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Most pregnant and postpartum parents have never heard of intrusive thoughts or images.

They arise completely unbidden and can be graphic and disturbing.

Though intrusive thoughts and images are common, they’re also highly treatable. You’re not alone.

Once upon a time, my grandmother told me a bizarre story: After she delivered my father in the early 1930s, she began having graphic and disturbing, unbidden thoughts and images (trigger warning; a bit gruesome here). Over and over again, she imagined herself cutting off her mother’s head.

These thoughts were so tortured that my grandfather had to find a psychiatrist who would make a home visit. Needing psychiatric care was so shameful at the time, very hush-hush—you had to be really “crazy” to need a psychiatrist.

Decades later, when Granny recounted this story, I had the feeling she was repeating it for the first time. I was a newly-minted nurse-midwife, and the whole tale sounded excruciating. It was not like anything I’d ever heard of or been taught, even as an obstetric provider. Granny intimated it happened again—maybe even more severely—following her two subsequent pregnancies.

As it turns out, her experience wasn’t that peculiar. Intrusive thoughts and images plague about 1 in 10 pregnant or postpartum parents. The content of these thoughts and images are often so distressing (in the already anxious time of new parenting) that parents fear mentioning them. Shrouded in silence, unwanted intrusive thoughts (UITs) can worsen, snowballing into greater anxiety and even OCD—a perinatal type of OCD that differs from any other time in life. And, left untreated, these thoughts and images tend to become more severe with each pregnancy.

Intrusive thoughts are often focused on the infant but, like my grandmother’s, don’t have to be. UITs can be about physical harm, both accidental—like dropping the baby or bumping its head—or intentional—like letting the infant fall down the stairs, or poking the baby with a sharp object (or worse). Even more frightening, and also not unusual, are UITs of accidental or intentional sexual harm to the baby.

While disturbing, we’ve known for a long time that intrusive thoughts of physical harm do not increase the risk of harming the baby. (An important caveat: Intrusive thoughts are categorically different than postpartum psychosis, a dangerous and separate disorder involving hallucinations and/or delusions, not intrusive thoughts and images.) In fact, parents with intrusive thoughts usually take extra care not to behave in a way that could increase the likelihood of harm.

Unfortunately, many pregnancy and postpartum health care providers don’t know, and/or haven’t been taught, about UITs and pregnancy and postpartum OCD. Unknowingly, providers can grow alarmed or overreact to patients revealing these thoughts—exactly what pregnant or postpartum parents don’t need.

Instead, parents need to know intrusive thoughts don’t increase the risk of physical harm and, as shown in a new study, don’t increase the risk of infant-related sexual harm, either. Beck and colleagues (2026), in their recent study, artfully normalized intrusive thoughts and images, collecting data anonymously so parents felt safe divulging whatever kinds of infant-related UITs they experienced.

Simply normalizing intrusive thoughts in pregnancy and postpartum can be reassuring to any pregnant or postpartum parent, ameliorating unnecessary shame and guilt. As routine as suggesting prenatal vitamins, providers could say something like, “Some people experience strange and intrusive thoughts when pregnant, and especially postpartum. These thoughts can involve harming the baby physically, or even sexually. Just having these thoughts can be scary, but they don’t increase your risk of hurting your baby. I want you to know this is common, so you can let me know if it happens to you and we can help.”

Take our Postpartum Depression Test

Find a therapist to overcome depression

If you or someone you know experiences UITs, just normalizing them and offering sites like Postpartum International can be highly reassuring. Pregnancy and postpartum are difficult enough without unneeded guilt and shame. Help is close, and available if you need.

To find a therapist, please visit the Psychology Today Therapy Directory.

Beck, Q.M.; Sachet, J.; Cargnelli, C.; Lathrop, B.; Challacombe, F.L.; Fairbrother, N. Unwanted Intrusive Thoughts of Infant-Related Sexual Harm. J. Clin. Psychiatry 2026, 87, https://doi.org/10.4088/jcp.25m15985.

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