Why Intrusive Thoughts Increase in Postpartum (and What You Can Do About It)

If you’re a new mom struggling with distressing thoughts that seem to come out of nowhere, you’re not alone. In my practice, I can’t tell you how common it is for me to be told by a mom “I never struggled with this before, but since having a baby…..” That is because Postpartum is a unique stage that is a common place where OCD likes to come out.

First things first- let’s talk about what intrusive thoughts are. Intrusive thoughts are unwanted, repetitive, and often disturbing mental images or ideas that can make you question yourself. Many moms experience them in postpartum, and while they can feel incredibly alarming, they do not reflect who you are or your ability to be a good parent.

Understanding why intrusive thoughts increase after birth can help reduce the fear surrounding them. More importantly, knowing how to respond in a way that doesn’t fuel anxiety or OCD-related patterns can help you feel more at ease in your motherhood journey.

So Why Do Intrusive Thoughts Increase in Postpartum?

1. Hormonal Shifts

After giving birth, estrogen and progesterone levels drop dramatically. These hormonal fluctuations can impact mood regulation and anxiety levels, making intrusive thoughts feel more intense or frequent. While these changes are a natural part of postpartum recovery, they can amplify distressing thoughts, especially for moms who have a history of anxiety or OCD.

2. Heightened Responsibility & Hyper-Awareness

The moment your baby is born, your brain shifts into full protection mode. This heightened awareness is biologically designed to keep your baby safe, but for moms with OCD or anxiety, it can backfire. Your brain might become overly focused on possible dangers, leading to “what if” thoughts about harm coming to your baby—even if you would never act on them.

3. Sleep Deprivation & Stress

Exhaustion makes everything feel more overwhelming. Sleep deprivation affects cognitive function, emotional regulation, and your ability to dismiss unhelpful thoughts. When you’re running on little sleep, your brain is more reactive, making it harder to filter out intrusive thoughts as mere background noise.

4. Social Pressures & Fear of Judgment

Moms are often bombarded with messages about how they should feel in postpartum—overjoyed, grateful, and deeply connected to their baby. But what if you’re exhausted, anxious, and having thoughts that terrify you? Fear of judgment can make moms hesitant to open up about their struggles, reinforcing isolation and shame.

What You Can Do About It

1. Understand That Thoughts Are Not Dangerous

Having a thought does not mean you will act on it. Intrusive thoughts are automatic and often the opposite of what you value most. In ICBT (Inference-Based Cognitive Behavioral Therapy), we focus on recognizing that these thoughts are driven by doubt, not reality. The fact that they distress you is proof that they are not aligned with who you are.

2. Use Common Sense Over Anxiety

Instead of analyzing intrusive thoughts or seeking reassurance, try this:

• Ask yourself, What do I know to be true based on my real-life experiences?

• Ground yourself in the five senses—what can you see, hear, touch, taste, and smell right now?

• Recognize that the thought is just that—a thought, not a reflection of reality.

3. Reduce Compulsions (Even the Subtle Ones)

Many moms unknowingly engage in compulsions that reinforce OCD patterns, such as:

• Mentally reviewing their thoughts for reassurance.

• Avoiding being alone with their baby out of fear.

• Seeking constant validation from others that they are a good mom.

These behaviors strengthen the brain’s belief that intrusive thoughts are important when, in reality, they are just noise. Gently noticing and reducing these compulsions can help weaken OCD’s hold.

4. Prioritize Sleep & Self-Care

While uninterrupted sleep might not be realistic in postpartum, small changes can help:

• Accepting help from a partner or loved one when possible.

• Resting when you can, even if it’s just closing your eyes for a few minutes.

• Nourishing yourself with food, hydration, and fresh air.
  Self-care isn’t selfish—it’s essential for regulating your nervous system.

5. Seek Support

If intrusive thoughts feel overwhelming, reaching out to an OCD-informed therapist or support group can make a huge difference. You don’t have to figure this out alone. Many moms have been where you are and have found relief through the right support and tools.

Intrusive thoughts in postpartum can feel isolating and terrifying, but they are not a reflection of who you are as a mom. They are simply a misfiring of the brain, often triggered by stress, hormones, and anxiety. By understanding what’s happening and responding in a way that doesn’t reinforce fear, you can break free from the cycle and step into motherhood with more confidence and peace.

You’re not alone in this. If you found this post helpful, check out my resources on ICBT for moms with OCD, or follow me on Instagram at @soundmindocd for more support and encouragement.

You are a good mom. Your thoughts don’t define you—your love and actions do.