Introduction:

While some might perceive tokophobia as an irrational dread, the experiences of women grappling with this condition validate its reality with a prevalence of 14 per cent of women experiencing fear of childbirth (O’Connell et al, 2017). Acknowledging tokophobia as a valid concern is crucial. This blog aims to enlighten the readers and particularly women into the complexity of tokophobia, exploring its causes, and potential solutions.

Defining Tokophobia:

The term “Tokophobia” was used for the first time as a “symptom of prenatal depression” and a medical condition to describe the fear of childbirth. Tokophobia is not only related to pregnant women, but this condition can even start before conception leading some women to make the decision to be childless even if deeply, they want to have children (Scollato et al, 2013).

Childbirth is a physiological process, and it is normal to experience a sense of anxiety and fear (Scollato et al, 2013). But excessive fear can be damaging on the women’s mental health and well-being. It encompasses a range of anxieties, from worries about the pain of childbirth to fears of complications or even death during delivery and can have a devastating impact on women’s choice leading some of them to opt for an elective cesarean section, preferring a major surgery with all the risks and complications that it implies to overcome their fears (Fenwick et al, 2010).

Causes of Tokophobia:

Some common factors include a past traumatic birth experience (Dal Moro et al, 2023), individuals with existing anxiety disorders or even the fear of losing control can be triggered for individuals who value control and predictability. In the era of technology, exposure to negative birth stories in the media and social media can contribute to the development or exacerbation of tokophobia (Slade et al, 2019).

Overcoming Tokophobia:

Addressing tokophobia involves a holistic approach that combines psychological support, education, information, preparation during pregnancy, and in certain cases therapeutic interventions. Here are some strategies for overcoming tokophobia:

  1. Counseling and support: the guidance and support from health professional can help women to address and manage their fears.
  2. Education and Empowerment: Providing accurate and comprehensive information about childbirth process can help alleviate fears, build confidence, and empower women to make informed decisions.
  3. Support Groups: Joining support groups with women who have similar experiences can offer a sense of community and understanding.
  4. Partner and Family Support: Involving partners and family members in discussions and preparations for childbirth can create a supportive environment.
  5. Referral: Early referral when medical support is required significantly improves the experience of pregnancy, childbirth, and the postpartum period (NHS London Clinical Networks, 2018).

Conclusion:

Tokophobia is a complex and often misunderstood condition that can have a significant impact on a woman’s mental health and decision-making regarding childbirth. Recognizing the prevalence, understanding the various facets of this fear, and seeking for a professional support are crucial steps that will foster women to overcome their fears and make informed decisions.

References

  • Dal Moro A P M, Soecki G, Schier de Fraga F, Rasmussen Petterle R & Zanghellini RuckI S, Fear of childbirth: prevalence and associated factors in pregnant women of a maternity hospital in southern Brazil, BMC Pregnancy and childbirth, volume 23, Article number: 632 (2023)
  • Fenwick J, Staff L, Gamble J et al. Why do women request caesarean section in a normal, healthy first pregnancy? Midwifery 2010; 26 (4): 394 – 400. doi.org/10.1016/j.midw.2008.10.011.
  • NHS London Clinical Networks. Fear of childbirth (Tokophobia) and traumatic experience of childbirth: Best practice toolkit 2018; NHS London.
  • O’Connell M A, Leahy-Warren P, Khashan A S, Kenny L C, O’Neill M S, Worldwide prevalence of tocophobia in pregnant women: systematic review and meta-analysis, 2017 Aug;96(8):907-920., doi: 10.1111/aogs.13138.Epub 2017 May 17.
  • Scollato L, Lampasona R, Tokophobia: When fear of childbirth prevails, Mediterranean Journal of Clinical Psychology MJCP VOL. I, N. 1 (2013)

Najat Ould Hadj, Senior Midwife & Founder of NativaCare

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