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Perinatal Obsessive-Compulsive Disorder

Perinatal OCD Intensive Outpatient Program

The Perinatal OCD Intensive Outpatient Program serves pregnant and postpartum adults with obsessive-compulsive disorder (OCD), health anxiety, social anxiety, panic disorder, and phobias (intense, specific fears).

Treatment consists of exposure and response prevention (ERP), which is based on cognitive-behavior therapy (CBT), delivered in a group format.

To make a referral, please click here or call us at (401) 453-7955 or email BHDHdesk@wihri.org.

Contact Information:

Women & Infants Hospital of Rhode Island
Center for Women’s Behavioral Health
101 Dudley St.
Providence, RI 02905
P: (401) 453-7955
Email: BHDHdesk@wihri.org
Fax: (401) 276-7873

Spanish-speaking staff members are available in the department, and the hospital has interpreters in other languages available upon request.

Perinatal Obsessive-Compulsive Disorder (OCD)

What is Perinatal Obsessive-Compulsive Disorder (OCD)?

The term perinatal refers to pregnancy and postpartum (12 months after delivery). Although you may have heard of postpartum depression, this is not the only mental health challenge that occurs during this time period.

Many people struggle with perinatal anxiety. OCD is a specific kind of anxiety that is even more common during pregnancy and postpartum compared to other times in a parent’s life.

OCD consists of two parts: obsessions and compulsions. Obsessions are unwanted, intrusive thoughts, images, or urges that are upsetting/distressing. Compulsions are repetitive behaviors or rituals that attempt to decrease anxiety/distress from the obsessive thoughts, although relief is usually short-lived. Many perinatal parents will have only obsessions and not compulsions while others have compulsions without obsessions. You do not need to have both obsessions and compulsions to have perinatal OCD.

Examples of Common Obsessions:

  • Something bad happening to your baby/children, yourself, and/or people you care about
  • Hurting your baby and/or other people
  • Fear of germs/contamination
  • SIDS
  • Sexual thoughts about babies/children that you experience as disturbing
  • Mentally reviewing...replaying behaviors in my mind to see if I made a mistake
  • Excessive preoccupation with fetal movements

Examples of Common Compulsions:

  • Checking baby constantly
  • Avoiding the baby or avoiding certain activities like bathing or changing the baby
  • Cleaning
  • Googling
  • Repeatedly asking for reassurance from loved ones and/or medical providers
  • Excessive requests for fetal monitoring when not advised by the obstetrical provider
  • Constant disinfecting
  • Excessive handwashing
Why is this happening to me?

No one knows exactly why some people get perinatal OCD. The intense hormonal changes that occur during pregnancy and postpartum, sleep deprivation, past history, genetics, and demands of caring for a newborn are all likely contributors.

This is important: OCD does NOT mean you are a bad parent. Scary or unwanted thoughts are your brain’s (ineffective) way of trying to help you manage the anxiety of caring for a new baby. We do not have control over the thoughts that come into our heads; we can only control what happens next.

What can I do about it? (Treatment for OCD)

The good news is that OCD is very treatable. You will get better! The most effective treatment for OCD is a specific type of cognitive-behavioral therapy called exposure and response prevention (ERP). For some parents, the addition of medications can also be helpful In ERP treatment, you work with a skilled provider in a specific, systematic way that allows you to let go of your obsessions and/or compulsions. By adopting and practicing certain strategies, your symptoms will no longer dominate your life and your relationship with your baby.

In addition to OCD, there are other anxiety disorders that may affect you during pregnancy and postpartum, including panic disorder, health anxiety, specific phobia (intense fear), and social anxiety.

Expectations:

  • Participation: This type of treatment works best when engaged in consistently. This is a specialized treatment program for perinatal individuals - in fact, the first of its kind in the country. Therefore, we want to ensure every person in the program is willing to fully participate in the treatment.
  • The average length of stay is approximately 6 weeks.

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Individual Sessions:

Patients will meet individually with a therapist for 45-minutes/week and may maintain outside appointments with a psychiatrist if they have one. If not, we can arrange for a psychiatry consultation by request.

Family Sessions:

Members of a patient's support team (partner, family, close friend) may be invited to an individual family session.

Group Schedule:

Groups are 3 days a week (Mondays, Wednesdays, and Thursdays), from 9:30 am-12:30 pm. See below for the group schedule and details. 

Monday
Group 1 | 9:30 a.m. - 10:20 a.m. Psychoed/Homework Review
Group 2 | 10:30 a.m. - 11:30 a.m.  Exposure Group
Group 3 | 11:40  a.m. - 12:30 p.m. Homework Planning

 

Wednesday
Group 1 | 9:30 a.m. - 10:20 a.m. Psychoed/Homework Review
Group 2 | 10:30 a.m. - 11:30 a.m.  Exposure Group
Group 3 | 11:40  a.m. - 12:30 p.m. Homework Planning

 

Thursday
Group 1 | 9:30 a.m. - 10:20 a.m. Psychoed/Homework Review
Group 2 | 10:30 a.m. - 11:30 a.m.  Exposure Group
Group 3 | 11:40  a.m. - 12:30 p.m. Skill/Homework Planning