An exploration into the occurrence of unusual thoughts after childbirth

Background: It is increasingly recognised that the normative experience of early motherhood involves complex psychosocial transition and can be a time of anxiety, low mood and psychological vulnerability for many mothers. Hence, it is likely that the range of thought content women experience during this period is reflective of this complex process. Research indicates that during this period, healthy mothers can experience thoughts that are similar in content to women diagnosed with postpartum mental illness. However, studies have not yet investigated this hypothesis in relation to unusual thought content typically associated with postpartum psychosis. The current study aimed to investigate whether unusual thought content is experienced within a non-clinical population during the postpartum period. Method: A mixed methodology was used which involved an initial stage of qualitative data collection via online discussions with mothers (n=7). Unusual thought content identified from the qualitative data were subsequently used to inform an online cross-sectional survey; asking new and recent mothers to indicate whether they had experienced a list of unusual thoughts following childbirth (n=60). Results: Women in phase one of the study provided qualitative accounts of unusual thoughts with themes of potential harm, connection, and experiences of mediating the impact of such thoughts. In phase two, 83.3% of the sample reported experiencing at least one unusual thought postpartum. The thoughts reported were comparable in content to thoughts identified in accounts of postpartum psychosis; including thoughts of threat, paranoia, reincarnation and fear of the infant. Levels of anxiety and depressive symptoms were positively correlated with frequency of unusual thought occurrence. Conclusions: Unusual thought content, typically associated with postpartum psychosis can occur within non-clinical experience. Increasing awareness of the commonality of unusual thoughts may allow maternal health professionals to reassure mothers, potentially alleviating guilt and secondary distress which might arise from concealment or suppression of unusual thoughts. Further research is necessary to validate the findings in a larger more representative sample and to explore the range of associated variables.