Perinatal Obsessive-Compulsive Disorder (OCD)

What if I harm my baby?

 

What is Perinatal Obsessive-Compulsive Disorder (OCD)?

Obsessive-compulsive disorder (OCD) is an anxiety disorder characterised by obsessive thoughts, and behavioural compulsions.

Ψ Obsessions are intrusive, unwanted and persistent thoughts and mental images.

Ψ Compulsions are repetitive acts, including avoidant behaviours, that aim to reduce the distress associated with the obsessive thoughts. They could look like cleaning rituals, repeated checks, counting, saying a particular word or phrase, or avoiding certain places or activities.

Perinatal OCD occurs during pregnancy or a year after childbirth. It could be another manifestation of existing OCD or a sudden onset of a new condition.

Find out more about Obsessive-compulsive disorder

Symptoms of the condition often centre around the baby. They are associated with fears that the baby would be harmed, such as through contamination, inappropriate handling, etc. While individuals with perinatal OCD probably recognise that their obsessive thoughts and compulsive behaviours are irrational, they feel consumed by those thoughts and unable to break free from the rituals.

Often Undetected and Unspoken

Having a baby is stressful and overwhelming. As parents, it’s normal to feel anxious about caring for a young child, and worried that they will harm the child. This anxiety, at manageable level, could actually be helpful in ensuring that you avoid potential risks to your pregnancy and child. 

While many parents have that fear, people who suffer from perinatal OCD give undue importance to those thoughts, and believe that they are capable of causing harm.

These parents may be reluctant to disclose their anxious thoughts for fear that they may be regarded as the potentially dangerous and harmful parent.

Parents may also not be aware of the condition or recognise it as an illness. They may see themselves as an unreliable and unfit parent, or attribute their fears as “going crazy”. 

Failure to detect and address perinatal OCD can result in persistence of the distressing thoughts, and affect the relationship the parent has with the child and their family members. New fathers and mothers (or even those without children) with perinatal OCD may struggle to enjoy moments and bond with the child.

Depending on the severity of your condition, it can also impact your confidence in caregiving and overall quality of life as you spend the day worrying about your child being harmed.


How can I Cope with Perinatal OCD?

Ψ Learn more about OCD

Find out more about the condition. Understand that it is not your fault, and that you are not going mad.

It is often comforting to find an explanation for what you are going through. With better understanding of the condition, you could also make sense of the consuming thoughts and compulsions that you have.

Ψ Learn about your symptoms

Everyone’s triggers and symptoms would look different. It is always a good idea to note how your symptoms present and when they present. This give yourself and ideally your therapist a clearer idea of your presenting difficulties and how to manage them.

Ψ Talk to someone

Reach out to a loved one and share with them what you are going through. It can be relieving just to tell someone your feelings. It could be helpful to first write down your thoughts and feelings before you bring this up with someone.

It can be also reassuring to hear that similar anxious and distressing thoughts are experienced by other people too. Connect with support groups online or in your local community (e.g, OCDNetwork) to receive the emotional support much required in this journey.

Ψ Get practical support

Your anxiety may make you unavailable to care for your child for the time being. Reach out to your family and friends to help with the caregiving tasks.

Let them know how they can help (e.g., could you help to change the baby’s nappy)

Ψ Seek professional help

OCD can be managed with psychological therapy, and sometimes with the additional help of medication. Typically, Exposure and Response Prevention Therapy (ERP) and Acceptance and Commitment Therapy (ACT) are used to help individuals with OCD. They involve exposure to anxiety-provoking situations and accepting the intrusive thoughts while engaging in value-aligned behaviours respectively.

Your therapist will work with you to develop a management plan that best supports you. Things would get better, however overwhelming they seem now.

 

Supporting a Loved One Who is Struggling with Perinatal OCD

Many individuals who experience perinatal OCD worry that they get ostracized when others find out. Do not criticise their compulsions. Assure them that you are there to support them if they ever need it. 

Learn about the condition. With greater understanding of the condition, it may be easier for you to see why your loved one is acting the way they do. You would also realise that providing assurance (e.g., “I’ve sterilized the milk bottle”, “the baby is still breathing”) might not be the best form of support for them – counterintuitively it may sound. Instead consider staying by their side as they experience the discomfort rather than reinforce their rituals.

If you are concerned that you or someone you know is struggling with perinatal OCD, seek professional help. Feel free to reach out to us for support with coping with OCD.