What an intrusive thought actually is

An intrusive thought is an unwanted thought or image that arrives without warning and causes real distress. These thoughts can involve something terrible happening to your baby, or — and this is the part that most parents find hardest to say — even an image of you harming your baby on purpose.

Why does this happen? Your brain is designed to scan for danger. After having a baby, that system can become especially sensitive. In trying to protect your baby, your mind starts imagining "what if" scenarios or images, even though they are completely unwanted.

Research is clear that people who experience these thoughts are usually deeply disturbed by them. This is because they go against everything the person actually wants. To be clear: a thought is not a wish, a plan or a rehearsal for something that is going to happen. Having a scary thought is not the same as wanting it, planning it or being likely to act on it.

When a thought arrives, what can help in the moment

Intrusive thoughts come automatically, without warning. You can't stop a thought from arriving. But you can change your relationship to it.

The first step is to notice it as a thought, not something that is actually happening or about to happen. It showed up, but it doesn't mean anything about you. You may even want to name it or tell yourself “this is an intrusive thought,” which might help give it some distance.

If the thought has focused your attention on a small, genuine risk, such as a nearby sharp object or an unstable surface, make one simple, practical change to ensure safety. Then let the catastrophic image go.

When a frightening thought hits, many people find their heart rate spikes and their body tenses up. Once it passes, do something that helps you come back to yourself: a few slow breaths, a moment of noticing your baby is safe, a quick text to someone you trust. Many people find that over time these thoughts lose some of their impact.

How to say it out loud: Words you can borrow

Shame and secrecy can make intrusive thoughts feel worse. Many parents want to tell someone but worry they'll be judged or thought of as dangerous, or that their baby will be taken away. As a result, many new parents suffer in silence.

Here are some words you can use:

To a partner or support person: "I keep having scary thoughts I can't shake, and they're upsetting me. I need to say them out loud so I'm not carrying them alone."

To a midwife, doctor or health visitor: "I'm having intrusive thoughts about something happening to the baby. They scare me, and I want to understand what's common and what isn't."

To a friend: "This is hard to say, but I've been having frightening thoughts. Can I just talk?"

If you're the non-birthing parent or support person: Non-birthing parents also have these thoughts. The same reassurance applies: the distress you feel is evidence of how much you care. The scripts above apply to you, too. If you're reading this on behalf of someone else, a place to start is saying something like, "I noticed you seemed shaken earlier. I'm not going anywhere, you can talk about it if you want to."

When to reach out for more support

For many people, intrusive thoughts naturally ease as they move through the first weeks and months of parenthood. If they continue and you’re feeling distressed, or if these thoughts take up a lot of your time, interfere with sleep, bonding or daily life, or lead you to avoid your baby or certain situations, it may be helpful to reach out to a healthcare provider or other support person with training in perinatal mental health. This can also include noticing patterns like checking, reassurance-seeking, or repeating mental or physical rituals in an attempt to manage the anxiety these thoughts bring. You don’t need to be in crisis to seek support.

Get help the same day if:

• The thoughts start to feel less like an unwanted intrusion and more like a pull or an urge, or if there’s intent or a plan forming

• You’re having thoughts of harming yourself, or feel that you or your family would be better off without you, and that acting on this feels like an option you would consider

• You’re losing touch with what's real, seeing or hearing things others don't, or holding strong beliefs about your baby that no one else shares.

This last sign can indicate postpartum psychosis [1], a rare condition (affecting about 1–2 in 1,000 people after birth) that is a medical emergency. Urgent care is available and effective.

If any of this is happening right now: call 9-1-1 or go to your nearest emergency department.

Providers who work with new parents know how to have this conversation. Telling them what's happening is what gets you to the right support.

If these thoughts are getting in the way or you can't stop them, you're not alone. Mention it at your next appointment; one sentence is enough to start.

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, as well as the following cited research and clinical practice guidelines: