By Emma Clark, Psychotherapy Intern

Perinatal Obsessive-Compulsive Disorder (OCD) is a mental health condition that involves intrusive, unwanted thoughts, images, or impulses, along with compulsive behaviors meant to reduce the anxiety these thoughts cause. These experiences can feel distressing, out of control, and isolating for new or expectant parents.

Perinatal OCD affects at least 3% of all birthing parents and the rate may be higher among those who had OCD prior to pregnancy. While some intrusive thoughts are common during the transition to parenthood, perinatal OCD is different: it causes significant emotional distress and disrupts daily life.

Common Themes in Perinatal OCD

Intrusive thoughts and compulsions in perinatal OCD often center around the unborn or newborn baby. These thoughts can fall into one or more of the following categories:

Contamination

Fear of the baby getting sick or dying from germs or toxins

Unwanted Sexual Thoughts

Fear of molesting the baby or others harming the baby sexually

Harm

Fear of accidentally or intentionally hurting the baby
Fear of outside harm coming to the baby (e.g., car accidents, choking)

Perfectionism

Fear that something terrible will happen if things aren’t “just right”
Obsessive focus on cleanliness, symmetry, or routine

Religious or Moral Obsessions

Worry about the baby’s soul, morality, or spiritual safety

Common Compulsions

To cope with these intrusive thoughts, parents may engage in compulsive behaviors such as:

Excessive cleaning, sterilizing, and hand-washing
Excessive rumination or replaying past actions for reassurance
Constantly seeking validation from others to confirm they’re a “safe” parent
Repeatedly checking the baby or baby monitor, or obsessively monitoring fetal movements
Repeating tasks until they feel “just right”
Praying in specific ways or numbers to prevent something bad from happening

You're Not Alone

It’s important to know that many new parents experience intrusive thoughts or heightened fears as they adjust to their new role. These often ease over time. However, if the thoughts cause significant distress or lead to repetitive, disruptive behaviors, it could be a sign of perinatal OCD.

The thoughts associated with perinatal OCD can be extremely frightening, but they do not reflect a parent's true character, desires, or capacity to love and care for their child. These are symptoms of a treatable disorder, not a reflection of who you are.

Support and Treatment

Help is available and effective. Treatment options for perinatal OCD may include:

Counseling or psychotherapy
Exposure and Response Prevention (ERP) therapy
Medication
Peer support groups
Self-care and wellness practices

If you or someone you know is struggling with perinatal OCD, compassionate, nonjudgmental support is available. You are not alone, and with the right help, it’s absolutely possible to feel calmer, more confident, and empowered in your parenting journey.

Understanding Perinatal OCD: What Parents Need to Know