Tokophobia is a fear of pregnancy & can lead to avoidance of childbirth.
It can be classified as primary or secondary. Primary is morbid fear of childbirth in a woman, who has no previous experience of pregnancy. Secondary is morbid fear of childbirth developing after a traumatic obstetric event in a previous pregnancy.
Common Tokophobia Thoughts:
“I will come to harm – childbirth is dangerous or torture.”
“I will die or my baby will die.”
“I can’t cope with this anxiety; I can’t cope with pregnancy; I can’t cope with childbirth; I can’t cope with the pain and suffering.
“I will never recover from pregnancy or childbirth; I will never be the same.”
“I will go mad; I will be depressed; I will have mental health issues.”
“I’m not normal, there is something wrong with me.”
“No-one else has these problems, I’m alone.”
“I won’t be a good parent, I won’t love my baby, I’m not maternal.”
“If I hadn’t avoided pregnancy and childbirth, my life would be ruined.”
* If you experience some of these thoughts, it's possible that you suffer from Tokophobia.
20% to 78% of pregnant women report fears associated with the pregnancy and childbirth (Bhatia and Jhanjee, 2012).
13% of women report a fear that’s overwhelming enough to make them postpone or avoid getting pregnant altogether.
Tokophobia is more common than you know & can often be overcome with some practical, emotional & sometimes professional support.
Treatment:
Treatment for tokophobia is determined based upon individual factors such as the woman’s level of fear, Impact of fear, stage of pregnancy & individual wishes.
Early conversations about fear of childbirth, understanding those fears, may reduce negative impact & prevent anxiety.
For women with birth trauma (and potential secondary tokophobia), preparing for uncertainty, building trust in themselves & caregivers can result in a future positive experience.
Approaches that may help include:
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Midwifery support to discuss the birth, receive continuity of care, which is where the same midwife and/or midwifery care team sees you throughout pregnancy/labour
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Obstetrician care in planning & decision-making around labour
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Education about Childbirth
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Birth partner support
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Supported visits to the maternity department
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Development of a supportive birth plan.
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Talking therapies with a skilled therapist trained in& understanding the complexity of tokophobia & awareness of the national care pathways for multi disciplinary support & treatment.
What should I do if I’m afraid of childbirth?
Tell your midwife or doctor about your fears, as early in your pregnancy as possible, they can refer you to a mental health specialist for pregnant women. Ideally, this should be someone with experience of childbirth fears.
You will be given advice on how to cope with your feelings of fear & any other symptoms you may have. You may also be offered cognitive behavioural therapy (CBT).
Your specialist will discuss your options for giving birth that may help lessen your fears.
Make a wellbeing plan Tommy’s online Wellbeing Plan a tool that promotes thinking about how you feel & what support you might need in your pregnancy & postnatally. It may help you talk to your partner, family, friends or midwife about how you are feeling.
Requesting a planned caesarean section, talk to your midwife or doctor, they will discuss the risks & benefits of having a caesarean compared to a vaginal birth.
The National Institute for Health and Care Excellence states that you should be offered a planned caesarean section if you have had treatment and support but are still too afraid to have a vaginal birth. If an obstetrician is unwilling to perform a caesarean section you should be referred to one who will.
I adopt a flexible, compassionate, educative treatment approach when working with Tokophobia, integrating CBT & CFT to treatment.
Early intervention is always best.
Individual and peer support available.