Podcast Summary

Your Anxiety Toolkit – Practical Skills for Anxiety, Panic & Depression

Episode 459: Navigating OCD During Pregnancy: A Compassionate Guide (with Erin Jones)
Date: November 10, 2025
Host: Kimberley Quinlan, LMFT
Guest: Erin Jones, PMHC

Overview

This episode dives into the nuanced experience of managing Obsessive-Compulsive Disorder (OCD) during pregnancy. Kimberley Quinlan hosts Erin Jones, a counselor with a perinatal mental health certificate, for a compassionate and practical discussion. They examine how OCD manifests during the major reproductive stages—conception, miscarriage, delivery, and postpartum—while offering evidence-based strategies, especially Exposure and Response Prevention (ERP), and highlighting the importance of support and self-compassion for birthing parents.

Key Discussion Points & Insights

1. Introduction to Perinatal OCD & Erin’s Expertise

• OCD can show up before pregnancy, during conception, and at every perinatal stage.
• Erin Jones has special training (PMHC—Perinatal Mental Health Certificate) and personal experience with infertility and pregnancy.

"OCD and anxiety can unfortunately tackle things way before the pregnancy even happens."
— Erin Jones [01:24]

2. Stage 1: OCD During Conception

• Common Manifestations:
  • "What if" worries about ability to conceive.
  • Magical thinking and “just right” compulsions (habits or rituals believed to influence outcomes).
  • Amplified personal responsibility for the process.
• Typical Compulsions:
  • Excessive pregnancy/ovulation testing.
  • Hypervigilance and symptom spotting.

"OCD just takes a lot of the pretty normal worries of trying to conceive and just amplifies it even more."
— Erin Jones [02:55]

• Validation:
  • It's normal for conception not to feel joyful all the time.
  • People should not feel guilty for not enjoying the process.

3. Stage 2: Miscarriage Fears

• OCD latches onto the uncertainty and risk of miscarriage, intensifying feelings of responsibility.
• Compulsive Behaviors:
  • Hypervigilance to bodily sensations.
  • Excessive research, reassurance seeking, and checking.
• Factors Increasing Vulnerability:
  • Previous miscarriages and trauma.
  • Health anxiety overlaps.

"OCD really tends to push to that personal responsibility aspect of things... What if you have a miscarriage and it's because you did something?"
— Erin Jones [06:29]

Personal Story Highlight

• Kimberley shares hypervigilance after mowing the lawn while pregnant, exemplifying real-life OCD catastrophizing.

  "No matter what little move my body made... everything felt like this is it, this is it happening."
  — Kimberley Quinlan [07:36]

4. Practical Support & Strategies

• Game Plan: Clarify what's “normal” for you vs. what's compulsive.
• Delay Compulsions: Even short delays can help break the compulsion cycle.
• Leaning Into Values:
  • Determine what you’d do without OCD.
  • Collaborate with partners or support people to define non-compulsive approaches.

"Even if you can put as little of a time delay on it as possible, start with that."
— Erin Jones [12:40]

• Compassionate Alternatives:
  • Talk to your baby, focus on values, or engage in another activity while delaying compulsions.
  • Engage your support network.

5. Stage 3: OCD During Delivery

• Typical Intrusive Thoughts/Compulsions:
  • Catastrophic images (e.g., tearing), fears about not loving the baby or failing to bond, harm and pedophilia obsessions.
  • Excessive birth plan editing, reassurance seeking, online researching.
• Key Distinction:
  • All new parents have worries, but with OCD, thoughts become repetitive, intrusive, and impair day-to-day functioning.

"OCD tends to take that and amp it up more. It just adds to the frequency and duration of the worries."
— Erin Jones [15:45]

6. Stage 4: Postpartum OCD

• Themes:
  • Harm obsessions (“What if I hurt my baby?”)
  • Contamination, superstitious/magical thinking, sexual obsessions.
  • Relationship obsessions (“What if I don’t love my baby?”)
• Compulsions:
  • Mental reviewing/checking, avoidance of caregiving tasks, excessive reassurance seeking, and rumination.

"What really defines OCD is that your obsessions are ego dystonic—meaning they're opposite of your worldview. You don't want these things to happen."
— Erin Jones [27:12]

• Complex Grief:
  • Many mourn the loss of expected joy due to OCD’s intrusion at this monumental life stage.

  "It’s such a grief process for folks with OCD... ‘Why did OCD take this beautiful moment from me?’"
  — Kimberley Quinlan [25:20]

7. Stigma, Shame, and Seeking Support

• Shame about intrusive thoughts is common. Erin emphasizes self-compassion and separating identity from OCD symptoms.
• Multiple support groups exist (e.g., International OCD Foundation SIG: Moms with OCD, Erin’s monthly support group).

"I would encourage people to approach it with some self-compassion... You are not your thoughts."
— Erin Jones [26:52]

Practical Tips for Talking to Providers

• Prepare a simple explanation (“I’m having extra worries; I could use support.”).
• Ask about provider’s experience with OCD/intrusive thoughts.
• Use articles, podcasts, or resources if verbalizing is difficult.

8. Treatment: ERP through the Perinatal Experience

• Gold Standard: ERP (Exposure and Response Prevention) is effective throughout perinatal/pregnancy/postpartum stages.
• Adjustments:
  • ERP is tailored to be value-based and safe for mother/baby.
  • Focus initially may be on response prevention if exposures need to be softened.
• Gradual Progression:
  • Start with what’s tolerable—small steps are okay (“baby steps”).
• Support is Crucial:
  • Having a supportive, informed environment is key.

"OCD during... perinatal/postpartum period, people can have OCD fears surrounding their kids way past the postpartum period. We still want to use exposure and response prevention."
— Erin Jones [29:39]

"We can be anxious and do things. We can be tired and do things."
— Erin Jones [35:16]

9. Managing Sleep Anxiety

• Lack of sleep in the postpartum period can amplify anxiety and OCD.
• Planning for rest and support is vital; flexibility and compassion with oneself are encouraged.

"If I haven't slept, my anxiety is always so much worse... and that was a huge part of the anxiety of having a kid for me."
— Kimberley Quinlan [32:05]

10. OCD Does Not Define Parenting Ability or Fate

• Having OCD should not deter one from becoming a parent.
• OCD is highly treatable, and relapse can be managed effectively.
• Erin and Kimberley stress that parents with OCD are often especially caring and attentive.

"Being prone to OCD or anxiety or the possibility that it could come up does not mean that you shouldn't have a child."
— Erin Jones [40:40]

"My clients with OCD are the most incredible parents. Just sometimes the brain steps in and makes it a little messy."
— Kimberley Quinlan [43:20]

Notable Quotes & Memorable Moments

• "It's okay if conception or pregnancy doesn't always feel fun. I don't want anyone to feel guilty if they're not having fun all the time."
  — Erin Jones [03:29]
• "If you have OCD, you might even go above and beyond that hypervigilance, to being hyper aware of your body, constantly checking... Now we have ChatGPT, asking ChatGPT, researching normal symptoms of miscarriage."
  — Kimberley Quinlan [07:58]
• "Even if you can put as little of a time delay on it as possible, start with that... maybe put your hands on your belly and talk to the baby."
  — Erin Jones [12:35]
• "You are not your thoughts. This doesn't mean you're a bad mom or a bad parent."
  — Erin Jones [27:12]
• "OCD is not a disqualifier for being a parent."
  — Erin Jones [43:35]

Resource Links & Support:

• Erin’s Instagram: @ErinTalksOCD for support group info.
• Support Group Co-lead: Megan Davis, megandavispsychotherapy.com.
• International OCD Foundation (IOCDF): iocdf.org
• Postpartum Support International: postpartum.net
• Erin’s Workplace: Bull City Anxiety, North Carolina (bullcityanxiety.com)

Main Takeaways

• OCD can intensify through the entire pregnancy and postpartum journey, latching onto normal uncertainties and magnifying them.
• Compulsions around checking, seeking reassurance, hypervigilance, and avoidance are common but manageable.
• Exposure and Response Prevention (ERP) remains the gold standard for treatment, adaptable to perinatal contexts.
• Self-compassion, community, and accessible support are essential for parents experiencing OCD.
• Having OCD does not mean someone cannot be a loving, capable parent, and hope for effective treatment and thriving is very real.

For listeners struggling with perinatal OCD, you are not alone. Compassionate help is available, and a fulfilling journey into parenthood is possible—even if OCD plays a role in your story.