Maternal obsessive compulsive disorder (OCD)

Obsessive-compulsive disorder (OCD) is a form of anxiety disorder. It is often talked about in daily conversation. We hear people being described as being 'a bit OCD', in reality the disorder is far more complex and serious than someone merely wanting things to be clean and tidy.

Perinatal OCD is when you experience OCD during pregnancy or in the year after childbirth.

You may also hear the disorder being referred to as postpartum OCD.

Until recently OCD in pregnancy and/or after having a baby had not been researched in much detail. However, this has changed in recent years. It's now said that OCD may well be more common at this time than other times in life.

Perinatal OCD often (but not always) revolved around significant fear of harm coming to your baby, with the worries often focused on accidentally or deliberately harming your baby or the baby becoming ill. It is important to note that this is completely normal and very common to occasionally experience these worries. However, some people find themselves so distressed that they will take measures to manage their anxiety or prevent their fears coming true in the form of obsessive and/or compulsive behaviours. These are the two primary behavioural patterns of OCD:

• Obsessions - are intrusive thoughts , ideas or urges that repeatedly appear in your mind. An example of this could be thinking that dirt and germs have contaminated you. Or, it could be worrying that you might hurt someone.
• Compulsions - are repetitive activities that you feel you have to do. This could be something like repeatedly washing your hands to make sure they're clean, or repeating a specific phrase in your head to prevent harm from coming to a loved one.

Below are some examples of common obsessions and compulsions:

• Intrusive thoughts about hurting your baby, by suffocating them or throwing them down the stairs, for example
• Disturbing thoughts about sexually abusing your child
• Intrusive thoughts of accidentally harming your baby while you're pregnant by eating dangerous foods or taking the wrong medication
• Fear of being responsible for giving a child a serious disease such as HIV
• Fear of making the wrong decisions - for example, about vaccinations or medical treatment

• Excessive washing of clothe, toys or bottles
• Avoiding changing soiled nappies out of fear that you might accidentally touch your baby inappropriately
• Keeping your baby away from other people in case they hurt them or contaminate them
• Constant checking on the baby - for example, waking them up when they're asleep to check on them
• Repeatedly asking people around you for reassurance that your baby hasn't been hurt or abused
• Mentally going over what happened each day to reassure yourself that you've not been responsible for harming your baby

We know that talking about how you are feeling can often be very difficult, however, there is help out there. You do not have to feel like this. We hear that women often worry that they will be judged or seen to be 'not coping' - this is a common misconception. Health professionals are aware of how prevalent OCD can be during the perinatal period, and you are able to support you and your family.

There will be a range of treatment options available to you:

Self help - offers you the option of exploring how you might be feeling through workbooks which you can download or print off. Reading well books are available from most libraries, they promote the benefits of reading for health and wellbeing.

Talking therapy is a NICE recognised therapy delivered by a therapist either face to face, over the telephone or in groups. The therapy is available wherever you live via the NHS and is completely free. Women in the perinatal period (antenatal and up to 1 year post-birth) will be prioritised for talking therapy treatment. There are many different types of therapy available including Cognitive Behavioural Therapy (CBT), which has proved very effective. You should receive your treatment within 6 weeks of the initial referral (NICE 2014).

Medication - You will need to seek the advice of your GP. For mild to moderate anxiety, talking therapy is the first choice of treatment and medication won't usually be considered until you have undertaken some therapy. If you are pregnant or breastfeeding there is still medication that you can take, but you need to discuss this with your GP. Please see further advice. It is not generally recommended that you take holistic medication without speaking to your GP in the first instance.

• Your local Health Visitor in Hampshire here or Dorset and the Isle of Wight here.
• Your GP
• Click here to find your local talking therapies service
• Hampshire Lanterns are a group of mums who have experienced mental health problems during pregnancy or after child birth. They aim to support each other via the internet and group meetings so that no mum should have to suffer alone.

Self help:

• Computerised CBT programme
• NHS self help guides
• MIND self help guides

Useful services & resources:

• Maternal OCD
• Hampshire Lanterns
• Recovery College in Hampshire & Dorset
• PANDAS Foundation
• Local Specialist Perinatal Mental Health Team (Hamphire tel: 01962 89 7780) (Dorset tel: 01202 584 329)
• Baby Buddy is the multi-award winning free app that guides you through pregnancy, birth, parenting and beyond. You can explore the web version of Baby Buddy or download the full version of the app for free on the App Store and Google Play. There is a lot of information including videos about your physical and mental health.We know that talking about how you are feeling can often be very difficult, however there is help out there, you do not have to feel like this. We hear that women often worry that they will be judged or seen to be 'not coping', this is a common misconception. Health professionals are aware of how common anxiety is during the perinatal period, and are able to support you and your family.

Content adapted from MIND