Understanding Perinatal OCD: Expert Treatment and How an IOP for OCD in Austin, TX Can Help
At Austin Anxiety and OCD Specialists, we understand that pregnancy and new parenthood should be filled with joy, not overwhelming fear. If you're experiencing disturbing, intrusive thoughts about your baby's safety or finding yourself trapped in endless checking rituals, you're not alone. Our specialized team of therapists provides evidence-based treatment for perinatal OCD at our three convenient Austin-area locations: Westlake, Round Rock, and Central Austin.
Bringing home a new baby should be one of life's most precious experiences. Yet for many Austin mothers and parents, this beautiful time becomes overshadowed by terrifying thoughts about harming their baby, constant worry about their child's safety, or overwhelming urges to perform repetitive behaviors. If this sounds familiar, you may be experiencing perinatal obsessive-compulsive disorder (OCD).
You're not alone, you're not dangerous, and most importantly, you're not a bad parent. Perinatal OCD is a real, highly treatable condition that affects expectant and new mothers more often than many people realize. At Austin Anxiety and OCD Specialists, through services like our IOP for OCD in Austin, TX, we've helped hundreds of Austin-area parents overcome perinatal OCD and reclaim the joy of parenthood.
What Is Perinatal OCD?
Perinatal OCD is a form of obsessive-compulsive disorder that emerges during pregnancy or within the first year after childbirth. Unlike general anxiety about becoming a parent, perinatal OCD involves persistent, intrusive thoughts (obsessions) about harm coming to your baby, coupled with repetitive behaviors or mental rituals (compulsions) performed to reduce the anxiety these thoughts create.
The condition can develop at various stages:
During pregnancy (prenatal OCD) - often focusing on fears about accidentally or intentionally harming the baby, contamination concerns that could affect the baby, and excessive worry about the baby's safety and well-being.
Immediately after birth - often within the first 2-3 weeks postpartum.
Throughout the first year - symptoms can emerge at any point during the baby's first year.
For Austin mothers who already have OCD, pregnancy and childbirth can significantly worsen existing symptoms. What makes perinatal OCD particularly challenging is that the intrusive thoughts often center around the very person you love most - your baby. These thoughts feel completely at odds with your natural protective instincts, creating intense shame and fear that prevent many mothers from seeking help.
At Austin Anxiety and OCD Specialists, we specialize in treating OCD and understand the unique challenges faced by mothers in Austin and the surrounding Texas communities.
How Common is Perinatal OCD?
Perinatal OCD affects approximately 3-5% of expectant and new mothers, though some studies suggest rates could be much higher. In our Austin practice, we see that many women with existing OCD experience worsening symptoms before and after childbirth.
Despite these significant numbers, perinatal OCD remains under-recognized and under-diagnosed throughout Texas. Many Austin mothers suffer in silence, afraid to share their intrusive thoughts with healthcare providers or loved ones for fear of being judged or having their baby taken away.
Recognizing the Signs and Symptoms: Do These Experiences Sound Familiar?
If you're an Austin mother reading this article, you might be wondering if what you're experiencing falls within the range of anxiety that is typical among new parents or if it’s something more.
Perinatal OCD symptoms fall into two main categories: obsessions (intrusive thoughts that feel overwhelming and unwanted) and compulsions (behaviors or mental acts you feel driven to perform to reduce anxiety).
When Intrusive Thoughts Take Over: Understanding Obsessions
Even mothers without OCD experience intrusive thoughts from time to time — it’s a normal part of being human, especially during the intense and vulnerable perinatal period. What sets perinatal OCD apart is the frequency, intensity, and persistence of these thoughts, which become overwhelming and distressing. The intrusive thoughts that often characterize perinatal OCD are often shocking, disturbing, and completely at odds with your values as a mother. You might find yourself thinking, "What kind of mother has thoughts like this?" The answer is: a mother with perinatal OCD. These thoughts are symptoms of OCD, not reflections of your character.
Harm-Related Intrusive Thoughts: The Most Frightening Symptoms
These are often the most distressing and shame-inducing thoughts that mothers experience:
Accidental harm thoughts might sound like this in your mind:
Standing at the top of the stairs holding your baby and suddenly having a vivid image of dropping them.
Driving around Austin with your baby and having intrusive thoughts about crashing the car.
Bathing your baby and being flooded with images of them drowning, even though you're holding them safely.
Walking near windows and having thoughts about accidentally letting your baby fall.
Preparing formula and having intrusive thoughts about accidentally poisoning your baby.
Every time I walked down the stairs with my daughter, I would have this horrible image flash in my mind of dropping her. It was so vivid and terrifying that I started crawling up and down the stairs while carrying her, which I knew was ridiculous, but the thought was so scary.
Intentional harm thoughts are perhaps the most disturbing and misunderstood:
Having sudden thoughts about shaking your baby when they're crying.
Intrusive images of suffocating or smothering your baby.
Thoughts about intentionally dropping your baby down the stairs.
Mental images of stabbing your baby with kitchen knives.
Thoughts about leaving your baby in dangerous situations intentionally.
I couldn't go into the kitchen while holding my baby because I would have these horrible thoughts about the knives. I knew I would never hurt her, but the thoughts were so loud and scary that I couldn't function.
Disturbing sexual thoughts that mothers rarely discuss:
Unwanted sexual thoughts or images involving your baby during caregiving.
Intrusive thoughts during diaper changes or bath time.
Fear that normal caregiving activities might be inappropriate.
Worry that having these thoughts makes you a predator.
These thoughts are particularly shame-inducing, but they are a recognized symptom of perinatal OCD.
Contamination and Safety Obsessions: When Germs and Toxins Become the Enemy
Contamination fears in perinatal OCD go far beyond normal hygiene concerns:
Germ and illness obsessions:
Paralyzing fear that germ exposure will seriously harm or kill your baby.
Obsessive worry about family members, visitors, or pets carrying dangerous bacteria.
Intrusive thoughts about invisible contaminants on surfaces, clothing, or your own body.
Catastrophic thinking about common illnesses becoming life-threatening for your baby.
Fear that your breast milk might be contaminated or harmful.
I was convinced that if anyone touched my baby without washing their hands, she would get sick and die. I made everyone who came over wash their hands multiple times, and I still couldn't stop worrying about the germs they might have missed.
Chemical and environmental contamination fears:
Obsessive worry about cleaning products, even when stored safely away from your baby.
Fear that residue from detergents or soaps on baby clothes could poison your child.
Intrusive thoughts about air pollution, water quality, or food contamination affecting your baby.
Worry that paint fumes, carpet chemicals, or household materials are slowly harming your baby.
Fear of using any products (lotions, shampoos, medications) on or near your baby.
Medical contamination obsessions:
Excessive worry about medications passing through breast milk.
Fear that taking any medication yourself will harm your baby.
Obsessive concern about vaccine ingredients or side effects.
Excessive worry that medical procedures or doctor visits expose your baby to dangerous infections.
Responsibility and Perfectionism Obsessions: The Weight of Being "Enough"
These obsessions center around the overwhelming responsibility you feel for your baby's well-being:
Hypervigilance about caregiving:
Obsessive worry that you're not feeding your baby enough, too much, or at the right times.
Fear that your baby's normal fussiness indicates serious medical problems you're missing.
Constant second-guessing of every parenting decision, no matter how small.
Intrusive thoughts that your baby isn't developing properly because of something you did or didn't do.
Worries about whether your baby is properly secured in the car seat.
I would lie awake at night going over every moment of the day, wondering if I had missed some sign that my baby was sick or if I had done something wrong. Every little thing felt like life or death.
Bonding and love obsessions:
Intrusive thoughts that you don't love your baby enough or in the "right" way.
Worry that not feeling instant, overwhelming maternal love means something is wrong with you.
Fear that your negative thoughts about motherhood mean you're a bad person.
Obsessive analysis of your feelings toward your baby.
Worry that your baby can sense your anxiety and will be damaged by it.
Future harm responsibility:
Intrusive thoughts that decisions you make now will ruin your child's entire life.
Obsessive worry about how your current actions will affect your child's development, personality, or future relationships.
Fear that any mistake in early parenting will cause lasting psychological damage.
Overwhelming sense that you hold complete responsibility for your child's well-being.
Fear of Losing Control: When Thoughts Make You Feel Crazy
Fear that having intrusive thoughts means you’re dangerous or mentally unstable.
Fear that you will lose control and act on your thoughts despite not wanting to.
Worry about becoming a “bad mother” or “monster”.
Fear of developing schizophrenia or passing on mental illness to your child.
Religious and Moral Obsessions (Scrupulosity): Fear of Sinning or Being A Bad Person
Fear that having certain thoughts makes you sinful or a bad mother in a spiritual sense.
Fear of sinning or upsetting God.
Obsessive guilt over “immoral” thoughts or feelings related to your baby.
Fear of divine punishment or karmic consequences for intrusive thoughts or perceived failures.
Magical Thinking and Superstitious Obsessions: Believing Thoughts or Rituals Can Protect Your Baby
Belief that certain thoughts or actions (e.g., stepping into the nursery a certain way or stopping the microwave when the timer gets to a certain number) will “cause” harm or protect the baby.
Fear that not performing specific rituals will cause harm.
Obsessions involving lucky/unlucky numbers, colors, or objects related to baby care.
Belief that “bad energy” or tainted objects can harm the baby unless neutralized.
Symmetry and Order Obsessions: The Quest for “Just Right”
Need for caregiving tasks to be done in a precise, “perfect” order or manner (e.g., diaper changes, dressing, feeding rituals).
Feeling extreme distress if routines feel “off” or out of sync with an imagined ideal.
Obsessions related to symmetrical or balanced environments around the baby.
Relationship and Identity Obsessions: Doubts About Your Role as a Mother
Fear that the mother-baby bond is “broken” beyond repair.
Intrusive doubts about being the “right” mother or having the “right” identity as a parent.
Concerns that your baby will reject you.
The Compulsive Response: When Anxiety Calls the Shots
Compulsions in perinatal OCD are behaviors or mental acts that mothers feel driven to perform to reduce the intense anxiety caused by obsessive thoughts. While these behaviors might temporarily relieve anxiety, they ultimately reinforce the OCD cycle.
Safety-Checking Compulsions: The Never-Ending Need for Reassurance
Sleep-disrupting breathing compulsions:
Checking that your baby is breathing every few minutes, sometimes dozens of times per night.
Using apps or monitors to constantly verify breathing.
Placing your hand on your baby's chest repeatedly to feel for movement.
Waking your baby unnecessarily just to confirm they're alive.
Unable to sleep because you're listening for breathing sounds.
I was checking on my son's breathing every 10-15 minutes all night long. I was getting maybe 2 hours of sleep total, and I was exhausted, but I couldn't stop checking.
Compulsive health monitoring and checking:
Constantly examining your baby's skin color, eyes, or facial expressions for signs of illness.
Taking your baby's temperature or weight without reason.
Photographing perceived symptoms to analyze or show to doctors.
Comparing your baby's appearance to online photos or other babies obsessively.
Documenting every feeding, diaper, and sleep session in extreme detail.
Medical reassurance seeking:
Calling your pediatrician's office multiple times per week about normal baby behaviors.
Excessive internet research about baby symptoms, development, or safety.
Seeking reassurance from family, friends, or online forums about your baby's health.
Multiple unnecessary doctor visits for normal infant behaviors.
Inability to trust medical professionals who say your baby is healthy.
General Checking Compulsions:
Repeatedly checking the car seat.
Checking bath water temperature repeatedly.
Excessively checking expiration dates.
Checking locks, room temperature, or other metrics to ensure safety.
Cleaning and Sanitizing Compulsions: When Clean Is Never Clean Enough
Excessive hand hygiene:
Washing hands unnecessarily.
Using hand sanitizer dozens of times per day.
Specific hand-washing rituals that must be performed exactly right.
Avoiding touching anything between washing your hands and touching your baby.
Rewashing hands if the process doesn't feel “complete".
Over-sterilization of baby items:
Sterilizing bottles, pacifiers, and toys beyond recommended guidelines.
Rewashing clean baby clothes multiple times.
Using excessive amounts of disinfectant on surfaces.
Excessively sterilizing items that other people have touched.
Throwing away dirty items rather than washing them.
I was re-sterilizing bottles if I accidentally touched them before washing my hands. I was rewashing my baby’s clothes if anyone else touched them or if I touched them before washing my hands. I knew it was excessive, but I couldn't stop.
Environmental decontamination:
Excessive cleaning of your home in a quest to maintain a sterile environment.
Avoiding certain cleaning products but then obsessing about whether things are clean enough without them.
Changing clothes multiple times per day to avoid "contaminating" your baby.
Showering excessively before handling your baby.
Creating "clean" and "dirty" zones in your home.
Avoidance Behaviors: When Anxiety Holds You Back
Caregiving Avoidance
Refusing to bathe the baby unsupervised due to fears of drowning.
Avoiding diaper changes because of intrusive sexual or violent thoughts.
Avoiding feedings out of fear of contamination, poisoning, or choking.
Steering clear of the kitchen when holding your baby due to fears of knives or other hazards.
Avoiding certain rooms or even entire areas of the house that have become associated.
I couldn't be alone with my daughter because I was terrified of my intrusive thoughts. I would make up reasons for my husband to come home from work or for my mom to come over. I felt like such a failure.
Social and Environmental Avoidance
Avoiding playdates, mommy-and-me groups, or community classes.
Refusing to let friends or family members hold or care for your baby.
Staying home from events or errands out of fear of germs or accidents.
Mental Rituals: The Hidden Compulsions
Mental compulsions are often invisible to others but can be just as time-consuming and exhausting as physical behaviors:
Neutralizing rituals:
Replacing a “bad” thought with a “good” one, like forcing a positive image of your baby to counter a violent, intrusive image.
Mentally “canceling” a thought by thinking the opposite, or replaying a scenario “the right way” in your mind.
Repeating a movement such as walking through the nursery doorway to “undo” a bad thought.
Mental Reviewing and Reassurance-Seeking
Replaying interactions with your baby to make sure you didn’t harm them or act inappropriately.
Analyzing how you felt during caregiving tasks—wondering, “Was that a normal emotion?”
Scanning your thoughts for signs you’re a threat or desperately trying to prove you’re not.
Constantly monitoring yourself, your impulses, and your internal state for reassurance.
I spent hours every day mentally reviewing everything I had done with my baby, looking for evidence that I hadn’t hurt her somehow. My mind never stopped analyzing and checking. It was like having a lawyer cross-examining me in my head all day.
Compulsive Seeking of Emotional Certainty: When You Need to Feel Like a Good Parent
Mentally checking whether you feel “enough” love or connection to your baby.
Repeating affirmations like “I’m a good mother” to reassure yourself.
Comparing your emotional reactions to what you believe other mothers feel.
Compulsively reading books or on-line posts about maternal bonding to confirm your feelings are “normal”.
I kept wondering: Why don’t I feel more joy? Do I love her enough? I'd replay my emotions over and over, convinced something was wrong with me.
"Coming Clean” or Repetitive Confessing: When Guilt Feels Unbearable
Confessing intrusive thoughts to your partner or loved ones repeatedly for reassurance.
Telling your therapist or doctor every “bad” thought to make sure you’re not a danger.
Admitting to imagined parenting mistakes to get feedback that you’re still a good person.
Seeking forgiveness for thoughts you never acted on.
Scanning for subtle changes in facial expressions, tone of voice, or body language while recounting events or seeking reassurance from loved ones searching for signs of judgment, fear, or validation.
Every time I told my partner what I was thinking, I watched his face like a hawk. If he even paused before answering or looked slightly uncomfortable, I would spiral, thinking he thought I had done the unthinkable or I was an unfit mother.
Recognizing Yourself: The Relief of Understanding
If you're an Austin mother reading these descriptions and thinking, "That's exactly what I'm experiencing," you might feel a mixture of relief and fear. Relief because you finally have a name for what you're going through, and fear because seeing it written out makes it feel more real.
It's important to understand that recognizing yourself in these symptoms is the first step toward freedom. You're not crazy, dangerous, or a bad mother. You're experiencing a treatable mental health condition that affects many expectant and new mothers.
These symptoms might feel overwhelming right now, but they don't define you, and they won't last forever. At Austin Anxiety and OCD Specialists, we've helped countless Austin mothers recover from perinatal OCD and experience the joy and connection with their baby that they deserve.
What Perinatal OCD Is NOT
Understanding what perinatal OCD isn't can be just as important as recognizing what it is:
It’s Not Postpartum Psychosis
Perinatal OCD is often misunderstood, but it’s different from postpartum psychosis. People with perinatal OCD may experience unwanted, intrusive thoughts that feel upsetting because they go against their deeply held values. Importantly, they recognize these thoughts as irrational and don’t want to act on them. Postpartum psychosis, while rare, is a separate and more severe condition that involves symptoms like hallucinations, delusions, and agitation. It requires prompt medical attention and is treatable with appropriate care. Because these conditions can sometimes feel similar or be difficult to sort through alone, a thorough evaluation by a medical or mental health professional can help provide clarity and guide you toward the right support. To learn more about postpartum psychosis, including what to watch for and how to get support, visit Postpartum Support International’s guide here.
It's not typical new-parent anxiety.
While all expectant and new parents worry about their baby's safety and well-being to some extent, perinatal OCD involves intrusive thoughts that are significantly more disturbing, persistent, and interfere with daily functioning.
It's not a reflection of your character or desires.
The intrusive thoughts in perinatal OCD are ego-dystonic, meaning they go against your values and desires. Having intrusive thoughts doesn't make you dangerous or a bad mother.
It's not postpartum depression alone.
While perinatal OCD and depression can co-occur, they're distinct disorders. Depression typically involves persistent sadness, hopelessness, and loss of interest, while OCD involves a specific pattern of obsessions and compulsions
Breaking the Silence: Why Mothers Don't Seek Help
Despite the significant impact of perinatal OCD, many Austin mothers delay seeking help or suffer in silence. Understanding these barriers is crucial for encouraging treatment.
Fear and Shame
The intrusive thoughts in perinatal OCD are often violent or disturbing, leading mothers to believe they're dangerous or "crazy." The shame surrounding these thoughts can be overwhelming, particularly given societal expectations of maternal love and protection.
Misunderstanding About Risk
Many mothers fear that sharing their intrusive thoughts will result in their baby being taken away. In reality, mothers with perinatal OCD are not at increased risk of harming their children. The recognition that these thoughts are unwanted and distressing actually indicates good judgment and protective instincts.
Lack of Awareness
Many healthcare providers, family members, and mothers themselves aren't familiar with perinatal OCD. Symptoms may be dismissed as normal new-parent anxiety or misdiagnosed as postpartum depression.
Cultural and Social Factors
Cultural expectations about motherhood, stigma surrounding mental health, and lack of social support can all contribute to delays in seeking help.
Specialized Treatment at Austin Anxiety and OCD Specialists
At Austin Anxiety and OCD Specialists, we provide comprehensive, evidence-based treatment for perinatal OCD. Our team of specialized OCD therapists understands the unique challenges faced by expectant and new mothers, and we're committed to helping you recover and enjoy your journey into motherhood.
Individual Therapy: Personalized Treatment for Perinatal OCD
Our individual therapy program offers one-on-one weekly therapy sessions tailored specifically to your unique experience with perinatal OCD. Our Austin therapists are specially trained in evidence-based treatments that have been demonstrated to be most effective for OCD.
OCD Intensive Outpatient Program (IOP): Accelerated Recovery Without Leaving Your Baby
When anxiety, intrusive thoughts, or compulsions begin to interfere with your ability to function or enjoy motherhood, weekly therapy may not feel like enough. That’s why we offer a specialized OCD Intensive Outpatient Program (IOP) for individuals experiencing OCD. Our IOP is designed to provide intensive, evidence-based treatment, which allows you to stay home and care for your baby.
Unlike inpatient and residential OCD treatment programs, our IOP offers comprehensive, structured treatment, including ERP (Exposure and Response Prevention), CBT, and ACT, without requiring separation from your baby. In fact, involving your baby in therapy sessions may be helpful, as it allows you to practice new skills and apply strategies in real time, within the context of your daily life as a parent. If you're located in the Austin area, we can even come to your home for intensive home therapy sessions, allowing therapy to take place in the exact settings where your distress occurs, whether that’s during feedings, bedtime routines, or while using baby gear that triggers anxiety. If you're outside of Austin, we also offer secure virtual sessions, so you can still receive expert support and practice skills in your natural environment, where OCD and anxiety are most likely to show up. This real-world approach makes therapy more meaningful, efficient, and sustainable.
Our Approach to Care
We specialize in providing focused, evidence-based care for OCD and anxiety disorders.
At Austin Anxiety and OCD Specialists, treatment goals are highly individualized and anchored in your personal values, including your values about motherhood and the kind of parent you want to be. Our therapists collaborate with you to ensure that your treatment goals are aligned with what matters most to you. We don’t offer a one-size-fits-all model. We tailor care to your unique symptoms, needs, and goals.
Our approach to therapy acknowledges the emotional and logistical challenges of the perinatal period. We focus on helping mothers navigate distressing thoughts, reduce compulsions, and regain confidence in themselves, all in a compassionate environment that honors their role as both a parent and a person.
Whether you're grappling with fears about harm, moral scrupulosity, contamination, or overwhelming guilt, our OCD IOP provides skills and support tailored to the perinatal experience. You don’t have to choose between getting better and being there for your baby; you can do both.
Take the First Step: Contact Austin Anxiety and OCD Specialists
If you're an Austin mother struggling with perinatal OCD, remember that you're not alone, you're not dangerous, and you deserve support. At Austin Anxiety and OCD Specialists, we're here to help you reclaim the joy of motherhood. Our Intensive Outpatient Program (IOP for OCD in Austin, TX) offers structured, compassionate support to help you regain balance, find relief, and feel more present in your daily life.
Here’s how to get started:
Contact us at hello@austinanxiety.com or call 512-246-7225 to schedule your free consultation.
Learn more about how our IOP in Austin is designed to support parents experiencing OCD and anxiety with evidence-based, tailored care.
Partner with our team as we guide you through treatment options and provide the tools you need to begin healing.
You don’t have to face this alone. Together, we can help you reclaim calm, confidence, and connection.
Expanded Services at Austin Anxiety and OCD Specialists in Austin, TX
At Austin Anxiety and OCD Specialists, we recognize that anxiety, OCD, and related challenges affect each person differently. That’s why our care extends well beyond our Mental Health IOP. We provide therapy for children & teens, and adults addressing concerns such as OCD, phobias, PTSD, panic disorder, generalized and social anxiety, separation anxiety, selective mutism, emetophobia, tics, body-focused repetitive behaviors (BFRBs), and depression. Our team also offers parent coaching, SPACE treatment, psychological assessments, and group therapy, with the option for virtual sessions anywhere in Texas.
We’re also proud to offer Camp Courage, a supportive program where kids and teens can practice facing fears, develop coping strategies, and build lasting confidence in a fun, safe environment.
Whether you’re seeking early support or more structured treatment, our approach is always personalized, evidence-based, and collaborative. Each clinician is committed to creating a respectful, compassionate space while helping clients move toward lasting growth and relief.
Meet the Intensive Outpatient Program (IOP) Team in Austin, TX
At Austin Anxiety and OCD Specialists, our IOP for OCD is led by a group of highly skilled, compassionate clinicians committed to guiding clients toward meaningful progress. We support children, teens, and adults managing anxiety, OCD, and related conditions with care that is collaborative, evidence-based, and tailored to each person’s goals and values.
Dr. Samantha Myhre, PhD – Assistant Clinical Director & IOP Coordinator
Dr. Myhre is an expert in anxiety and OCD treatment with additional focus on depression, mindfulness, and self-worth concerns. Working with clients ages 6 and older, she uses a warm, collaborative style to help people build confidence, gain clarity, and take intentional steps forward.
Ann Elise is extensively trained in OCD, anxiety, trauma recovery, and perinatal mental health. As a Postpartum Support International–certified provider, she blends CBT, ACT, ERP, and EMDR to help adults heal, reconnect, and move toward sustainable growth.
With a passion for helping children, teens, and families, Ayla specializes in OCD, anxiety, ADHD, and behavioral challenges. She integrates CBT, ERP, and PCIT with a strengths-based perspective to encourage resilience, courage, and effective coping skills.
Dr. Youssef focuses on adolescents and young adults experiencing OCD, anxiety, and depression. She combines evidence-based approaches with cultural sensitivity, creating a safe and affirming space for genuine growth and emotional well-being.
Whether you or your child are just beginning treatment or seeking more structured support, our IOP team offers developmentally appropriate, compassionate care—walking alongside you every step of the way.
This content is for informational and educational purposes only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician, mental health provider, or other qualified health provider with any questions you may have regarding a medical or mental health condition. If you are experiencing a crisis or emergency, please seek immediate help by calling 911 or visiting your nearest emergency room.