Postpartum Intrusive Thoughts: You Are Not Alone

Having a baby is often described as an exciting time filled with love, joy, and new experiences. However, the reality for many new parents is more complex. Yes, there are beautiful moments, but there are also sleepless nights, overwhelming responsibilities, and a pressure to get “back to normal” almost immediately. You’re expected to settle into parenthood and carry on as if you haven’t just experienced one of the most physically and emotionally transformative events of your life.

Postpartum depression has become more widely acknowledged, but it still carries an unfair amount of stigma. New parents might feel like they’re failing if they are struggling with depression, suicidal ideation, or if they’re having trouble bonding with their child. On top of that, there are intrusive thoughts that can crop up during the postpartum period. Despite how common these thoughts are—around 70% of birthing people have unwanted, distressing thoughts about something bad happening to their baby—they’re rarely talked about, leaving many parents to silently struggle with feelings of shame and fear.

If you’re dealing with postpartum intrusive thoughts or depression, or just having a hard time after birth, you’re not alone. These experiences don’t define your worth as a parent, and acknowledging them is the first step toward healing. Let’s take a closer look at these intrusive thoughts and discuss some ways new parents can find support. 

What are postpartum intrusive thoughts?

Intrusive thoughts are ideas and images that come to mind uninvited and unwanted. These thoughts typically make us uncomfortable and cause distress. Intrusive thoughts can be fleeting, occuring every once in a while, or can appear in patterns. 

Intrusive thoughts can become obsessions, which occur when someone is so afraid of their thoughts happening in real life that they can’t stop thinking about them and how to stop them from coming true. In this case, the intrusive thoughts may be connected to obsessive compulsive disorder (OCD), which we will get into in greater detail later on. 

Postpartum intrusive thoughts are the unwanted ideas and images that occur after having a baby, and typically involving your ability as a parent or the wellbeing of your child. Intrusive thoughts can affect any parent, regardless of whether you gave birth or not. These thoughts do not make you a bad person, namely because they are intrusive. 

Taylor Newendorp, M.A., LCPC is the Network Clinical Director at NOCD. Newendorp has three children of his own, and shares some advice on how to frame your intrusive thoughts: “If those thoughts are bothering you and upsetting you, that’s actually an indication of how much you love and care for your child.” 

He explains that if you didn’t actually care about your child and you weren’t being careful with them, the thoughts and images wouldn’t phase you as much. The intrusive thoughts aren’t something you’re sitting comfortably with, and they’re not a reflection of your actual thinking.

Postpartum intrusive thoughts can occur for a number of reasons. Your body and mind are naturally on high alert after giving birth, and your instincts are working overtime to protect your baby from any potential danger. This extended period of hypervigilance can lead to unwanted thoughts sneaking in. 

Postpartum intrusive thoughts can also be caused by the hormonal fluctuations both parents experience, explains Newendorp. For the birthing parent, a significant drop in estrogen and progesterone levels can trigger emotional shifts. For partners, witnessing birth and the transition into parenthood itself can cause hormonal changes. These shifts can bring on feelings of stress and anxiety for both parents. 

Common postpartum intrusive thoughts

Newendorp explains that postpartum intrusive thoughts are actually incredibly common, and there doesn’t need to be a history of mental illness or prior intrusive thoughts for them to occur. 

“We have three kids, and after every child we were new parents,” he shares. “We’ve both experienced an increase in those fears and doubts and thoughts. It totally happens.” He says postpartum intrusive thoughts are “either some sort of general harm coming to the child, or the parent actually somehow being responsible for harm.”

A few examples of common postpartum intrusive thoughts include:

• What if I drop the baby?
• What if I accidentally feed them something poisonous?
• What if something I give them makes them sick?
• What if I accidentally cause the baby to die?
• What if I lose control and intentionally hurt the baby?
• What if I push the baby off the changing table?
• What if I lose control and throw the baby over a balcony or out a window?

These thoughts can also take the form of doubts about being a “good enough” parent. You might find yourself questioning every little thing you do—whether you’re feeding your baby the right way, whether they’re developing fast enough, or if you’re doing everything you can to keep them safe and happy.

Mental illness and intrusive thoughts: are they linked?

Postpartum intrusive thoughts can be linked to anxiety, depression, and obsessive compulsive disorder (OCD), but they can also occur on their own. It all depends on the severity of the thoughts and how much they are affecting you. 

Some parents, Newendorp explains, “have these thoughts and be bothered here and there, but they are able to just let them go, and still interact with and care for their child the way they want to.” On the other hand, sometimes intrusive thoughts can become overbearing and start affecting your ability to parent. It becomes problematic when you start fixating on the thoughts to the extent that you are avoiding your parental responsibilities.

Newendorp shares that if parents have persistent intrusive thoughts, they might actually start to withdraw from their own child and avoid them out of those fears. If this happens, it is important to seek help, even if your thoughts aren’t related to mental illness.

If your postpartum intrusive thoughts are becoming too much, Newendorp encourages you to be open about what you’re experiencing—share your feelings with your partner, tell a trusted friend or family member, and tell your doctor. He also points out that most hospitals have parent support groups and pediatric social workers that can help out in this area.

Postpartum intrusive thoughts and mental illness

Postpartum intrusive thoughts can sometimes bring underlying mental health issues to the surface or even make existing ones feel more intense. Common conditions such as anxiety, depression, and OCD, can sometimes be linked to an increase in these thoughts. If you already live with any of these conditions, the big life change of having a baby can sometimes cause an increase in symptoms, making the postpartum period even more challenging. 

Postpartum Depression

Postpartum depression is identified when depression symptoms are caused by or related to having a child. It’s characterized by intense feelings of sadness, anxiety, and tiredness that can make it difficult to care for yourself and your baby. It’s not uncommon for postpartum depression and intrusive thoughts to go hand in hand. After giving birth, your body goes through so many changes—physically, emotionally, and mentally—that it’s no wonder things can start to feel overwhelming. 

If you feel like you may be experiencing postpartum depression, it is important to seek help from a licensed professional that specializes specifically in that area. The best treatment for postpartum depression, according to Newendorp, is evidence-based treatment in the form of behavioral activation. 

If a parent is severely depressed and is having trouble interacting with their child, clinicians focus on small, manageable steps to help them gradually re-engage. Newendorp emphasizes that this process is compassionate and supportive, not overwhelming. 

Postpartum depression is difficult, but part of breaking down the stigma around it and making sure people feel comfortable to reach out for help is ensuring the treatment is encouraging and sensitive. The goal is to help parents work through their depression and reconnect with their child and family at a pace that feels doable, without adding to the guilt or pressure they may already be feeling. 

Postpartum Anxiety

For parents who already deal with anxiety, the postpartum period can make those feelings a lot worse. They might constantly worry about their baby’s safety, feel like something bad is going to happen, or just have a general sense of unease that makes it impossible to relax. 

Even if anxiety has never been an issue for you before, postpartum anxiety can pop up due to the stress, exhaustion, and massive hormonal shifts that come with new parenthood. If you are experiencing more anxiety than normal and it’s beginning to affect your overall well-being on a daily basis and persists for even a month, Newendorp recommends you seek professional help. 

“Honestly, my recommendation to most people is don’t wait around to seek help. There are a lot of stressors that go along with having a baby. It’s usually a very happy, positive event, but it’s stressful because it is a major change,” he shares.

Postpartum anxiety can be treated with exposure and response prevention therapy (ERP). This form of therapy involves exposing you to your specific triggers and helping you navigate them in a way where eventually, you will no longer react negatively to them. Sometimes, medication might also be recommended to keep symptoms under control.

Postpartum OCD

For parents with obsessive compulsive disorder (OCD), having a new baby can ramp up obsessive thoughts and compulsive behaviors. OCD is a mental health condition that causes people to experience intrusive thoughts that lead to repetitive behaviors in an attempt to alleviate distress. These thoughts and behaviors are called obsessions and compulsions, respectively. 

With postpartum OCD, you might find yourself having intrusive thoughts about something bad happening to your baby, and then feeling like you need to check on them constantly, clean everything, or avoid certain things to prevent harm.

People with postpartum OCD tend to describe it as this sense or feeling they’re about to do something they really, truly do not want to do. “An example would be I’m holding my baby and I’m on the 12th floor of my apartment building and I get this urge that I’m about to literally toss him out the window,” says Newndorp. “I don’t want to do that! That sounds like a terrible, horrible idea to me.” Newendorp says in this example, the person would back away from the window and try to avoid going near it again at all costs to prevent the intrusive thought from actually happening.

Common compulsions for postpartum OCD include avoiding your child out of fear that you might harm them, checking on them repeatedly, or calling the pediatrician excessively. Newendorp says “I’ve worked with parents with postpartum OCD that are not sleeping at night because they feel like they have to watch their child every moment they’re sleeping to make sure they don’t die. That’s excessive, it’s unnecessary, and it’s causing a lot of impairment for the new parent.” Another common compulsion he has seen includes seeking constant reassurance from family, doctors, friends, etc., that the baby is okay.

“If somebody has a previous diagnosis of OCD, or they’ve actually been experiencing obsessive compulsive tendencies prior to getting pregnant, they do have an increased chance of experiencing postpartum OCD symptoms,” Newendorp explains.

However, he notes that there are numerous cases where a parent has no previous history of anything that sounds like OCD and then they experience a sudden onset of OCD symptoms shortly after childbirth. 

Like postpartum anxiety, the evidence-based treatment for postpartum OCD is ERP. Your clinician will work with you to face your intrusive thoughts, fears, and images in a safe setting and learn coping mechanisms to experience them without performing compulsions. The goal is that with ERP, you will be able to face triggers and find a permanent solution to your fears without feeling the need to find temporary relief. 

For example, if someone keeps having intrusive thoughts about dropping their baby and completely avoids holding the child out of that fear, a therapist trained in ERP would take steps to help the parent sit with the discomfort of their fears without acting on their compulsion. The therapist would create a controlled, supportive environment where eventually, the parent would learn to hold the baby without fear of a negative consequence.

Bottom Line

Having a baby is a huge life change, and it can come with a lot of stress—some of it exciting and good, but some of it a bit overwhelming. Along with that stress, many new parents experience intrusive thoughts that make them question their ability to parent. These thoughts can feel really frightening and isolating, but they don’t define who you are as a parent or a person. 

Remember, the reason these thoughts are “intrusive” is because you love and care for your child so much that your brain is telling you that these thoughts are intruding into your mind. It’s completely understandable to feel scared, but it’s also important to remember that you don’t have to face this alone. Most parents experience intrusive thoughts after birth, so know that you are not going through this all by yourself. 

If these thoughts are starting to take over or make it hard to get through your day, there is always support available. Reaching out to a therapist who understands postpartum challenges can help you find the tools to manage these feelings and feel more in control. You deserve to feel supported and cared for during this time, and your wellbeing is just as important as your baby’s.