Glossary

Term · Postpartum: Mind

intrusive thoughts

Also: intrusive thought, unwanted thoughts, scary thoughts about the baby

Unwanted, upsetting thoughts that pop into the mind, such as images of harm coming to the baby. Most new mothers have them, and they do not reflect a wish to act.

In plain words

Intrusive thoughts are unwanted ideas or pictures that appear in the mind without an invitation. In the postpartum period, many are about the baby being hurt by accident, or about the mother harming the baby. They can feel shocking and make you wonder what kind of parent you are. Surveys find that a large majority of new mothers have them. Usually they are a normal part of new parenthood, and the mother finds them distressing rather than wanted. They differ from a wish to act, and from psychosis, where a person loses touch with what is real. Thoughts become a concern when they are constant, when you avoid the baby to stop them, or when they fill much of your day. Talking with a provider about them is common, and help is available.

The deeper version

Intrusive thoughts are cognitions, resisted and experienced as foreign, with the form of obsessions in obsessive-compulsive disorder. In a survey of new mothers, Fairbrother and Woody (2008) found that thoughts of accidental harm to the infant were reported by most women, and thoughts of deliberate harm by a large share, and that these thoughts were usually distinguished from psychotic ideation by insight and by the absence of intent. is diagnosed when obsessions are time-consuming, distressing, or impairing, and when compulsions such as checking or reassurance seeking are present (DSM-5, American Psychiatric Association, 2013). The main controversy is how much of the content and frequency is normative, versus an early marker of perinatal OCD or depression, and whether routine screening for intrusive content changes outcomes.

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Sources

  • Fairbrother N, Woody SR — New mothers' thoughts of harm related to the newborn. Archives of Women's Mental Health, 2008
  • American Psychiatric Association — Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), 2013

The Mothership Topic Wiki is general information for mothers and the people who care for them. It is not medical, legal, or mental-health advice and does not create a provider relationship. Experiences posted by members are their own. In an emergency call 911. If you are having thoughts of harming yourself, call or text 988.