Why am I thinking these terrible things?

Intrusive thoughts are unwanted thoughts, images or impulses that pop into your mind when you don't want them to. In the postpartum period, they're extremely common. They often focus on exactly the thing you care about most, the safety of your baby, which is part of why they're so disturbing.

Most people have thoughts of harming themselves or their baby by accident. Some people have thoughts about harming their baby or themselves on purpose. Intrusive thoughts can be extremely violent and even sexual in nature, but what these thoughts all have in common is that they’re distressing. It’s a normal function of the brain, meant to shock you with worst-case scenarios so that you’ll be extra careful with this new responsibility in your life. These thoughts do not align with your values and are not reflective of who you are. Parents who experience them are almost always horrified by them, and that horror is itself the clearest sign that the thought doesn't reflect who you are or how you’ll act.

Some common examples of intrusive thoughts are:

• Fears or images that something bad is happening to your baby
• Fears that something bad will happen to you
• Fears or images of accidentally harming your baby
• Images of intentionally harming yourself or your baby

Does this mean I might hurt my baby?

This is the question that keeps most people silent, so it deserves a direct answer: no.

People are distressed by their intrusive thoughts precisely because they don't want to be having them. The thoughts feel wrong, frightening and completely inconsistent with who they are. That distress is exactly what separates an intrusive thought from intent. The research is clear: people do not act on unwanted intrusive thoughts. Many people with intrusive thoughts stay silent for a long time. Not because they don't know something is wrong, but because they're terrified that saying it out loud will confirm their worst fear about themselves, or that someone will judge them or think they’re dangerous to their baby.

The thoughts aren't the problem, the fear of them is

Most people have intrusive thoughts, and they pass. But sometimes, especially in the postpartum period, those thoughts start to take up more and more space. When that happens, it stops feeling like an occasional unwanted thought and starts feeling like something you have to manage constantly. You might find yourself checking on your baby more than you know is necessary. Asking someone to confirm, again, that everything is fine. Avoiding the kitchen, the stairs, the bath, anywhere the thought tends to appear. Researching risks late at night. Trying to think the thought away, or replace it with a safer one. These responses make complete sense. Each one brings a moment of relief. But the relief doesn't last, and the checking, avoiding and seeking reassurance can actually keep the cycle going. The more attention a thought gets, the more significant it feels.

What is OCD?

OCD stands for obsessive-compulsive disorder, and has two main features:

Obsessions: repeated, unwanted, distressing thoughts or images

Compulsions: the behaviours people use to reduce the anxiety those thoughts cause

When intrusive thoughts become more persistent and distressing, they can shift into obsessions. When we feel pulled to do something (repeat a behaviour, follow a ritual or seek reassurance) in order to bring down the anxiety, those are compulsions.

When these compulsive behaviours start taking up more than one hour a day, disrupt your typical way of doing daily life and follow very strict, rigid and often illogical rules, then it could be OCD. What makes this even trickier is that many of these behaviours are framed as “good parent” behaviour. Regularly checking on the baby or washing the baby’s clothes using a very specific method are routines that are usually praised by parents. For many new parents, these behaviours might feel expected or even necessary, even though they’re exhausting and take up a lot of time and energy.

What’s the difference between intrusive thoughts and OCD?

The biggest difference is how much the thoughts affect your life and whether you feel like you have to do things differently in response to the thoughts. If the thoughts are causing a lot of distress or changing how you care for yourself or your baby, it's a good idea to talk with a healthcare provider or mental health professional. Help is available, and treatment works.

As with intrusive thoughts, many people with postpartum OCD stay silent for a long time. That fear is completely understandable. It's also one of the main reasons postpartum OCD goes unrecognized for so long. If you think you have postpartum OCD, the most important step is to reach out to a healthcare professional immediately. Speak with your medical or mental healthcare provider. It’s highly treatable, and early intervention is key to helping you feel better. It's also worth knowing how postpartum OCD differs from postpartum psychosis [1], which is a separate and rare condition. Someone experiencing psychosis may hold unusual beliefs with conviction, feel that thoughts are coming from outside themselves or struggle to distinguish what is real. Someone with OCD knows the thought is unwanted and is deeply troubled by it. These are not the same thing.

If you're the non-birthing parent

Non-birthing parents also have intrusive thoughts, and the information in this article applies to you too. You may also notice that your partner is struggling: checking more than usual, pulling back from the baby, seeming more distressed than exhausted. These can be signs that something more than tiredness is going on. The most useful thing you can do is say something simple: "I've noticed you seem really worried. I'm here if you want to talk about it." You don't need to diagnose anything. You just need to open the door to a conversation and let them know you’re safe to talk with.

You don't have to manage this on your own

Postpartum OCD is treatable. Speak with your medical or mental healthcare provider to get started. Our Service Finder can also help you connect with someone who specializes in working with new parents. You don't need to describe every thought or explain the whole picture. One sentence is enough to start: "I've been having upsetting thoughts I don't want, and they're becoming hard to ignore." A provider who hears that can take it from there.

This article was developed using sourced educational content from Canadian Perinatal Mental Health Trainings CPMHT, and informed by the collective knowledge and expertise of CPMHT professionals and Karen Clarke, BA, MSW, RSW, Doula Open Book Doula, Counselling and Consulting Services.