The image arrives, unbidden: you’re feeding the baby and suddenly there’s a picture in your mind of dropping them. You’re carrying them downstairs and your brain generates a scenario in which you fall. You’re bathing them and the thought ‘what if I held them under’ appears from nowhere. You feel a wave of horror and then shame and then terror that this thought has come to you, that you are the kind of person capable of having it.
You are not dangerous. This is one of the most important things I can tell you.
What intrusive thoughts actually are
Intrusive thoughts are unwanted, involuntary thoughts, images, or urges that appear without being chosen, that feel alien to your values and wishes, and that cause distress precisely because they are repellent to you. They are ego-dystonic — meaning against your own values — which is exactly what distinguishes them from genuine intent.
Research by Dr Jonathan Abramowitz and others has found that intrusive thoughts about harm coming to a new baby — including thoughts of dropping, shaking, smothering, or harming the baby — occur in approximately 50–90% of new parents, including fathers and non-birthing parents. They are extraordinarily common. They are so common that their presence does not distinguish people who go on to harm a baby from those who do not. The distinguishing factor is whether the thoughts are distressing and unwanted (intrusive thoughts — not a risk indicator) or experienced as tempting, pleasurable, or driven by anger (a very different clinical picture, requiring immediate assessment).
Why new parents get intrusive thoughts
The new parent brain is in a state of heightened threat-detection. Oxytocin and prolactin increase vigilance toward the baby; sleep deprivation reduces the prefrontal cortex’s ability to gate what enters consciousness; the stakes of caring for a vulnerable person activate the brain’s risk-assessment systems in ways that can produce catastrophic scenarios without warning. Your brain is trying to protect the baby by generating worst-case scenarios — the same system that makes you check the baby is breathing at 3am produces the thought that something might go wrong.
It is, in a sense, love generating anxiety. The more you care, the more threat scenarios your brain produces.
What to do with them
The worst thing you can do with intrusive thoughts is to give them significance — to respond to the thought with shame, guilt, or avoidance, which paradoxically makes them more frequent and more distressing. The mental equivalent of ‘don’t think about a pink elephant.’ The more you try not to have the thought, the more you have it.
The most effective approach: observe the thought without engaging with it. ‘There’s that thought again.’ Don’t add a story about what it means. Don’t reassure yourself by mentally arguing against it. Don’t confess it to someone in search of reassurance that you’re not a bad person — reassurance-seeking maintains the anxiety loop. Let it pass like weather.
When intrusive thoughts need professional support
If intrusive thoughts are so frequent and distressing that they’re interfering with your ability to care for your baby or function daily; if they’ve taken on an obsessional quality (you’re checking and rechecking, seeking reassurance repeatedly, performing rituals to ‘prevent’ the thought from coming true); or if they are accompanied by an urge to act on them — speak to your GP. This is not a moral emergency; it’s a treatable anxiety presentation that responds very well to CBT and ERP therapy.
You are not your intrusive thoughts. The fact that they horrify you is the clearest evidence of that.
When to seek help today
Intrusive thoughts — unwanted, distressing images or impulses that arrive without invitation — are experienced by the majority of new parents and do not reflect your character or intentions. However, some intrusive thoughts require professional support today, not eventually. Seek help the same day if: the thoughts feel less like intrusions and more like urges you might act on; you are making specific plans or taking steps to avoid being alone with the baby out of fear of acting on thoughts; the distress is so severe you cannot function or care for the baby; or thoughts are accompanied by other PND or psychosis symptoms (confusion, hearing voices, losing touch with reality).
Call your GP, midwife, or health visitor and describe what you are experiencing. The PANDAS Foundation helpline (0808 1961 776) is staffed by specialists in perinatal mental health. The Samaritans (116 123, 24 hours, free) provide confidential support. If you believe you or your baby are in immediate danger, call 999 or go to A&E.
Related Reading
- Postnatal anxiety: how it differs from PND and how to get help
- Postnatal depression: honest signs, seeking help and recovery
- When the baby blues don’t go away
You are not alone. Sign up to the LylyMama newsletter for honest writing about the real experience of motherhood — the hard parts, the complicated parts, and occasionally the beautiful ones.
