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Postpartum Intrusive Thoughts: Why They Happen and What to Do About Them

From the Rattled podcast, episode with Sabrina Rudin.

Dr Becky Kennedy

Dr Becky Kennedy, Clinical Psychologist

4 min read

closeup of woman holding baby close to her face

Introduction

You're holding your baby at the top of the stairs and a thought flashes through your head: what if I drop my baby? You're at the kitchen sink and suddenly picture the knife in your hand doing something terrible. You're driving and imagine swerving off the road.

And then the second wave hits - the one that's actually the problem: What is wrong with me? What kind of parent thinks like this? Am I dangerous?

If any of that sounds familiar, you are not broken, you are not alone, and you are very likely experiencing postpartum intrusive thoughts. In a recent podcast episode with Sabrina Rudin, she talked openly about having them, her post-partum OCD, and what actually helped. 

Here are the basics.

What postpartum intrusive thoughts actually are

Intrusive thoughts are unwanted, often disturbing images or thoughts that pop into your head uninvited. In the postpartum period, they are extremely common - research suggests the majority of new parents experience them in some form. They can be visual (an image of harm coming to your baby), verbal (a sudden disturbing phrase), or situational (a "what if" scenario in a totally ordinary moment).

The single most important thing to know: having an intrusive thought is not the same as wanting to do the thing in the thought. In fact, the reason these thoughts are so distressing is precisely because they go against everything you actually want. Your brain is essentially running a hyper-vigilant safety scan - what could go wrong here? - because you have just become responsible for a tiny, fragile human. The thought is the alarm - not the intention.



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They can be a form of OCD - and that's actually useful to know

Sabrina shared something on the episode that's worth naming clearly: postpartum intrusive thoughts can be a form of OCD (obsessive-compulsive disorder). When most people hear "OCD" they picture handwashing or light switches, but at its core OCD is about unwanted, distressing thoughts (obsessions) and the mental or physical things we do to try to make them go away (compulsions). Postpartum intrusive thoughts often fit exactly that pattern - a scary thought shows up, and then the brain spirals into checking, reassuring, or avoiding (often avoiding being near your baby).

Knowing this matters for two reasons. First, it takes some of the shame out of it - this is a recognized pattern, not a sign that something is uniquely wrong with you. Second, it points toward what actually helps: OCD responds well to specific kinds of therapy (Sabrina shared that CBT was life-changing for her), which is why finding the right therapist can be such a turning point.

The key isn't the thought - it's the story you tell yourself about the thought

This is the shift that changes everything.

When an intrusive thought shows up and you respond with what is wrong with me, I must be a terrible parent, this means something awful, normal parents don’t think these things, I hope I don’t have that thought again - that story makes the thought bigger, scarier, and stickier. The thought sets off the alarm, but the story is what keeps the alarm ringing.

When an intrusive thought shows up and you respond with oh, that's an intrusive thought, hello intrusive thought!, my brain is doing its anxious safety-scanning thing, this is a thought not a report card on who I am as a parent - the thought has somewhere to land. And then it can pass through.

And here is maybe the most powerful story of all: I am having this thought because I care so much. Because I love this baby so deeply. My brain is scanning for every possible danger precisely because the stakes feel enormous to me - and they feel enormous because of how much love is here. The thought is not evidence that something is wrong with you, it is evidence of how much you love your baby.

TLDR: The thought itself is not the problem. The story you tell yourself about the thought is what determines whether it stays for thirty seconds or thirty hours.

What helps

When an intrusive thought scares you and you respond by trying to push it away, lock it out, or prove to yourself you'd never think such a thing - you accidentally build a fortress of fear around it. And the fortress is what makes the thought powerful. The thought itself is just a thought. The fear around it is what gives it weight.

So instead of bracing against it, try the opposite: say hi to it.

Hi, thought. You're a thought. You're a part of me, but you're not all of me. I'm a good parent having an intrusive thought.

That last sentence is the whole game. A good parent having an intrusive thought. 

Not a bad parent because of an intrusive thought. The thought is something passing through you. It is not who you are. Separating the thought from your identity is what lets it move on through instead of setting up camp.

What Sabrina said actually helped her

  • Name it: Out loud or in your head: "That's an intrusive thought." Naming it separates you from it. You are not the thought. You are the person noticing the thought.
  • Tell people: Intrusive thoughts lose an enormous amount of their power the moment they are spoken out loud to someone safe. Shame is what keeps them big. Daylight is what makes them smaller.
  • Find a therapist: This matters. If intrusive thoughts are showing up often or sticking around, please don't try to white-knuckle through it. Because these thoughts often have an OCD-style pattern, the kind of therapist you see matters - Sabrina found a CBT (cognitive behavioral therapy) therapist especially helpful.

For partners

  • See the pain as real, and separate it from the content. This is one of the most generous things a partner can offer. When your person shares an intrusive thought with you, the distress they are in is completely real - and the content of the thought is almost never the thing to focus on.
  • Sabrina shared that one of the most helpful things her husband said, essentially, was that he wasn't impressed. He knows her. She wouldn't hurt a spider. Thoughts like this are normal. That response did not minimize what she was feeling - it took the content of the thought off its pedestal and reminded her who she actually is. If you are a partner reading this, that is the move: take the feeling seriously, take the content lightly.

One more thing: know the line

Intrusive thoughts that feel unwanted, distressing, and not-you are very different from thoughts that feel like urges or plans. If a thought ever feels like something you want to act on, please call your doctor or a mental health provider right away.

You are not your scariest thought

If you take one thing from this: a thought is not a threat, and a thought is not a verdict on who you are as a parent. The fact that the thought horrified you is itself the strongest evidence that it does not reflect what you actually want for your baby.



Listen to the full episode

For the full conversation with Sabrina Rudin, listen to Rattled, and explore more at Good Inside.

One of the things we're proudest of about Good Inside Baby is that yes, we cover feeding and sleep and solids - but we also focus on parental mental health, coping skills, and partnership communication. Because the early months are about so much more than what's happening with your baby. They're about what's happening with you. Check it out here - it's the best investment you can make in your first year as parents.



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