“After 5 years of marriage and 3 years of trying to get pregnant, my wish finally came true.
All those years leading up to this moment, I had expected to feel overwhelming happiness when I finally found out I was pregnant. But confusingly, this was not what I felt.
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Horror. Anxiety. Fear.
These were the emotions that flooded my system. I told my husband and he was devastated at first, then confused and angry. But I knew that the only way I could feel better was to terminate my pregnancy.
Luckily, my husband was able to convince me to seek a specialist’s opinion — and I was diagnosed with a condition called tokophobia.
I went through with the pregnancy in the end and with treatment, but instead of being the happiest time of my life, for me, it was torture.
Now, looking at my darling baby girl, I can’t imagine how close I came to losing her.” — Anna, 38
What is tokophobia?
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For the majority of pregnant women — including the most confident ones — feeling anxious about various matters, including birth, is normal.
But for some like Anna, this anxiety is magnified a million times, resulting in a terrible, all-consuming fear of either the pregnancy and/or childbirth.
This crippling, pathological fear of pregnancy/ childbirth is known as tokophobia, and is experienced by handful of women — approximately six in every hundred worldwide, according to one study.
Tokophobia is classed by health experts as primary or secondary.
Primary tokophobia
This is experienced by a first-time mother and may even manifest way before the woman is old enough to have kids, when she is a child or teenager.
Women experiencing primary tokophobia may have a history of trauma, rape, sexual abuse or traumatic experiences of intense pain or bad hospital experiences.
They may even have been exposed to horrifying stories in the media portraying birth/pregnancy stories as intensely painful and even dangerous.
Secondary tokophobia
This typically is experienced by women who have previously had traumatic birth experiences or pregnancies.
The trauma may relate to abortion, late-term miscarriage, bad experience with hospital staff, severe morning sickness (hyperemesis gravidarum), stillbirth or feeling that they or their baby was going to die.
There is another group of women who may find pregnancy and childbirth scary due to related fears, such as a phobia of blood or injury. Pregnancy and childbirth can be very confronting to such women, who may faint or experience extreme distress even at even routine pregnancy blood tests.
Symptoms of tokophobia
Tokophobia, if left untreated, can be dangerous for both mum and baby.
While the physical and psychological symptoms of tokophobia can vary, they may include:
- Feelings of dread or panic when the topics of pregnancy and childbirth are brought up
- Recurrent nightmares about birth/pregnancy
- Demanding an elective C-section and refusing to go through with birth otherwise
- Anxiety and panic attacks
- Thoughts of death or dying
- An intensified experience of anxiety or depression while pregnant
- Expressing a strong desire to have kids while at the same time, refusing to or putting off getting pregnant
- Previous terminations of healthy pregnancies
May women with this condition are not aware of their phobia until they get close to delivery. And like all phobias, there is no specific cause that can explain tokophobia — as discussed previously, it could be a combination of factors.
Treating tokophobia
If this condition is not treated appropriately, the symptoms can become more intense and damaging. Left untreated, tokophobia can result in the termination of a perfectly healthy pregnancy and severe psychological stress to the mother which may also be harmful to the pregnancy even if the mother doesn’t opt for termination.
Since tokophobia is a psychological disorder, consultation with a mental health expert to decide on the best treatment/management plan is crucial.
After this, it’s important that the mother’s obstetrician works closely with a psychiatrist to best manage the condition and ensure that even after birth, the mother is healthy as is her relationship with her baby.
Health experts agree that one of the most important components of a treatment plan for a woman with tokophobia is education on birth. This could be either through antenatal classes or the mum-to-be’s obstetrician.
Knowing what to expect — including pain management options — can really help to reduce or eliminate irrational fears about birth. And having a trusted person present at birth (whether this be the pregnant mum’s partner or a doula) can also help her have a positive birth experience.
Sometimes, antidepressant or anti-anxiety medications are prescribed to a pregnant woman with tokophobia after careful consideration of the severity of symptoms by her healthcare provider.
The experience of sexual abuse as a child may contribute to the development of tokophobia subsequently
Other therapies include cognitive behaviour therapy, psychotherapy, hypnotherapy and EMDR (eye movement desensitisation reprocessing).
EDMR, though somewhat controversial, is shown by studies to be a very effective way of alleviating the fear that accompanies tokophobia.
According to midwife Jennifer Griebenow, EMDR involves “sessions with a trained professional, individuals work through specific traumatic memories while using an external stimulus, such as eye movement or tapping, to facilitate processing the traumatic memories.”
For some women though, an elective C-section might be the only option they consider to deal with the fear of childbirth, some even requesting for a general anaesthetic to avoid being present at all in the birth experience.
Having a good support system during pregnancy and proper information about labour, birth and gentle methods of pain management during labour can go a long way to control a pregnant woman’s fear of birth.
Can tokophobia be prevented?
For many women thinking of becoming pregnant or pregnant for the first time, their only ‘experience’ of birth is via what is portrayed on the media.
This usually takes the form of reality TV shows featuring over-dramatised emergency birth situations that usually don’t portray a pretty picture.
In 2007, actress Helen Mirren revealed herself to be a tokophobe. She blames her phobia on a distressing educational film about childbirth shown to her at school when she was a teenager.
“I swear it traumatised me to this day,” she said, in an interview with the Daily Mail. “I haven’t had children and now I can’t look at anything to do with childbirth. It absolutely disgusts me.”
As for Mirren, such programmes become many women’s reference point in relation to pregnancy, labour and birth, both misinforming them and increasing their levels of fear and anxiety.
Because of this, being informed about pregnancy, labour and birth in a positive, realistic way can go a long way to help women avoid the fear of birth when they become pregnant.
The support of family and friends can also go a long way in helping women overcome an overwhelming condition like tokophobia.
As pointed out by Dr Jazlan Joosoph, a specialist in obstetrics and gynaecology at Raffles Hospital, “with good, strong spousal and family support and careful explanation, anticipation and reassurances from a caring and compassionate obstetrician, most cases of perinatal anxiety can be successfully managed.”
References
The British Journal of Psychiatry
Do you know anyone who has experienced tokophobia? Share your thoughts on this article in a comment below.
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