoughts and images) are disturbing and the opposite of what that person really wants to do and who they are. What defines OCD is the distress and avoidance, not danger.
What Can You Do to Help?
If you think you might be experiencing Perinatal OCD, here are some steps to consider:
Name it to tame it. Learning that intrusive thoughts are a symptom of OCD—not a reflection of who you are—is the first step in reducing shame.
Avoid self-diagnosing in isolation. Many parents think they have postpartum depression or anxiety (and you might!)—but OCD often hides underneath.
Avoid compulsions when possible. Reassurance-seeking, checking, and avoiding the baby might feel protective but only reinforce the fear cycle.
Reach out for support. Tell a trusted medical provider, OCD therapist, or partner. You don’t have to do this alone.
Find a specialist. OCD requires specific treatment approaches, which brings us to the most important support: therapy.
How Can an OCD Therapist Help?
The gold-standard treatment for Perinatal OCD is Exposure and Response Prevention (ERP), a form of Cognitive Behavioral Therapy (CBT). ERP helps you gradually face intrusive thoughts without engaging in the rituals that keep them alive.
Here's how a specialized OCD therapist can help:
Normalize your experience and reduce shame by validating that these thoughts are common in OCD.
Teach you ERP strategies to reduce compulsions and build distress tolerance.
Guide you through exposures that are tailored, compassionate, and collaborative.
Address co-occurring anxiety or depression that often overlaps with the perinatal period.
Support partners and family in understanding your experience and reducing stigma.
At Better Minds Counseling & Services, our therapists are trained in evidence-based approaches like ERP. We understand how overwhelming it can feel to carry these thoughts alone—especially during such a sensitive chapter of life. You deserve a therapist who sees the full picture and can walk with you toward relief.
You’re Not Alone—And You’re Not Broken
Having intrusive thoughts doesn’t make you a bad parent. It means your brain is doing what OCD brains do: trying to protect through control, even when it causes distress. With the right support, you can find relief, regain confidence, and enjoy your role as a parent again.
