Thoughts About Harming Your Baby Can Feel Scary. You Are Not Alone.

There’s a harrowing scene from the 1993 film The Joy Luck Club where a new mother drowns her baby in a bathtub. I haven’t watched the film in decades, but after I delivered my first baby I couldn’t stop seeing the scene play over and over in my mind. Unbidden, the images would come at random moments —  nursing, trying to fall asleep, riding in a car —  and I would feel this irrational panic that my baby was going to drown and it would somehow be my fault. 

Psychologists call these types of unwanted, uncontrollable thoughts intrusive thoughts. Sometimes these thoughts may be about harm coming to your baby accidentally, such as worrying that your baby will fall down a long flight of stairs. Some parents experience what are called harming intrusions, or thoughts about intentionally hurting your child — maybe you’re plagued with the concern that you will throw your baby down the stairs. Harming intrusions may feel particularly scary for a new parent.  

However, harming intrusions and other intrusive thoughts are incredibly common in pregnancy and within the first month postpartum. Importantly, there is no evidence that harming intrusions are related to an increased risk of hurting your baby. Harming intrusions are common in anxiety and obsessive-compulsive disorder (OCD) and typically do not require emergency medical intervention. Indeed, hospitalizing a new parent for simply having common intrusive thoughts is likely incredibly harmful for that person’s recovery and well-being.

Intrusive thoughts are different from delusional thoughts, or strongly held false beliefs that are not accepted in one’s culture. Someone experiencing a delusion about harming their infant, such as believing that they must harm their baby because the child is an imposter or is possessed by a demon, likely needs medical intervention right away, including possibly hospitalization. 

Delusional thoughts are associated with postpartum psychosis, a rare but serious psychiatric condition that affects approximately 1-2 out of every 1000 people after they give birth. Having a family or personal history with bipolar disorder or a psychotic disorder puts one at greater risk of experiencing postpartum psychosis, though approximately 40% of people who experience the condition have never been diagnosed with a psychiatric illness. 

While the majority of people who experience postpartum psychosis will not harm their child, the condition is related to a small increased risk of harming one’s baby compared to new parents who are not diagnosed with the condition. When someone has delusions related to harming their baby alongside other symptoms of postpartum psychosis, such as hallucinations (hearing, seeing, or sensing things that others do not sense), disorganized behavior (unusual or erratic behavior that doesn’t make sense to others), and/or manic behavior (such as going days without sleep but feeling rested, suddenly starting multiple new projects at once, and/or feelings of intense euphoria or irritability), it is considered a medical emergency because the person experiencing the condition has lost insight into what is real and what is not and may act in ways they otherwise would never act. With appropriate and timely treatment, most people who experience postpartum psychosis fully recover from the illness. 

Harming intrusions and delusions may look similar on the surface. They may both involve scary thoughts about harming your baby. Both intrusive thoughts and delusions may vary in how much conviction one has about the truth of the thought, how much distress one experiences from the thought, and how much insight one has about whether they will act on the thought or not. 

There are several red flags you can be on the lookout for if you are experiencing intrusive thoughts about harming your baby. Please seek out immediate professional support when: 

• You find yourself having strong conviction in your intrusive thoughts (i.e., believing the thought to be true even in the face of contradictory evidence, or experiencing urgency that you have to act on the thought), even if the conviction waxes and wanes across moments or days

• You are preoccupied by thoughts of harming your baby, where you are thinking about the thoughts most of the day, nearly every day, and not able to focus on much else, or you start wondering whether acting on the thoughts would relieve you from the distress of having the thoughts 

• Friends and family members find your thoughts about your baby strange, unusual, or disturbing

• You start experiencing your thoughts as an external voice (a verbal hallucination) telling you to harm yourself or your child

• You have a period of intense sleep deprivation, such as going 24-48 consecutive hours without sleep and you feel rested, euphoric, and/or an intensely irritable 

Remember: Intrusive thoughts are incredibly common during pregnancy and postpartum and do not mean that you are at heightened risk of harming your baby. Even in the rare circumstances that a person experiences postpartum psychosis, it is unlikely that they will harm their child. Scary thoughts can be treated, but only if you share them with people you trust who can help. Accurate assessment of postpartum mental health conditions and reducing the time between the experience of symptoms and accessing appropriate care can help reduce the likelihood that people who experience postpartum psychosis will harm themselves or their child. 

My postpartum intrusive thoughts went away after a month or two. If you are having thoughts of harming your baby and those thoughts are distressing, distracting, or making it difficult for you to take care of yourself, please find a mental health care provider who can help you understand your thoughts better and how to treat them. Postpartum Support International has a free helpline that you can call or text (1-800-844-4773) as well as a directory of mental health care providers with specialized training for addressing mental health difficulties during pregnancy and postpartum.

All types of thoughts are treatable. Thoughts by themselves can’t hurt us or our loved ones, and having scary thoughts does not make you a bad person or a bad parent. You are not alone. 

-Dr. Jasmine Mote, PhD

References

1. Fairbrother, N., Woody, S.R. New mothers’ thoughts of harm related to the newborn. Arch Womens Mental Health 11, 221–229 (2008). https://doi.org/10.1007/s00737-008-0016-7 

2. Jones I, Chandra P, Dazzan P et al. Bipolar disorder, affective psychosis, and schizophrenia in pregnancy and the post-partum period The Lancet, 384, 1789-1799

3. Perry, A., Gordon-Smith, K., Jones, L., & Jones, I. (2021). Phenomenology, Epidemiology and Aetiology of Postpartum Psychosis: A Review. Brain Sciences, 11(1), 47. https://doi.org/10.3390/brainsci11010047 

4. Alford, A.Y., Riggins, A.D., Chopak-Foss, J. et al. A systematic review of postpartum psychosis resulting in infanticide: missed opportunities in screening, diagnosis, and treatment. Arch Womens Mental Health 28, 297–308 (2025). https://doi.org/10.1007/s00737-024-01508-3 

5. Andrea Lawson, Kellie E. Murphy, Eileen Sloan, Elizabeth Uleryk, Ariel Dalfen, The relationship between sleep and postpartum mental disorders: A systematic review, Journal of Affective Disorders,Volume 176,015, Pages 65-77,ISSN 0165-0327, https://doi.org/10.1016/j.jad.2015.01.017.