People have plenty of phobias — achluophobia (the fear of darkness), acrophobia (the fear of heights), aerophobia (the fear of flying), claustrophobia (the fear of confined spaces), entomophobia (the fear of insects), hemophobia (the fear of blood), etc.
It's not uncommon for many women to also cope with tokophobia — the fear of pregnancy. Let's be clear: It it totally normal and OK to be afraid of pregnancy and childbirth. Your concerns are valid and, to some degree, your fear can actually be beneficial in that it may prompt you to seek the maternal care and advice you need.
That said, if your fear go too far, it might be classified as tokophobia.
What is tokophobia, what causes it, how does it manifest and how can you treat it? Here's everything you need to know.
What is tokophobia?
Tokophobia, also known as 'maieusiophobia' or 'parturiphobia,' refers to the fear of pregnancy.
"Tokophobia is a pathological fear of pregnancy and can lead to avoidance of childbirth," according to research titled, "Tokophobia: A Dread of Pregnancy." "Pregnancy is a major physical, psychological, and social event in every woman's life. Instead of being a joyful experience, pregnancy may become a worrisome and fearful event in few patients and the fear may assume a pathological dimension and becomes a disorder worth recognition and treatment. Majority of women are able to cope up with fear and anxieties by self-help efforts, social support and medical help. However, when it becomes pathological dread, it is called Tokophobia."
The term tokophobia has been around for quite some time; in fact, it was first described in literature by Knauer in 1897. Since it's been studied, researchers have found that anywhere between 20 and 78% of pregnant women report fears associated with pregnancy and childbirth. Meanwhile, around 13% report fear of childbirth strong enough to actually postpone or avoid pregnancy.
In fact, some research suggests that the fear of childbirth plagues as many as one in 10 women — which isn't surprising given how traumatizing and emergency-like the media and film can make it seem. In fact, fewer than 2% of women give birth comfortably at home or in centers in the United States, while almost four million birth in hospitals, according to the Centers for Disease Control and Prevention. And hopsitals may sometimes push unnecessary Caesarians (which attributes to the United States' 32% Caesarian rate, more than double what the World Health Organization recommends), inducing a lot more fear.
It is, however, important to note that tokophobia does not encompass all fears of childbirth.
"The term Tokophobia sometimes gets conflated with fear of childbirth," according to research published in the BMJ. "Fear of childbirth is a spectrum of fearful thoughts and feelings surrounding childbirth that exists on a continuum i.e fear of childbirth can consist of low (and normal) fear to severe fear that impacts a woman’s daily functioning."
Likewise, some women may be mistakenly diagnosed with tokophobia after experiencing a traumatic birth, when they actually have symptoms of Post-Traumatic Stress Disorder and Postpartum Depression. After all, an estimated 9% of women do develop PTSD following childbirth, according to Postpartum Support International, so it's not uncommon. And many of the symptoms of PTSD are similar to the symptoms of tokophobia (see below).
"Tokophobia is, therefore, a rare phobic disorder, whereas fear of childbirth exists on a continuum," according to the BMJ research. "Nevertheless, whether Tokophobia, PTSD or fear of childbirth at clinically significant levels are present, it is important to identify and support women through pregnancy, including psychological interventions where appropriate, and inform them about their delivery choices."
What causes tokophobia?
Tokophobia can be classified as primary or secondary, depending on what causes the phobia.
1. Primary tokophobia
This refers to a morbid fear of childbirth in a woman who has no previous experience of pregnancy.
"The dread of childbirth may start in adolescence or early adulthood," according to the aforementioned research. "Although sexual relations may be normal, several different methods of contraceptive use to delay the pregnancy is often scrupulous. Generally pregnancy is avoided because of fear of labor. Some suffering women go for abortion, caesarean or adoption."
2. Secondary tokophobia
This refers to a morbid fear of childbirth in a woman that develops after a traumatic obstetric event in a previous pregnancy. That said, Secondary Tokophobia can also occur after an obstetrically normal delivery, miscarriage, stillbirth or termination of pregnancy in some women, as well.
What are the symptoms of tokophobia?
Symptoms of tokophobia include but are not limited to:
- feelings of pain during childbirth
- incessant worries regarding being in the hands of healthcare professionals
- not understanding what might happen during pregnancy and/or childbirth
- fearing that the baby may be hurt or get injured
- fearing of injuries to themselves during pregnancy and/or childbirth
- fearing of dying during pregnancy and/or childbirth
- anxiety about being alone in pregnancy and/or childbirth
Of course, other symptoms related to general anxiety may also accompany tokophobia, like all phobias. According to Mayo Clinic, these include but are not limited to:
- Feeling nervous, restless or tense
- Having a sense of impending danger, panic or doom
- Having an increased heart rate
- Breathing rapidly (hyperventilation)
- Feeling weak or tired
- Trouble concentrating or thinking about anything other than the present worry
- Having trouble sleeping
- Experiencing gastrointestinal (GI) problems
- Having difficulty controlling worry
- Having the urge to avoid things that trigger anxiety
How can you treat tokophobia?
Treating tokophobia looks different for everyone. Women may need to seek different treatments to find a way that works for them. Here are some options, however:
- Seeking professional cognitive behavior therapy
- Seeking psychotherapy
- Using pharmaceuticals to treat anxiety symptoms
- Undergoing antenatal screening tests to certify "normalcy"
- Having discussions surrounding alternative childbirth options with an obstetrician
- Engaging in self-care activities like breathing exercises and endorphin-boosting pursuits (like exercise)
- Gaining access to positive pregnancy and childbirth stories (beyond all the scary stuff in the movies!)
- Having conversations with other pregnant women or mothers for moral support
- Taking a prenatal support class to educate and empower yourself with knowledge of your options throughout the journey, as well as with a team of support
- Devising a birth plan that'll provide some guidance and structure along the journey (it is, however, important to be open to change in case of emergencies)
AnnaMarie Houlis is a feminist, a freelance journalist and an adventure aficionado with an affinity for impulsive solo travel. She spends her days writing about women’s empowerment from around the world. You can follow her work on her blog, HerReport.org, and follow her journeys on Instagram @her_report, Twitter @herreportand Facebook.