Reviewed and updated September 2026 by Iris Hogan, MSW, LICSW
I Thought I Was Just Being Responsible
Many women have said some version of this to me over the years:
“I didn’t know I had postpartum anxiety. I just thought I was being responsible.”
“I did not know there was such a thing as postpartum anxiety” is something I have heard more than once in my practice.
You might admit you’re worried or concerned but not think of it as anxiety because, in some ways, it seems like a natural extension of caring.
Of course you worry about your baby. You love this tiny person who suddenly depends on you for everything.
Checking one more time can feel like caring. Researching one more question can feel like being responsible. Staying alert can feel like keeping your baby safe.
And sometimes that is exactly what it is.
But sometimes the worry doesn’t stop when you get an answer.
You may find yourself tracking everything. Researching baby sleep long after you meant to stop. Feeling guilty whenever you rest. Trying really hard to be a good mom while your brain keeps finding one more thing that needs your attention.
That’s part of what can make postpartum anxiety so difficult to recognize.
Anxiety Doesn’t Always Feel Like Anxiety
Anxiety does not always mean feeling panicked. Sometimes it is more like your brain never stops working.
“I don’t feel panicked. I just feel like my brain never shuts off.”
You might be lying awake going over your packing list one more time, although you’ve already done this five times. Reviewing the details of, well, everything, because you don’t want to miss anything.
Your brain is always on duty, with no scheduled or unscheduled breaks. You might even bring it with you into your dreams.
And then you have a baby.
Now there is so much more to keep track of. When did the baby last eat? How long was the nap? Should I wake her? Is she sleeping too much? Not enough?
And there is so much information available that it is easy to keep looking for the answer. You can find yourself researching baby sleep at 2 a.m. when you should probably be sleeping yourself.
Of course, some of this is simply part of having a new baby. Babies are confusing. One day they nap beautifully and the next day the exact same strategy works like you’ve personally offended them somehow.
But when anxiety is driving it, figuring something out does not necessarily bring much relief. Your brain just finds the next thing it needs to figure out.
For some women, anxiety is new after having a baby. For others, the tendency to worry was already there, and motherhood seems to turn up the volume.
When Checking Becomes Hard to Stop
Of course you check on your baby. That is part of caring for a tiny person who depends on you for everything.
Checking can feel good because, for a moment, it seems like the problem is solved. You feel like you know how things are.
Then you leave the room and the doubt starts building. The pressure to check one more time starts again, until you go back and look.
Yes, the baby is still sleeping.
And for a moment, you feel better again.
Research on perinatal anxiety has found that checking and asking for reassurance can become closely tied to worry.
And that makes sense. You check, and for a moment you feel better. Then the doubt starts creeping back in, and pretty soon you feel the pull to check again.
The question is not whether you check on your baby — of course you do. It is whether you can check and move on, or whether the doubt keeps pulling you back.
For some moms, that same worry can make leaving your baby feel much harder than expected.
The Scary Thoughts Can Be Hard to Talk About
Sometimes postpartum anxiety comes with thoughts or images that can be frightening.
“Sometimes I had these scary images. I saw him roll off the bed and get hurt. I was so afraid something would happen to him. And then I couldn’t let him leave my sight because I needed to know he was safe.”
The hardest images to talk about can be the horrific ones — vivid images of terrible things happening to your baby. And then there can be this deep sense of shame: How could I even think about something like that? What kind of person does that make me?
Unwanted scary thoughts and images are actually pretty common after having a baby, although women rarely talk about them.
Having the thought is not the same as wanting it to happen, having an urge to do it, or planning to act on it. Sometimes the very reason the thought feels so horrific is because it is exactly the opposite of what you want.
When the thoughts keep coming back, cause a lot of distress, or begin changing what you do because you are afraid of them, postpartum OCD may be part of what is going on. Postpartum anxiety and OCD are among the concerns I work with in maternal mental health therapy.
A safety note: Sometimes more than anxiety is happening. If the thoughts feel like something you might act on, you have an urge or plan to harm yourself or your baby, you feel unable to keep yourself or your baby safe, or you are losing touch with reality — including hallucinations, delusions, or severe confusion — please reach out for help right away.
Reaching out for help is part of keeping both you and your baby safe. Call or text 988, call 911 if there is immediate danger, or go to the nearest emergency department. Pregnancy and postpartum support is also available through the National Maternal Mental Health Hotline at 1-833-TLC-MAMA (1-833-852-6262).
And Then There Was the Sleep Deprivation
Right when you get to sleep, the baby cries again — or so it seems.
You start listening for the next wake-up call, lying in anticipation of milk duty instead of getting your stretch of sleep.
Even when the baby is sleeping, part of you may still be listening.
Sleep and anxiety can become tangled together during this time. Research has found an association between sleep problems and perinatal anxiety. That does not mean sleep deprivation by itself causes postpartum anxiety. But being exhausted while your nervous system is also staying alert can make it very hard to ever feel fully off duty.
When Anxiety Makes It Hard to Enjoy Anything
Anxiety makes everything harder!
You want to enjoy those sweet, connected moments with your baby, but it’s hard when you can feel adrenaline rushing through you, there is a constant urge to get up and do something, your mind is spinning, or there is just that quiet but ever-present push to be careful.
You can love your baby deeply and still have a hard time settling enough to enjoy being with them. And then, of course, you may worry about that too.
What Can Actually Help?
By the time women come to see me, they have usually tried quite a few things on their own. Some things helped a little. Some things didn’t.
Sometimes we start with very basic questions.
How much sleep are you actually getting? And not just how many hours the baby sleeps, but whether you are getting any stretch of sleep when you are truly off duty.
How much help do you have? Is there someone who can take a feeding, make dinner, do the laundry, or take the baby for a while without you having to organize all of it first?
And how alone are you? Having someone help with the dishes is important, but so is having another adult to talk to, taking a walk with a friend, or being around people who make you feel less alone in this enormous change in your life.
None of these things means that postpartum anxiety is simply a matter of needing more sleep or more help. Sometimes you can have support and still be very anxious.
And sometimes there really are only a few minutes available. I wrote about some realistic ways to use those small pockets of time in 5-Minute Postpartum Self-Care. Five minutes will not fix postpartum anxiety or sleep deprivation, but small moments of care can still matter.
That is where treatment can help. Maternal mental health therapy can help you understand what keeps the worry going and begin changing some of the patterns around it, including checking, reassurance-seeking, avoidance, and the feeling that you have to stay on guard. Medication can also be an important treatment option and is something to discuss with your medical provider.
If worry is taking up a lot of your day, keeping you from sleeping when you actually have the chance, or changing what you do because you are afraid, it may be time to get some help.
Postpartum Is a Period of Receiving
I once heard a lecturer on postpartum treatment announce, “It’s important to understand that the postpartum period is a period of receiving.”
What an astounding announcement. And yes, she is right.
New moms need help. Most of us don’t live in a village with aunties next door who can step in.
I tell the women I work with that asking for help may be part of your growth challenge as a mom. Feel free to set expectations with visitors that they help. Likely, they will feel good about being asked. No hosting.
Ask a friend to take the pup for a walk or fold laundry while you chat. Let someone bring dinner. Let someone else hold the baby while you shower or take a nap.
Receiving help can be pretty uncomfortable for many of us — and sometimes that is okay because we still need help. With time, receiving can get easier, and the season for this need will pass.
And if you feel bad about receiving so much right now, make plans to pay it forward when you are past this season.
Until we meet again — breathe gently, walk slowly, and treat yourself with kindness.
— Iris
Research & Resources
American College of Obstetricians and Gynecologists (ACOG). Screening and Diagnosis of Mental Health Conditions During Pregnancy and Postpartum. Clinical Practice Guideline No. 4. 2023.
American College of Obstetricians and Gynecologists (ACOG). Treatment and Management of Mental Health Conditions During Pregnancy and Postpartum. Clinical Practice Guideline No. 5. 2023.
Clinkscales N, Golds L, Berlouis K, MacBeth A. The effectiveness of psychological interventions for anxiety in the perinatal period: A systematic review and meta-analysis. Psychology and Psychotherapy: Theory, Research and Practice. 2023;96(2):296–327.
Green SM, Donegan E, McCabe RE, Streiner DL, Furtado M, Noble L, Agako A, Frey BN. Cognitive Behavior Therapy for Women With Generalized Anxiety Disorder in the Perinatal Period: Impact on Problematic Behaviors. Behavior Therapy. 2021;52(4):907–916.
Fairbrother N, Collardeau F, Woody SR, Wolfe DA, Fawcett JM. Postpartum Thoughts of Infant-Related Harm and Obsessive-Compulsive Disorder: Relation to Maternal Physical Aggression Toward the Infant. Journal of Clinical Psychiatry. 2022;83(2):21m14006.
For pregnancy and postpartum mental health support: National Maternal Mental Health Hotline — 1-833-TLC-MAMA (1-833-852-6262).