Postpartum OCD: The hidden compulsions parents don’t talk about

Postpartum OCD (PPOCD) is one of the least understood but most distressing perinatal mental health conditions. While intrusive thoughts are a hallmark, many new parents also experience compulsions, behaviours driven by anxiety and fear, often unnoticed by others.

In my work with new parents in private practice and at the organisation Netmums as a parent supporter, here are some key patterns I’ve seen in people experiencing PPOCD, and how therapy can help.

What is postpartum OCD?

Postpartum OCD involves repetitive, unwanted, intrusive thoughts, often about harm coming to the baby, either by accident or by the parent’s own hand. These thoughts can be visual, verbal, or impulsive in nature.

What makes this OCD, rather than another form of anxiety, is the compulsive behaviour that follows: attempts to neutralise or avoid the feared outcome.

Common compulsions in postpartum OCD

Whilst parents can experience a certain level of anxiety over their baby's health and well-being, especially new parents as it is all completely new, parents with PPOCD may engage in a variety of distressing rituals or avoidance behaviours, such as:

• Checking compulsively: repeatedly checking the baby’s breathing, the position of the crib, or the locks on windows and doors.
• Avoiding the baby altogether: refusing to be alone with the baby or avoiding feeding, changing, or bathing them out of fear of acting on intrusive thoughts.
• Mental rituals: constantly replaying events to “prove” nothing bad happened, or silently repeating phrases to cancel out a thought.
• Seeking reassurance: repeatedly asking a partner or GP, “Do you think I’m a bad parent?” or “Would I ever hurt the baby?”
• Hiding sharp objects: avoiding things like knives, scissors, or even bathwater to prevent feared harm.

These behaviours are not about wanting to harm a child – they are driven by a desperate need to protect their child. We call this 'ego-syntonic OCD', meaning the obsessions and compulsions align with or feel natural to a person's core values, beliefs, and desires. This is harder to spot as OCD, as we feel we are doing the right thing protecting our baby and are unaware of how much anxiety all of these obsessions and compulsions are causing us day to day.

The emotional toll of postpartum OCD

Parents with PPOCD often feel ashamed, isolated, and afraid to seek help. Even with the increased openness about mental health in the news and social media, parents are often terrified that if they tell the truth about what they are thinking or experiencing, then they may be judged, misunderstood or worse, their baby will be taken away from them.

This is simply not true. Mental health professionals, health visitors, midwives, GPS, and counsellors are all trained to spot the signs of PPOCD, anxiety and depression in parents. Many mums suffer in silence, not realising that their experience is:

• common (especially among first-time parents)
• treatable
• not reflective of their character or intentions

How therapy helps

In therapy, we explore the thoughts and compulsions without judgment. An integrative approach draws on CBT, compassion-focused techniques, and psychoeducation to:

• help clients understand and label what’s happening
• reduce compulsive responses gradually
• rebuild a sense of self-trust and emotional safety

Postpartum OCD can feel terrifying. But you’re not alone – and you're not a bad parent. Reaching out for therapy is a courageous first step toward reclaiming peace of mind and confidence as a parent.