You’ll Need A Crib, A High Chair, And Some Extra ERP: How To Manage OCD During Pregnancy

Pregnancy can be a stressful time for expecting parents, even under the best of circumstances.

When you combine OCD with drastic hormonal and physical changes, new health and safety considerations, and family dynamic shifts, it is the perfect storm… not to mention having to choose between an absurd amount of products for a baby registry! It is no wonder OCD wraps its tentacles around this time in your life. Whether you are pregnant yourself or your partner is pregnant, it should come as no surprise if your OCD is affected. 

OCD with a Dash of Pregnancy for Flavor

It would be impossible to fit all of the different obsessions someone might experience leading up to the birth of a child into one blog post, but some examples of ways pregnancy might influence common OCD themes are:

Contamination Obsessions in Pregnancy:

Examples of Obsessions:

• Fears about germs affecting you (or your pregnant partner)
• Fears about germs affecting the baby
• Fears about chemicals that might affect the baby’s growth/development

Examples of Compulsions:

• Excessive washing/showering/grooming routines
• Excessive research about chemicals/medications/products for a baby registry, etc.
• Asking others for reassurance 
• Excessive avoidance

Health Obsessions in Pregnancy:

Examples of Obsessions:

• Fears about your (or your pregnant partner’s) health (such as contracting an illness while pregnant, developing symptoms of a pregnancy complication etc.)
• Fears about the baby’s health 
• Fears about how your mental health is being, or will be, affected by pregnancy/having a child

Examples of Compulsions:

• Checking for signs/symptoms of a health condition
• Excessive health-related research
• Excessively calling/emailing your doctor and repeating questions 
• Asking others for reassurance

Hyper-responsibility Obsessions in Pregnancy:

Examples of Obsessions:

• Fears about what you (or your pregnant partner) might eat and drink during pregnancy
• Fears about doing things that could result in harm (exercising, being in a car, traveling, falling, etc.)
• Fears about the environmental impact of having a child
• Fears about how having another child might affect existing children

Examples of Compulsions:

• Trying to maintain perfect nutrition or fitness
• Trying to eliminate any environmental impact
• Excessive research about these topics
• Avoiding situations (ex: avoiding being in a car, avoiding taking the stairs etc.)

Harm Obsessions in Pregnancy: 

Examples of Obsessions:

• Thoughts about harming the baby during pregnancy (drinking excessive amounts of alcohol, taking harmful drugs, eating harmful foods, injuring the baby in utero, etc.)
• Thoughts about harming the baby after it is born
• Thoughts about harming yourself while pregnant (note: these thoughts are intrusive and unwanted and are different from suicidal ideation)

Examples of Compulsions:

• Excessive avoidance (avoiding being in the room with alcohol, avoiding using a knife, etc.)
• Mental reassurance
• Checking your own feelings/intentions
• Asking others for reassurance

Relationship Obsessions in Pregnancy:

Examples of Obsessions:

• Fears that you don’t feel connected enough to the baby
• Fears that you don’t or won’t love the baby enough
• Fears about your love for your partner while growing your family 
• Fears about how your relationship with your partner/friends/existing children/pets will change

Examples of Compulsions:

• Checking your feelings
• Excessive online research
• Asking others for reassurance/reassuring yourself
• Avoiding making plans for the baby
• Memory hoarding of your relationships before the baby

Miscellaneous Obsessions in Pregnancy:

Examples of Obsessions:

• Fears about the “rightness” of the pregnancy (Was this the right time? Was this the right egg/sperm?)
• Fears about how your life will be different after having a baby
• Fears about how your body will be different after having a baby 
• Needing to know and understand all information about pregnancy and birth, etc.
• Obsessions about choosing the “right” name

Examples of Compulsions:

• Mentally comparing past/present/future
• Memory hoarding of your life before the baby
• Imagining future scenarios
• Asking others for reassurance/reassuring yourself
• Excessive research

Put A Plan in Place

At any point on this journey, you can implement some helpful tools for dealing with OCD symptoms during pregnancy. Don’t let OCD convince you that all bets are off with compulsions just because the stakes feel higher. 

Here are some helpful steps that you can take:

• Work with a licensed OCD specialist to learn new skills, maintain old skills, and work on exposure response prevention 
• Ask your doctor what would constitute an emergency and aim to not call between appointments for anything other than those situations
• If something feels like an emergency, ask a trusted person such as a partner or close friend/family member if they view it as an emergency. If they are unsure, ask them to research it for you (note: you want to be on the lookout for this becoming a compulsion where you are telling your trusted person about a concern just to see their reaction)
• Keep research to a minimum and plan to only get your information from a few trusted sources such as your doctor/midwife/doula, one or two reputable pregnancy books/websites/phone apps, or a pregnancy class (stay away from the online forums! I cannot stress this enough)
• Keep a note in your phone with any questions that you might typically want to Google, and instead go through them only during your appointments with your doctor
• Practice mindfulness daily to strengthen your ability to stay in the present moment without judgement (Expectful is a great app with mindfulness meditations specifically for pregnancy!)
• Remind your loved ones that if you ask for reassurance more than once, they should respond with “I want to help you get better at tolerating uncertainty so I’m not going to answer that” or another agreed upon phrase
• Set a time or reputable-resource limit on necessary research such as food/medication safety, products for your registry, and parenting tips. Or, you can have your partner or another trusted person handle the bulk of this research for you if needed (if you have more than 4 internet tabs open simultaneously, it is time to step away from the computer!)
• Challenge yourself with at least one small exposure per day that is agreed upon with your therapist

I Hope They Get My Sense of Humor…But Not My OCD!

Another fear worth mentioning is the fear of passing OCD to your child. It is an understandable fear to have given that you know exactly how hard it can be to live with this disorder. But truly, who better to help them navigate life than you? Someone who will recognize the signs early and support them in their own treatment. Someone who knows how beautiful a mind that draws creative connections between seemingly unrelated things can be if properly treated. Becoming a parent is a very personal choice, but if it is one that you would otherwise choose, then this fear need not stand in your way.

What Does the Cat Say? What Does the Dog Say? What Does the OCD-Sufferer Say?

Regardless of OCD, being a parent is the ultimate exercise in living with uncertainty. Things can change moment to moment. Just when you think you’re getting it down, your child enters a new phase and you’re back to the drawing board. You don’t know who this tiny human will become or what challenges you or they will face. But life is actually a lot easier when you are more committed to living with uncertainty as opposed to feeling completely sure. It is terrifying but worth it. 

Parenting is also the ultimate exercise in setting a good example. An excellent value to pass down to your child is to teach them to experience life even in the face of uncertainty. You can be the kind of parent who demonstrates what it looks like to feel uncomfortable emotions and still move forward. You can be the kind of parent who encourages exploration and being present in the moment. You can be the kind of parent who models how someone who lives alongside uncertainty acts.

However, this does not mean going for perfection. You can also be the kind of parent who is not afraid to acknowledge that sometimes it is difficult to embrace uncertainty and be present. Some days it is just really, really hard to do the opposite of what your OCD wants. And when you slip, you can be the kind of parent who demonstrates to your child that you simply get back on track rather than beating yourself up.

OCD will always keep you on your toes. And so will pregnancy and parenting. With a little bit of planning and mindful awareness of your experience, you’ll have all the tools you need for this phase of life. 

Thank OCD for its creativity, and then drop the mental tug-of-war rope. You have better things to do (like looking at tiny little shoes that won’t even end up staying on their feet!) than follow OCD’s impossible rules.