Perinatal · OCD
Perinatal Intrusive Thoughts Worksheet
Ego-dystonic thoughts — common, treatable
Intrusive thoughts about harm coming to the baby are extremely common in postpartum — up to 90% of new parents report them. Unwanted, ego-dystonic thoughts are OCD-spectrum, not psychotic, and are treatable with ERP.
What I want a clinician to know
Types of thoughts; frequency; how upsetting; what I've been doing in response
Distinguishing signal
Intrusive (safe to disclose): unwanted, distressing, ego-dystonic. You're horrified. Postpartum psychosis (emergency): ego-syntonic, may feel right or commanded, often with confusion, paranoia, or unusual beliefs. Call emergency services.
ERP-informed response
- Name the thought as a thought
- Don't argue, reassure, or check
- Continue what I was doing
- Tell a clinician — silence is what OCD wants
Intrusive thoughts are not intent
The thoughts are horrifying precisely because they contradict what you value. That contradiction is proof of who you are, not evidence against you.