
Many new parents experience anxiety and worry. There’s so much change that happens while trying to conceive, pregnancy, birth, and everything that comes after! Sometimes, this anxiety can take the form of something called “intrusive thoughts.”
What are intrusive thoughts?
Intrusive thoughts are scary, disturbing, upsetting images or thoughts. These thoughts generally cause a lot of distress–they “intrude.” They can appear out of the blue, come and go, or stick around.
These thoughts often focus on the baby and baby’s safety during the postpartum period. They can also focus on other areas of life or people as well. Intrusive thoughts might also manifest as images that flash or “play” in the mind, much like watching a movie.
Examples of intrusive thoughts:
- What if I drop the baby?
- Imagining walking away while the baby is in the bath
- Picturing baby not breathing
- What if I fall down the stairs while I’m holding the baby?

Why do we have intrusive thoughts?
The human mind is complex and has evolved to try and protect us and keep us safe when we perceive danger or a threat. This can manifest as worry, anxiety, and the ability to imagine the “worst case scenario.” When we become parents, this desire to protect ourselves extends to our children.
In caveman times, being able to imagine what would happen if a mountain lion was nearby was useful for parents. Internal alarm bells helped to protect little ones and ensure that the species could continue because parents were invested in their children’s wellbeing.
What do intrusive thoughts have to do with perinatal anxiety or postpartum OCD?
While this process of experiencing anxious thoughts and worry as new parents is completely normal and can be helpful at times, it’s also complex. The combination of hormonal, sleep, and environmental changes during pregnancy and the postpartum period causes a lot of stress. Parents who have experienced trauma (either earlier in life or during the perinatal time) may also have a nervous system that has needed to operate on “high alert” for survival. As a result, for some parents, anxiety gets kicked into high gear and causes them to struggle with overwhelming fear, worry, and panic that they can’t easily move on from.
Parents who do not have a trauma history or anxiety disorder may experience these internal “alarm bells” but are quickly able to assess the situation and determine if danger is actually present. If there is no threat, they are then able to “move on” from the thoughts without much emotional disturbance.
Sometimes, however, this “moving on” is very difficult and may feel impossible. For these parents, if intrusive thoughts happen frequently, interfere with their ability to function in daily life, or create a negative impact on their life, it’s a sign that more help is needed. These thoughts are often described as being “obsessive” in nature and can be part of what is called Postpartum Obsessive-Compulsive Disorder (OCD).
Postpartum OCD often includes both intrusive thoughts (obsessions) combined with urges to do, or avoid doing, certain things (compulsions) in an attempt to manage the anxiety or try and prevent the scary thoughts from happening. Compulsions may be visible to others (overt), or be mental and unseen by others (covert).
Examples of compulsions:
- Checking on the baby over and over because of fears baby will stop breathing
- Checking to make sure doors are locked repeatedly due to fears someone will break in
- Washing baby’s bottles multiple times due to fears of contamination and baby getting sick
- Asking for reassurance repeatedly from friends, family, baby’s Dr., etc. but never feeling “okay”
- Googling symptoms repeatedly
- Mental rituals such as counting, saying certain words or phrases when intrusive thoughts are present, repeatedly checking one’s body or physical sensations

What should I do if I’m experiencing Anxiety or OCD?
If you’re experiencing intrusive thoughts or symptoms of postpartum OCD, the most important thing to know is that you are NOT alone. The International OCD Foundation estimates that at least 80% of parents experience intrusive thoughts at some point in time!
Just because you think something does NOT mean you will act on that thought or that the thought will happen. Having intrusive thoughts does not mean anything about you. Good moms and dads have intrusive thoughts!
Shame, embarrassment, and fear of judgment keep many people from seeking help, but feeling isolated keeps you stuck. Reach out and talk to someone who understands intrusive thoughts so you don’t suffer alone with them. Perinatal mental health therapists are specialists who have training in treating postpartum anxiety and OCD. You can learn skills that help you feel confident and better able to manage these difficult thoughts and emotions more effectively. It won’t always be as hard as it is right now.
Learning and understanding more about postpartum anxiety and intrusive thoughts can also be helpful. Here’s a couple of books and resources to explore:
- Good Moms Have Scary Thoughts
- The Pregnancy and Postpartum Anxiety Workbook
- Postpartum Support International
If you’re ready to get help, we’re here to support you. Scheduling an appointment is the first step towards feeling better!