Author: Alena Sofieva, EMJ, London, UK
PERINATAL OCD, TRAUMA-INFORMED CARE, AND MATERNAL MENTAL HEALTH
AT THE Royal College of Obstetricians and Gynaecologists (RCOG) Postnatal Mental Health Conference 2026, speakers explored key challenges in maternal mental healthcare, including perinatal obsessive-compulsive disorder (OCD), trauma-informed support, inequalities in care access, neurodiversity, and menopause-associated mental health changes.
A recurring theme throughout the congress was the need to position maternal mental health centrally within maternity care pathways and wider healthcare systems.
PERINATAL OCD: RECOGNITION AND DIAGNOSIS
Chrissy Jayarajah, Consultant Perinatal Psychiatrist and Clinical Research Lead of Perinatal Mental Health Services, Central and North West London NHS Foundation Trust, UK, discussed the diagnosis and management of perinatal OCD.1
Jayarajah explained that OCD presentations may emerge or worsen during pregnancy, the postnatal period, and other reproductive transitions. She highlighted biological, hormonal, and environmental contributors, including sleep deprivation, heightened responsibility, and sudden identity changes during pregnancy and postpartum care.
The session also focused on recognition of the condition. Jayarajah emphasised that many perinatal OCD presentations may not initially be recognised, with symptoms frequently mislabelled as depression or psychosis. Additional discussion focused on maternal perfectionism, reproductive mental health, and the interface between obstetric and psychiatric care.
PSYCHOLOGICAL TREATMENT APPROACHES
Fiona Challacombe, Associate Professor of Clinical Psychology, University of Oxford, UK, discussed psychological treatment approaches for perinatal OCD.2
The session focused on cognitive behavioural therapy and exposure and response prevention. Challacombe outlined practical approaches including behavioural experiments, formulation approaches, behavioural activation, and relapse prevention strategies.
She also discussed adapting psychological interventions to the perinatal context, including pregnancy, postpartum care, and complex birth outcomes. Resources for women affected by perinatal OCD, including Maternal OCD3 and OCD Action,4 were also highlighted during the session.
MATERNAL MENTAL HEALTH AS ‘CORE MATERNITY BUSINESS’
Another major focus of the congress was the positioning of maternal mental health within wider maternity care systems.
Speakers described perinatal mental health as ‘core maternity business’ and highlighted the importance of integrated neighbourhood care, family hubs, specialist perinatal services, and continuity of care beyond 6 weeks postpartum.
Additional sessions focused on maternal mortality prevention, inequalities in care access, and culturally responsive care pathways. Presentations highlighted higher mortality rates among Black women, poorer outcomes in women living in deprived areas, and the impact of social isolation, trauma, and migration-related barriers.
NEURODIVERSITY AND MENOPAUSE
The congress also explored neurodiversity and reproductive mental health.
One session discussed underdiagnosis of neurodiversity across different age cohorts, while another focused on menopause-associated mental health changes. Speakers highlighted evidence suggesting that some women may experience new-onset OCD symptoms during menopause, while others may experience worsening of pre-existing symptoms.
Additional life factors discussed included work pressures, family responsibilities, stressful life events, and caring responsibilities.
TRAUMA-INFORMED SUPPORT FOLLOWING CHILD REMOVAL
The final sessions of the congress focused on trauma-informed support for women involved with social care systems.
Kate Tilley, Director of Partnerships & Engagement, Pause, London, UK, discussed the organisation’s work supporting women who have had, or are at risk of having, a child removed from their care.5 The session focused on trauma-informed approaches and the importance of incorporating women’s lived experience into policy and practice development.
Angela Frazer-Wicks, Director, GivingHOPE, Lancaster, UK, presented on trauma-informed support within social care systems.6 The session introduced the GivingHOPE “HOPE boxes” initiative, designed to support mothers and babies separated close to birth due to safeguarding concerns.
Frazer-Wicks explained that the boxes contain practical and emotional items intended to help maintain connection between mother and child during separation. These include a photo album, in which foster families can regularly add photographs and updates that are exchanged during supervised contact visits, as well as blankets exchanged between mother and baby to maintain familiar scent and sensory connection. Additional essentials are also included to support bonding and continuity during periods of separation. Frazer-Wicks emphasised that the boxes are provided free of charge and are only offered if the mother wishes to receive one, with midwives playing a key role in introducing the initiative and offering support.
Across the meeting, speakers highlighted the importance of integrated multidisciplinary care, trauma-informed services, and improved recognition of maternal mental health conditions across obstetric and mental health settings.
