Understanding Tokophobia: The Fear of Childbirth

It’s common for many women to feel anxious about giving birth, especially those who have never gone through it before or those who experienced a difficult labor in their previous pregnancies. However, if those feelings are severe enough to affect your day-to-day life and potentially, the health of your baby, you may have a condition called tokophobia.

What is Tokophobia 

Tokophobia is a condition characterized by an extreme, pathological fear of getting pregnant and giving birth.

It can affect women who have never gone through childbirth and those who have, particularly those who had a traumatic experience during labor. Tokophobia can cause women to avoid getting pregnant, even in cases where they want children. It also causes some women to choose to receive a Cesarean section even though they can deliver their baby vaginally.

It’s normal to have some fear of childbirth. 80% of pregnant women have reported worrying about the pain and feeling anxious about safety and health during delivery. Most women cope with these fears by consulting with their healthcare professionals, talking to friends who have given birth, and getting informed about the whole process.

However, when the fear becomes debilitating and affects a woman’s quality of life, she may be diagnosed with tokophobia. It is estimated that the prevalence of tokophobia among pregnant women is 14%.

Tokophobia can also occur in men. Approximately 13% of men who are about to become fathers experience a pathological fear of childbirth. These fears include worrying about the health and life of the baby, the health and life of their partner and their own capabilities, reactions and behavior during labor.

Symptoms of Tokophobia 

Some symptoms of tokophobia that women experience include:

• Anxiety
• Depression
• Refraining from intercourse
• Feeling panic or distress when thinking of getting pregnant or childbirth
• Lack of excitement about a current pregnancy
• Dreading the due date
• Panic attacks
• Not wanting others to know about the pregnancy
• Feeling emotionally disconnected from your unborn child, partner, friends or family
• Choosing to give birth via a Cesarean section (c-section) even though a vaginal delivery is safe and possible.

Causes of Tokophobia 

There are two different types of tokophobia and the causes of each depend on the type.

• Primary tokophobia: This occurs in women who have never gone through childbirth. It may start to develop during their adolescence, after getting pregnant or after experiencing sexual assault or rape. 
• Secondary tokophobia: This occurs in women who have gone through a pregnancy and given birth, particularly for those who had a difficult delivery, experienced a stillbirth, a termination of pregnancy, miscarriage or unsuccessful fertility treatments. However, women who had a healthy pregnancy and gave birth normally can also be diagnosed with secondary tokophobia.

Other factors that have been found to contribute to tokophobia include:

• Exposure to traumatic labor experiences from other women and through social media
• Severe fear of something going wrong during delivery such as preeclampsia and death
• Fear of pain, uncertainty, loss of control, or lack of privacy during the birthing process
• History of childhood sexual abuse, anxiety or depression.
• No faith in or lack of trust in medical providers or the healthcare system
• Becoming pregnant at a young age, lack of social support, or inability to financially provide for the child

Diagnosis of Tokophobia 

For those who aren’t pregnant, diagnosis can occur during their visits with their medical practitioners. When the topics of contraception and family planning are brought up, this is a good time to bring up concerns about pregnancy and giving birth. Your healthcare provider can educate and guide you on the right path to manage this fear.

For those who are pregnant, diagnosis can occur during their regular prenatal appointments. When asked about your mental and emotional well-being, it’s important for you to be honest and share any worries you have about your pregnancy with your obstetrician or care provider. They can provide reliable information and reassurance, and work with you to develop a treatment plan that includes referrals to a mental health professional and healthy coping strategies to address your fears and concerns.

It’s important to never self-diagnose. Only a qualified medical professional such as your primary care provider, OB/GYN psychologist, psychiatrist, or licensed clinical social worker can diagnose tokophobia. They can help distinguish whether your symptoms or feelings of extreme fear are related to tokophobia, postpartum depression, or post-traumatic stress disorder (PTSD). Each of these conditions requires different treatment plans.

Treatment Options and Coping with Tokophobia 

There are a few ways to treat tokophobia. Treatment is not a one size fits all approach.

1. Therapy 

Cognitive Behavioral Therapy (CBT) is a therapy method that helps you identify the root causes of your fear of childbirth, and focuses on specific symptoms and how to address them. 

Hypnotherapy can also be used to treat tokophobia. Hypnotherapy quiets and calms your conscious mind so that you can tap into your subconscious thoughts, feelings and memories. From there, a certified hypnotist or hypnotherapist will guide you in discovering what’s causing your fears and provide you with suggestions to overcome them.

When seeking the advice of a mental health professional, it’s important to ensure they have the right training and qualifications to treat perinatal mental health conditions.

2. Medication 

If depression is one of your symptoms, antidepressants can help to balance the brain chemicals responsible for your mood. There is a range of medications to help treat anxiety disorders.

Your primary care provider or psychiatrist will determine whether medication can be prescribed as part of your treatment plan. They will be able to determine what is safe to take during your pregnancy.

3. Coping Methods 

Social support groups are incredibly beneficial for pregnant women. Speaking with other women who have had positive childbirth experiences can give you comfort and reassurance about pregnancy and childbirth. It’s important to find the right group of people who will provide the psychosocial support that you need. Avoid those who only want to tell their horror stories as they may worsen your fears. It’s okay to ask them to stop sharing. 

Stress reduction strategies can also help relieve those worries and fears. Some relaxation activities to help manage your stress levels include yoga, meditation, journaling and breathing exercises.

If you are struggling with a fear of pregnancy or childbirth, the best thing to do is to talk about your concerns with your healthcare professional. They can determine the right treatment plan that includes psychotherapy and/or medication that will ensure the health and safety of you and your child and help improve your experience in any future pregnancies.