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How do new/recent mothers experience unwanted harm thoughts related to their newborn?

4th November 2019

Dr Caroline Boyd, a clinical psychologist, summarises findings from her doctoral research. ‘How do new/recent mothers experience unwanted harm thoughts related to their newborn? A thematic analysis’ has been published and is available in the Journal of Reproductive and Infant Psychology (date of online publication 26/09/2019).

In this guest blog, Caroline summarises unique findings from her paper including recommendations for health professionals.

Dr Caroline Boyd, a clinical psychologist

The arrival of a new baby is usually connected with joy – not worries related to harm. Yet, one in two mothers experienced unwanted, intrusive urges or impulses to harm their baby, these new findings reveal.

Intrusive, infant-related thoughts, images, urges – including impulses to shake, smother or throw the baby against a wall – are common among mums but remain taboo.

None of the women in my study shared their thoughts with a healthcare professional. Mothers feared that they would be judged as a risk to their babies and, ultimately, that their baby would be removed from their care. Mums even placed limits on what they shared about their harm thoughts with a partner or friend. For some, feelings of shame led to worries about being judged unable to cope.

The new study highlights how commonplace such thoughts are, described in the research as a ‘normative aspect of early parenting’ (Fairbrother & Woody, 2008).  The majority of women reported ‘accidental’ harm thoughts, relating to suffocation, the baby falling or accidentally being dropped from a high surface, drowning and contamination. One in two women reported ‘intentional’ harm thoughts, ranging from impulses to shake or smother the baby, to pinching the baby or throwing the baby from a height or against a wall. Common themes in the nature of intentional thoughts have been found previously, including physical harm and infanticide.

Within the literature, unwanted, baby-related harm thoughts are defined as ‘ego-dystonic’. This means they tend not to sit comfortably with a mother, clashing with her sense of self, invoking horror, disgust or alarm. This in turn causes distress. Careful assessment by a healthcare professional may distinguish between these intrusive, ego-dystonic thoughts from those that should trigger safeguarding proceedings.

The new findings, derived from analysis of in-depth interviews with eight new/recent mums, showed that harm thoughts were characterised by an overwhelming lack of control. This related to limited controllability around the occurrence of thoughts and the chaotic nature of adjusting to early motherhood. Mums used strategies to manage their thoughts, such as self-dialogue and distraction.

Harm thoughts made women more conscious of their power in contrast to the baby’s vulnerability. Intentional harm thoughts can be viewed as helping mums work out clear boundaries between what is morally acceptable and what is not – serving as an ‘effective warning system’.

A strong theme of the findings highlighted how the pervasive ideology of motherhood (along with women’s early experiences of being parented) influenced meaning-making of their harm thoughts. The myth of motherhood, prevalent in Western society, depicts women as ‘natural’ mums, instantly able to care for their babies, and ultimately fulfilled in their cheerful sacrifice. The ideology sets the standard for what is a ‘good’ mother (and therefore a good woman) and what is a bad one.  And this myth influenced all participants’ desired maternal identities – their own internalised notions of ‘good’ and ‘bad’ mother – and therefore how they made sense of their harm thoughts.

Some pathologised their harm thoughts as ‘mad’, ‘bad’ or ‘dangerous’ to retain their ‘good’ mum identity. However, others were able to reconcile their harm thoughts – and the lived reality – with a reconfigured ‘good’ mother identity. These women came to resist the ideology, understanding harm thoughts as arising out of a particular context (tiredness/stress) and therefore not signifying maternal ‘badness’.

Unwanted, infant-related harm thoughts are widespread but little talked about. Study recommendations include encouraging women to talk about their harm thoughts, acknowledging that they’re normal. As shown by the women who were able to share with family or friends, the power of normalising through sharing brought huge relief.

These harm thoughts are grounded in people’s understandings of idealised motherhood – so it’s also worth clinicians exploring those expectations and how these sit with their lived reality.

Increasing awareness of baby-related harm thoughts, not currently asked about routinely in perinatal assessment, will help healthcare professionals to facilitate open, sensitive discussions with mothers.

http://doi.org/10.1080/02646838.2019.1657819

For more information about these harm thoughts, please visit my website:

www.drcarolineboyd.com

Dr Caroline Boyd, a registered clinical psychologist, writer and mother