What Is Postpartum OCD? A Therapist’s Guide for New Moms
Updated: July 15, 2025You’ve just had a baby. Your life has changed in a big way. You expected exhaustion, maybe some tears, but not this - intrusive, scary thoughts you can’t shake. You picture something bad happening to your baby, and it terrifies you. You start to wonder, What kind of mom has these thoughts?
This is something called postpartum OCD, and it’s more common than you might think. You are not your thoughts. And you are not alone.
What Is Postpartum OCD?
Postpartum OCD (also called perinatal OCD) is a form of obsessive-compulsive disorder that shows up during pregnancy or after birth. It affects about 3–5% of new moms (Fairbrother et al., 2016).
It often involves:
Intrusive thoughts (like imagining your baby getting hurt)
Compulsions (like checking the baby, washing your hands, or asking others for reassurance)
Strong guilt or fear about these thoughts
These thoughts go against your values. That’s why they feel so upsetting. But here’s the most important part: Having these thoughts doesn’t make you dangerous. It means you’re struggling with OCD—a treatable mental health condition.
Read our blog post, Could My Thoughts be OCD?
How Is Postpartum OCD Different from Postpartum Depression?
This is a common question.
Postpartum OCD is driven by fear and anxiety. You may feel constant mental pressure or dread, even when things seem "fine."
Postpartum depression tends to show up as sadness, hopelessness, or feeling numb. You may withdraw from people or lose interest in things you used to enjoy.
You can have one without the other—or both at the same time. A trained therapist can help you sort out what’s going on (Fairbrother et al., 2016).
Will I Act on My Thoughts?
No. These thoughts are unwanted. That’s a key part of OCD: people with OCD often feel intense fear because they would never want to act on the thought (Abramowitz et al., 2010). The anxiety makes your brain treat the thought like a threat, even though it’s not real.
In fact, research shows you’re less likely to act on intrusive thoughts if you find them distressing.
Can Postpartum OCD Start Months After Birth?
Yes. While it often begins within the first few weeks, some parents don’t notice symptoms until months later. For example, after big changes like weaning, returning to work, or sleep training. Postpartum OCD can show up anytime in the first year.
If things have felt “off” for a while, trust that instinct and reach out.
Can Dads or Partners Get Postpartum OCD?
Yes. OCD isn’t just something moms experience. Dads and non-birthing partners can also feel intense, intrusive thoughts about the baby’s safety. The same therapies—CBT and ERP—can help, regardless of gender.
Why Does Postpartum OCD Happen?
There’s no single cause, but there are a few common triggers:
History of OCD, anxiety, or perfectionism
Hormonal shifts during pregnancy and postpartum
Lack of sleep, stress, and big life changes
High expectations of what it means to be a “good parent”
One study found that OCD can show up for the first time after childbirth, even if you’ve never struggled with it before (Abramowitz et al., 2010). That’s because the brain is on high alert trying to protect the baby—but it misfires, and anxiety grows.
What Does Perinatal OCD It Feel Like?
Every experience is unique, but here’s how some moms describe it:
“I imagine accidentally hurting the baby—and it makes me panic.”
“I check if my baby is breathing, over and over.”
“I can’t let anyone else care for the baby. What if they mess up?”
“I clean everything multiple times a day. I’m scared of germs.”
These aren’t “quirks” or normal worries. They’re symptoms—and they deserve care and support.
Can Postpartum OCD Go Away on Its Own?
Sometimes it fades with time, especially if you sleep more or your hormones level out. But OCD often sticks around if it isn’t treated—and it can get worse.
Therapy, especially CBT and ERP, helps you feel better faster (Cuijpers et al., 2014).
5 Tips for Moms With Postpartum OCD
Don’t believe everything you think. Intrusive thoughts are just mental noise. They’re not your truth.
Talk to someone who gets it. Therapists who treat OCD can help. So can support groups and online communities.
Be kind to yourself. You’re not “broken.” You’re human. These thoughts don’t define you and we all have intrusive thoughts at times (even the therapist who wrote this blog post).
Take care of your body. Try to rest, move your body, and eat when you can. Even small wins help.
Stick with weekly treatment. Weekly CBT and ERP sessions—ideally for 6 to 20 weeks—work best (NICE, 2009; Cuijpers et al., 2014). If you don’t improve after 6–8 weeks, talk to your therapist about adjusting your plan or finding a specialist.
CBT and ERP for Postpartum OCD
Cognitive Behavioural Therapy (CBT)
CBT helps you understand how your thoughts and behaviors feed anxiety. It teaches you how to step back from fear and shift the way you respond to it (Beck, 2011).
Exposure and Response Prevention (ERP)
ERP is the gold standard for OCD. In ERP, your therapist helps you face the scary thoughts—without doing the compulsions. Over time, the fear starts to shrink.
Both CBT and ERP are safe and effective for postpartum OCD. And they work whether you're doing therapy in person or online. Read more about ERP for OCD.
Can Medication Help?
Yes. If symptoms feel too intense or don’t respond to therapy alone, a doctor might recommend SSRIs. They might suggest medications like fluoxetine (Prozac) or sertraline (Zoloft). But talk to your doctor about what’s right for you (Wiegartz & Gyoerkoe, 2010).
Connect with a Virtual Therapist for Postpartum OCD
Postpartum OCD is a challenging but treatable condition that affects new mothers. By raising awareness and understanding the symptoms, effects, and available treatment, we can break the stigma surrounding perinatal mental health.
At Virtual CBT Psychotherapy, we have a variety of therapists who offer CBT and ERP for moms experiencing postpartum and perinatal OCD. You can book a free consultation by clicking the tab below. * Must be an Ontario resident. Meet our team of registered social workers, psychotherapists and psychologists. We also offer online psychological assessments.
Written by Celissa Vipond, RSW, MSW (an OCD therapist in Ontario)
References
Abramowitz, J. S., Meltzer-Brody, S., Leserman, J., Killenberg, S., Rinaldi, K., Mahaffey, B. L., & Pedersen, C. (2010). Obsessional thoughts and compulsive behaviors in a sample of women with postpartum mood symptoms. The Journal of Clinical Psychiatry, 71(8), 1078–1084.
Beck, J. S. (2011). Cognitive behavior therapy: Basics and beyond (2nd ed.). The Guilford Press.
Cuijpers, P., Karyotaki, E., Weitz, E., Andersson, G., Hollon, S. D., & van Straten, A. (2014). The effects of psychotherapies for major depression in adults on remission, recovery and improvement: A meta-analysis. Journal of Affective Disorders, 159, 118–126.
Fairbrother, N., Young, A. H., Zhang, A., Janssen, P., & Antony, M. M. (2016). The prevalence and incidence of perinatal obsessive-compulsive disorder: A systematic review and meta-analysis. Journal of Clinical Psychiatry, 77(4), 486–494.
National Institute for Health and Care Excellence (NICE). (2009). Depression in adults: Recognition and management (Clinical guideline CG90). https://www.nice.org.uk/guidance/cg90
Wiegartz, P. S., & Gyoerkoe, K. L. (2010). The pregnancy and postpartum anxiety workbook: Practical skills to help you overcome anxiety, worry, panic attacks, and obsessive-compulsive symptoms. New Harbinger Publications.
