When it comes to maternal mental health, while I applaud the fact that the discussion around this is improving, it’s fair to say that much of it centres around depression or  post-natal depression – and quite rightly so, because so many mothers are affected by it. However did you know that such a thing as maternal OCD existed? Today I have a Q&A with Patrick Carey from nOCD, a self-help OCD app created by people in the OCD community to help people with OCD to shine a light on this maternal mental health issue which rarely gets spoken of:

What is maternal OCD and why does it happen?

Maternal, or perinatal, OCD is a subtype of OCD that appears in mothers either during pregnancy or soon after giving birth. It involves disturbing, unwanted thoughts about harming the baby, either intentionally or accidentally (for example, by giving the baby a contaminated bottle). In an attempt to reduce the distress caused by these thoughts, the person performs repetitive actions (compulsions) or avoids certain situations altogether. In some cases it’s an exacerbation of existing OCD– mothers who deal with other types of OCD find that their OCD latches onto their new baby too. In other cases, it’s the first time the person has dealt with OCD and it might go away on its own.

How common is maternal OCD?

Because maternal OCD is a subtype of OCD and not its own disorder, it’s hard to say exactly how common it is. It’s estimated that 1.2% of the population in the UK have OCD, and 1 in 40 adults in the United States –  but there isn’t much specific data on maternal OCD. It may be more common after childbirth than before because the new child becomes an epicenter for anxious thoughts.

What are some common obsessions experienced?

Because the time right before and right after giving birth to a new child brings so much stress, a wide variety of obsessions can emerge. Some of them might come from other OCD subtypes– like relationship or harm OCD– but the main focus of the obsessions is on the child.

It’s important to know that almost everyone with a new child will worry a lot about them. The thoughts below will seem “normal.” And having weird or frightening thoughts about bad things happening to your child does not, in itself, mean that you have maternal OCD. However, if the thoughts really bother you and seem to stick in your mind, leading you to behave differently than you normally would, it’s worth wondering if you might be dealing with OCD.  

People with maternal OCD might get obsessions like:

• There could be a deadly illness in my baby’s bottle
• What if my baby really isn’t in the back seat of my car right now? What if I left her somewhere?
• Could my baby be suffocating in his crib right now?
• I might have left something sharp around the house
• What if I just walked over and killed my baby?
• What if I just walked over and did something sexual to my baby?

What avenues are available to overcome maternal OCD/how can someone find help?

If these symptoms are really distressing and/or they last for a while, it’s best to seek professional help with someone who treats OCD and uses a behavioural approach. This means working toward the ability to tolerate the distress your thoughts cause you without feeling the need to do anything differently. Behavioural approaches, like exposure and response prevention (ERP), can make things much more painful in the immediate because you’re being asked to do the very things you’re most afraid of. But you want to do this with a trained professional, especially when there’s a baby involved.

Medication is also an option for some people, but behavioural therapy is usually the first option, especially for people who might be breastfeeding.

It can be difficult to find an OCD specialist, especially if you don’t live in an area with a high concentration of them. It’s better to talk with any clinician than none, but let them know you want to do behavioural therapy for OCD and hopefully they’ll be able to suggest someone they know.

Is there light at the end of the tunnel?

As difficult and disturbing as OCD can be, it has better treatment options than most other mental health conditions. It can be chronic, meaning you manage the condition but are never cured of it, but with the right types of treatment many people get better quickly.

If there is one thing people should know about maternal OCD it would be…

Maternal OCD is not just “typical worry for a new parent.” Family members and spouses often dismiss it as such, leaving the person feeling even more alone with their distress.  

Anything else you would like to add?

New fathers can also get something like paternal OCD, with many of the same worries. And fathers with preexisting OCD can find their condition worsens significantly with the stress of a new child. So, if you’re a new father and you’re getting similar symptoms, don’t think you need to “man up” or just get over it. You can also benefit greatly from treatment.

Oh, and anyone experiencing significant distress because of unwanted thoughts (and maybe changing their behaviour because of it) can get started with feeling better and finding a community on the nOCD app. Check it out here.

Have you experienced maternal OCD or perhaps you have found this because you think you might be experiencing perinatal OCD? Do leave a comment and share and let’s improve the dialogue around this.