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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

  • Obstetrician care in planning & decision-making around labour

  • Education about Childbirth

  • Birth partner support

  • Supported visits to the maternity department

  • Development of a supportive birth plan.

  • 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.

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