The truth about perinatal OCD
Updated: Jan 15, 2019
“Two o’ clock on a Tuesday afternoon and I'm standing in a maternity examination room in the local hospital hugging an extra large needle disposal box. You know one of those big yellow boxes with "danger dispose by incineration" marked on the front. One of those boxes filled with used needles and containing scores of different types of blood. Not normal behaviour for a mother of two young children, but for me, something I had to do if I was ever to break free of OCD.”
Emma suffered with low level Obsessive Compulsive Disorder throughout her thirties, but when she struggled to conceive and then became pregnant with her first child, it reached crisis point, “ruling every move and dominating every thought.”
I ask her why the needle box is so significant, a question which, in itself, causes her to break down. “Needles,” she explains, “are my biggest fear. A fear I’d managed – or so I thought – to keep under control until I became pregnant, when I suddenly couldn't walk down a street without looking for them, dreaded going to the doctors - or heaven forbid entering a hospital.”
But for Emma it didn’t end there, “something as simple as preparing my baby’s bottle left me in a cold sweat, I cleaned everything my little boy touched over and over and over again and my hands were raw from incessant washing. You see, it was no longer just about needles – germs, strangers, salt, eggs, cleaning products and cars were just some of the things added to my ‘danger’ list.” She goes on to tell me how she routinely made her son’s meals three or four times, throwing each one away for fear she’d done something to contaminate it. “Sandwiches were the worst.... I used to take out two boxes of them, in the hope that the one I gave him was ‘safe’.”
Emma’s experience may sound extreme, but it’s not uncommon. The Royal College of Psychiatrists estimates that around one percent of the population have OCD at any one time, but in the year after giving birth two to three percent of mothers are affected.
Dr Sarah Healy, a clinical psychologist who specialises in treating both men and women in the perinatal period (before and after the birth of a child), says the increase in OCD at this time is understandable. “There’s a huge sense of responsibility that comes with being a parent and it’s very normal to find yourself worrying about the wellbeing and safety of your baby. Some people become overwhelmed by these terrifying thoughts and will do anything to keep their baby safe.”
Sarah says mothers with OCD often fear they’re going to drop their baby down the stairs, burn them in the bath, smother them with a pillow or poison them. Thoughts and images which are, by their very nature, extremely distressing. “People with OCD don’t become violent or act on these thoughts”, Sarah explains, “they retreat and avoid the situations they fear will trigger them.”
Avoidance is something Emma knows only too well. “I brought the confines of my world closer and closer in by avoiding public toilets, the tube, subways, parks, the cleaning product aisle at the supermarket, motorways, restaurants and even hotels. I soon became too scared to even go out at night.”
I ask Emma how this made her feel and how on earth she kept going – looking after a baby and fighting this daily battle. She laughs. “I’m not really sure; I certainly didn’t make things easy for myself! I kept going because I didn’t really have a choice. My son needed me and I needed to be the best mother I could possibly be.” A drive that cruelly fuelled the OCD. “I’d achieved everything I’d ever wanted – a great career, a loving husband and a longed-for, healthy child. Life was good, but I was terrified it would slip through my fingers.”
Like most mental health issues and especially those which occur before, during or after child-birth there’s a massive stigma attached to OCD. In Sarah’s experience, “lots of women feel ashamed of the way they’re feeling, they think they ‘shouldn’t feel like this’ and therefore don't tell people what they are experiencing. Others can be worried that people will judge them or take their baby away if they open up.” “That was the worst thing,” says Emma, “not being able to talk about what was going on in my head. Deep, deep down I knew the thoughts I was having were irrational, but when a voice keeps telling you you’ve put bleach in your baby’s milk, you start to believe it.” Happiness coach, Olivia Horne, who herself suffered from mental health issues following the birth of her first child, believes, sadly much of this stigma seems to be between women. “We’re exhausting ourselves trying to show the perfect picture of motherhood to the world. A matter made worse by the fact our real-life villages have been replaced with heavily-filtered virtual ones.”
Olivia, does however, believe things are changing, “we’re definitely getting better at asking for help and showing support and solidarity, but there’s still a lot of work to be done.” Sarah agrees. “More and more people are opening up about their difficulties and I hope that with celebrities, such as Adele, speaking frankly about their struggles, this trend will continue.”
Thankfully, the government has also started to listen. In November last year it was announced that NHS England would spend £40 million on specialist mental health workers in a bid to help 30,000 more women by 2021. The funding meant that Sarah could finally help Emma overcome her OCD. “To say that Sarah changed my life would be an understatement”, says Emma, “I’ll be eternally grateful to her for putting me on the right track.” Sadly, Emma is one of the lucky ones. The National Childbirth Trust says that whilst the new funding is welcome, there’s still a very long way to go to help the 140,000 mothers each year who suffer mental health issues in the perinatal period. Until then, the advice is to keep talking, start listening and stop comparing.