Therapy for Pregnancy and Postpartum OCD
I provide specialized, evidence-based treatment for OCD that begins or worsens during pregnancy or the postpartum period. Perinatal OCD often centers on intrusive, unwanted thoughts or images about harm coming to the baby — sometimes accidental harm, sometimes frightening thoughts of causing harm — paired with frequent checking, avoidance, mental rituals, or reassurance seeking. These thoughts are among the most distressing experiences a new or expecting parent can have, and among the most treatable.
This work sits at the intersection of my two primary specialties. I completed a Residency in Reproductive Psychology at the UNC Chapel Hill School of Medicine, hold the Perinatal Mental Health Certification (PMH-C), and am a verified provider in the International OCD Foundation (IOCDF) directory. I primarily use Exposure and Response Prevention (ERP), the gold-standard treatment for OCD, thoughtfully adapted for pregnancy and the postpartum period.
✺ What is perinatal OCD? ✺
Perinatal OCD is an obsessive-compulsive disorder that emerges or intensifies during pregnancy or after birth. Like all OCD, it follows a cycle: an intrusive thought, image, or urge causes distress, a compulsion is performed to try to gain certainty or a sense of safety, and the short-term relief from distress teaches the brain that the thought was dangerous, which makes it return even stronger.
In the perinatal period, obsessions typically center on the baby. Common experiences include:
Intrusive thoughts or vivid images of the baby being harmed by accident, by illness, or by you
Fear of being alone with your baby, or avoiding tasks like bathing, changing, or carrying the baby near stairs
Excessive checking on breathing, on the car seat, on whether doors are locked or bottles were sterilized
Mental rituals: praying, counting, reviewing, or mentally "undoing" a frightening thought
Repeatedly asking your partner, pediatrician, or the internet for reassurance
Intense guilt or shame about the thoughts, and fear of what they mean about you
Some parents experienced OCD before pregnancy and notice it shift or intensify. For others, pregnancy or postpartum is the first time OCD appears, which can make it especially frightening and confusing.
✺ Intrusive thoughts do not mean you will harm your baby ✺
This is the most important thing to know: intrusive thoughts in perinatal OCD are ego-dystonic, aka the opposite of what a parent wants, and that is exactly why they are so distressing. Parents with perinatal OCD are not at increased risk of harming their babies. In fact, they typically go to extreme lengths to protect their babies.
Perinatal OCD is fundamentally different from postpartum psychosis, which involves a loss of contact with reality and requires urgent medical care. A clinician trained in perinatal OCD can tell the difference, and can help you understand it too.
Many parents suffer silently for months because they are terrified that disclosing their thoughts or urges will lead to being judged, or to someone taking their baby away. My practice is a non-judgmental space where these experiences can be named safely, understood, and treated.
✺ How I treat perinatal OCD ✺
I use Exposure and Response Prevention (ERP), the gold-standard treatment for OCD, thoughtfully adapted for pregnancy and the postpartum period. Treatment is collaborative and paced with you, and often includes:
Psychoeducation about intrusive thoughts and the OCD cycle for you, and for your partner if helpful
Values-guided exposure to feared situations (like bathing the baby or being alone with your child) while reducing compulsions and reassurance seeking
Acceptance and Commitment Therapy (ACT) to reconnect with the parent you want to be and what matters to you
Self-compassion approaches to reduce shame
Coordination with your OB, midwife, pediatrician, psychiatric provider, pelvic floor physical therapist, or lactation consultant when helpful
Because I work via telehealth, sessions can happen from home, with your baby nearby if needed, and exposures can take place in the real environments where OCD shows up.
Many people feel nervous about sharing frightening intrusive thoughts, sometimes for the first time, with anyone. I want you to know that I am comfortable discussing all types of disturbing intrusive thoughts as part of OCD assessment and treatment. This is work I do every day, and I approach it with care and without judgment. We move at a pace that feels appropriately challenging but not overwhelming, and I never suggest that clients do anything unsafe as part of the ERP process.
OCD symptoms affect a meaningful proportion of pregnant and postpartum parents, with research suggesting rates are substantially elevated during the perinatal period compared to the general population. If you never experienced OCD before pregnancy, its arrival can be frightening and confusing. With specialized treatment, parents recover, and many tell me that treatment gave them back the early parenthood experience OCD was stealing from them.
You can read more about postpartum OCD and intrusive thoughts on my blog: “Postpartum OCD: Intrusive Thoughts, ERP Therapy, and What Really Helps”.
✺ Perinatal OCD is treatable ✺
✺ FAQS ✺
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No. Intrusive thoughts are extremely common among new parents (98% of parents endorse them), and in perinatal OCD they are distressing precisely because they conflict with your values as a parent. Having the thoughts is not dangerous.
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Perinatal OCD can overlap and co-occur with postpartum anxiety or depression. However, perinatal OCD is defined by the cycle of obsessions and compulsions — intrusive thoughts followed by rituals, checking, avoidance, or reassurance seeking. I am trained in both perinatal mental health and OCD and can clarify what you're experiencing and what treatment fits.
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Yes. ERP is a collaborative, structured therapy, and I adapt exposures thoughtfully for the perinatal period. You are always in the driver's seat, and nothing in treatment is unsafe for you or your baby.
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Yes. Research supports ERP delivered via telehealth, and for pregnant or postpartum parents it is often the more practical option. Sessions happen from home, and exposures can take place in the real situations where OCD shows up, like caring for your baby.
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Yes. OCD and anxiety treatment is one of the core specialties of my practice, across all OCD themes. You can learn more on my OCD & Anxiety Treatment page.
If intrusive thoughts, checking, or fear are consuming your pregnancy or postpartum experience, you are not broken and you are not alone. Effective, specialized treatment exists. I offer telehealth therapy to adults in North Carolina, California, and 40+ PSYPACT states. You can contact me to schedule a free consultation.
Specialized therapy for reproductive mental health, OCD and anxiety, and PTSD — serving adults in North Carolina, California, and PSYPACT states