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:
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“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.”
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* If you experience some of these thoughts, it's possible that you suffer from Tokophobia.
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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.
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Early conversations about fear of childbirth, understanding those fears, may reduce negative impact & prevent anxiety.
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For women with birth trauma (and potential secondary tokophobia), preparing for uncertainty, building trust in themselves & caregivers can result in a future positive experience.
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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.
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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.
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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).
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Your specialist will discuss your options for giving birth that may help lessen your fears.
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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.
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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.
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I adopt a flexible, compassionate, educative treatment approach when working with Tokophobia, integrating CBT & CFT to treatment.
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Early intervention is always best.
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Individual and peer support available.