Perinatal & Postpartum OCD Therapy in San Antonio and Across Texas

perinatal & postpartum ocd

A Scary Thought Doesn't Make You a Scary Parent. Perinatal OCD Is Treatable.

You love your baby more than anything. So why do these thoughts keep coming? An image of dropping them down the stairs. A flash of hurting them in the bath. You check their breathing again and again, avoid bathing them alone, or keep knives out of sight, and you're terrified to tell anyone. You are not a bad parent, and you are not alone. Unwanted thoughts like these are very common in new parents, and when they take over, it's called perinatal or postpartum OCD.

Integratus Counseling therapist who treats perinatal and postpartum OCD in San Antonio

Perinatal OCD begins or gets worse during pregnancy or after birth.

Pregnant and postpartum women are more likely to have OCD than other women: about 2% during pregnancy and 2.4% after birth, compared with about 1% in the general female population [1]. Partners and fathers can develop it too. Researchers describe unwanted thoughts of accidental or even intentional harm to a baby as a normal, if distressing, experience for most new mothers [2]. OCD develops when those thoughts feel dangerous and meaningful, and you start checking, avoiding, and seeking reassurance to stay safe.

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A free 15-minute call. No forms, no commitment. Just a conversation about what you're facing.

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OCD thoughts versus a medical emergency

OCD thoughts are unwanted. Postpartum psychosis is different, and it's an emergency.

In OCD, the thoughts horrify you, you work hard to keep the baby safe, and you know the thoughts don't make sense. That is the opposite of wanting to act on them. Postpartum psychosis is rare, but signs include seeing or hearing things that aren't there, severe confusion, not sleeping for days, or believing harmful thoughts are true or right. If you or someone you love notices these, call 911 or go to the nearest emergency room. You can also call or text the National Maternal Mental Health Hotline at 1-833-TLC-MAMA (1-833-852-6262), 24/7, or 988.

How we treat perinatal OCD: the two leading OCD treatments, adapted to life with a baby.

Exposure and Response Prevention (ERP): step by step, you return to the caregiving OCD has taken from you, such as bathing your baby or holding them near the stairs, without the checking and avoidance [3, 4]. Inference-Based CBT (I-CBT) helps you see how OCD builds doubt about yourself as a parent from "what ifs" rather than from the care you actually give [5].

  • We coordinate with your OB or psychiatrist as needed, including around medication during pregnancy or breastfeeding.
  • Babies are welcome at in-person and telehealth sessions.
  • Partners are welcome to join a session to learn how to support recovery without feeding reassurance.
Schedule a free 15 minute consultation

A free 15-minute call. No forms, no commitment. Just a conversation about what you're facing.

why integratus counseling

Warm, judgment-free care for new and expecting parents.

Our team treats perinatal and postpartum OCD with warmth and without judgment. These thoughts won't shock us. Telehealth anywhere in Texas means you can do sessions from home, during naps, without arranging childcare, and babies are always welcome. Our team is trained in both ERP and I-CBT, and we also see clients in person at 16607 Blanco Rd, Ste 1308, San Antonio.

Meet our team →
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Common signs of perinatal OCD

Obsessions (the thoughts)Compulsions (what you do to feel safe)
Images of dropping, drowning, or hurting your babyAvoiding bathing, changing, or being alone with the baby
Fear of SIDS or the baby stopping breathingChecking breathing over and over, day and night
Fears of germs or making the baby sickExcessive washing, sterilizing, or limiting visitors
Unwanted sexual thoughts while changing or bathingAsking a partner to do diapering, or mentally reviewing
Fear of a medication or food harming the pregnancyResearching, calling providers, or seeking reassurance
"What if I'm a bad mother, or secretly want to hurt them?"Confessing, hiding knives, or staying away from the baby

Learn more about our approaches: ERP therapy and I-CBT. Perinatal OCD often overlaps with harm OCD and contamination OCD.

Related types of OCD

Harm OCD
Unwanted thoughts about causing harm
Contamination OCD
Germs, illness, and feeling "dirty"
Just Right OCD
Symmetry, order, and perfectionism
Relationship OCD
Doubts about your partner or relationship
Scrupulosity
Religious and moral fears
Unwanted Sexual & Taboo Thoughts
Including Sexual Orientation OCD (SO-OCD)

Back to OCD therapy at Integratus.

Frequently asked questions

Will you think I'm a danger to my baby?

No. Unwanted intrusive thoughts are a recognized OCD symptom, not a sign that you'll act on them. We'll explain confidentiality and its limits at your first session so you know where you stand.

Can I bring my baby to sessions?

Yes. Babies are welcome at in-person and telehealth sessions.

Can I start treatment while pregnant?

Yes. Treating OCD during pregnancy can help prevent it from worsening after birth.

Is this postpartum depression?

They can occur together, but they're different. We'll screen for both and make sure you get the right care.

How long does treatment take?

It varies with your symptoms and goals. We review your progress together regularly and adjust the plan as you go.

How much does it cost?

Individual sessions are $150 for 50 minutes. We're a private-pay practice, and clients working with Luke Mayeux, LPC, can request a superbill for possible out-of-network reimbursement.

References

  1. Fawcett, J. M., Russell, E. J., & Mazmanian, D. (2013). Risk of obsessive-compulsive disorder in pregnant and postpartum women: A meta-analysis. Journal of Clinical Psychiatry, 74(4), 377–385. https://doi.org/10.4088/JCP.12r07917
  2. Fairbrother, N., Thordarson, D. S., Challacombe, F. L., & Sakaluk, J. K. (2018). Correlates and predictors of new mothers' responses to postpartum thoughts of accidental and intentional harm and obsessive compulsive symptoms. Behavioural and Cognitive Psychotherapy, 46(4), 437–453. https://doi.org/10.1017/S1352465817000765
  3. Öst, L.-G., Havnen, A., Hansen, B., & Kvale, G. (2015). Cognitive behavioral treatments of obsessive–compulsive disorder: A systematic review and meta-analysis of studies published 1993–2014. Clinical Psychology Review, 40, 156–169. https://doi.org/10.1016/j.cpr.2015.06.003
  4. Wang, Y., Miguel, C., Ciharova, M., et al. (2024). The effectiveness of psychological treatments for obsessive-compulsive disorders: A meta-analysis of randomized controlled trials published over last 30 years. Psychological Medicine. https://doi.org/10.1017/S0033291724001375
  5. Aardema, F., Bouchard, S., Koszycki, D., et al. (2022). Evaluation of inference-based cognitive-behavioral therapy for obsessive-compulsive disorder: A multicenter randomized controlled trial with three treatment modalities. Psychotherapy and Psychosomatics, 91(5), 348–359. https://doi.org/10.1159/000524425

Ready to Feel More in Control and Less Overwhelmed by OCD and Anxiety?

You don’t have to face OCD and anxiety alone. Let’s work together to help you feel more calm, confident, and in control.

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