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Tokophobia – Extreme Dread of Pregnancy and Childbirth

Tokophobia – Extreme Dread of Pregnancy and Childbirth

Published on Jul 06, 2022

Tokophobia - Definition, Signs, Causes, Impact and Treatment Plan

Motherhood is not always about peaches and cream. 

Though for the majority of women, this is a much-awaited phase of life, there are some of them who suffer anxiety, fear, and extreme dread related to pregnancy and childbirth. This pathological fear is known as Tokophobia.

Women suffering from this terror are concerned about labor pain, medical expenditure, the birthing process, and the new responsibilities that are about to come in their life.

Tokophobia – Definition, and Meaning

Tokophobia is an extreme and unrealistic fear related to pregnancy and childbirth. The fear is usually crippling which leads to avoidance of regular sexual behavior and conjugal pleasure.

You may wonder why you feel uneasy when it comes to issues such as pregnancy and childbirth. Such thoughts make you jittery and aversive.

Tokophobia is a pathological dread of being pregnant occurring in women that makes them avoid giving birth. This phobia also causes feelings of dread and terror and losing control over various life issues.

It is categorized as either primary or secondary. The main issue is a woman’s pathological fear of childbirth when she has never previously been pregnant. 

Issues and concerns related to labor pain, additional responsibility, medical expenses, etc.

Sometimes this crippling fear can be related to a previous episode of intense labor pains, or excessive discomfort suffered during the process of childbirth.

After a traumatic birthing episode during a prior pregnancy, a morbid fear of giving birth often develops as a secondary concern. 

So you see every woman’s life is significantly impacted by pregnancy on a physical, psychological, and social level. 

In some women, pregnancy can turn from being a happy time to being anxious and dreadful. In these cases, the dread can take on a pathological aspect in the lives of both men and women, and become an illness that needs to be recognized and treated. 

The majority of women can deal with their fears and anxieties by using self-help techniques, social support, and medical assistance. 

A research report published in 2012 suggests that about 13% of non-pregnant women report fearing the process of childbirth. They also showed reluctance to become pregnant altogether.

Study findings also reveal that 6 to 10% of pregnant women suffer from tokophobia. 

Tokophobia comes in two varieties 

1. Primary tokophobia 

This condition develops when a person has tokophobia but has never given birth. This happens to adolescents who must have heard in stories that childbirth is a difficult process.

Sometimes, girls and women who have suffered rape or sexual assault can also develop primary tokophobia. Various unfortunate flashbacks of trauma and suffering can trigger tokophobia.

2. Secondary tokophobia

This is a fear that results from having previously given birth and experienced the pain and suffering associated with the process.

Secondary tokophobia is caused by previous trauma of difficult labor, sickness during pregnancy, etc.

At times, women who had suffered a previous miscarriage or termination of the fetus due to medical reasons can also develop a fear of getting pregnant again.

Tokophobia Signs and Symptoms

You will see that not all tokophobia women will exhibit all of these symptoms, but a few of them will show many problematic symptoms.

Certain signs are mentioned below

  • The main symptom of tokophobia is a severe, psychological aversion to delivery or the process of giving birth.
  • Avoiding sexual activity
  • Postponing plans for motherhood by delaying getting pregnant despite wanting kids
  • Fixation on potential pregnancy complications like maternal or infant death or the emergence of congenital abnormalities
  • Rejecting vaginal birth and requesting a cesarean-section without a valid medical reason
  • Symptoms of depression, such as fatigue, body pain, decreased appetite or libido, or loss of interest in favorite activities
  • Continuous negative thoughts about labor pains even if it is irrational
  • Tokophobia may co-exist with post-traumatic stress disorder also.

Major symptoms of Tokophobia in women

1. They refrain from discussing pregnancy and birth

It’s a common misconception that mothers want nothing more than to chat about their children, but this isn’t the case. 

When discussing babies, pregnancy, or birth in a group setting, women who have tokophobia sometimes avoid speaking. 

They may act in this manner simply because they lack something to say and find it difficult to react to what is being said. 

Many of the symptoms are similar to those of generalized anxiety disorders and depressive disorders, and they can affect your mood, food, sleep, and general quality of life.

2. They object to holding a newborn

The mere act of holding a baby could easily spook them out and cause a strong reaction. This proves that they have most likely never held a baby.

3. They worry about their health

Women with tokophobia frequently have one or more concerns related to health-related issues.

Therefore, it is very typical to have a fear of needles and injections, hospitals, doctors, or even certain medical procedures like vaginal exams.

4.  They are zealous about birth control

These women make considerable efforts to avoid becoming pregnant (such as doubling or tripling birth control methods). 

So you see birth control could quickly become an obsession for a woman who has tokophobia since she will want to avoid being pregnant and giving birth at all costs.

Because of this, they might also discover that pregnancy testing will be a major source of fear for them.

5. Fantasies of surrogacy

As you see, since these women don’t want to bear the baby or extremely fear the delivery process, they may start fantasizing about things like artificial wombs.

This indicates that as options, surrogacy or fostering may be of interest to them.

6. They’re uncomfortable getting intimate or having sex.

This is simply due to the fact that sexual activity might result in pregnancy and birth, both of which can be terrifying to people. So the easiest approach for a woman with tokophobia to avoid either is to simply avoid sex.

7. Frequent thoughts of injustice 

You might have seen a woman who has tokophobia frequently feels that it is unfair that women must go through the life experience of pregnancy and childbirth. 

They detest the thought that they would be the ones in the relationship to go through the difficulty and hazards of pregnancy and birth because they view both as unpleasant experiences.

8. They worry about passing away too soon

This could be a worry that they or the baby will die during labor. This might, to a lesser extent, be a dread of obstacles or the unexpected. 

They do not believe that this phobia is as ridiculous as it is frequently depicted to be. They have excellent reason to be concerned because they take maternal mortality seriously and are likely familiar with the numbers.

These are only a few of the plainly visible symptoms of tokophobia in women. Be considerate and sympathetic if you believe you know a woman who experiences tokophobia.

It’s crucial for you to understand that women who have tokophobia might also experience psychological disorders such as panic attacks. 

Along with a variety of physical symptoms, these are sudden, powerful feelings of fear and anxiety. 

When a person has tokophobia, thoughts, pictures, or memories of childbirth might set off panic episodes.

Tokophobia and Panic attack signs and symptoms 

For a woman suffering from tokophobia, panic attacks are not uncommon. Many women suffer from symptoms such as:

  • Faster heartbeat or palpitations
  • Sweating or Shaking
  • Shortness of breath 
  • Choking sensation 
  • Chest pain 
  • Nausea or stomach pain
  • Feeling faint, lightheaded, or derealization
  • Fear of losing control or going insane
  • Fear of dying 
  • Chills or hot flashes
  • Numbness or tingling throughout the body

You will find in some panic attacks sufferers claim that they feel as though they are having a heart attack, are having trouble breathing, or feel that they are about to pass away. 

This frequently results in needing urgent medical care. Although uncomfortable, panic attacks are not life-threatening.

Tokophobia and PTSD (Post-traumatic stress disorder)

It has been found that about 3% of women develop PTSD symptoms after childbirth. The painful delivery experience, labor, and medical procedures can increase stress and anxiety to significant levels.

The symptoms of PTSD with tokophobia may look like this:

  • Nightmares
  • Nervousness and restless mindset
  • Flashbacks of trauma involved with the process of birthing
  • Hypervigilance

Tokophobia diagnosis

Same as any other mental health issue, tokophobia is diagnosed by a mental health expert by thorough mental status examination and detailed history of the patient. 

Often it is a paralyzing fear, just a fear of spiders or the fear of heights.

Sometimes a general physician or a Gynae/OB can also make a diagnosis or refer the patient to a psychiatrist if they find persistent symptoms in the patient

Women suffering from tokophobia may find a significant negative impact in their daily life. They may not function normally and avoid talking about pregnancy also. 

The mere thought of conception and childbirth can be extremely fearful and nerve-racking for them.

Since tokophobia is a specific fear response, the diagnosis of this illness is done by following the guidelines of the Diagnostic and Statistical Manual of Mental Disorders. (DSM-5).

Tokophobia shows depressive symptoms and anxiousness both. The presence of other psychiatric illnesses such as postpartum depression and PTSD should be ruled out before making a diagnosis of the mental illness.

There are several other types of phobia that may either give rise to tokophobia or can co-exist with the disorder. Some of the most common ones are as follows:

  • Algophobia – fear of pain
  • Thanatophobia – fear of dying
  • Trypanophobia – fear of needles
  • Obesophobia – fear of weight gain
  • Pedophobia – fear of children
  • Genophobia – fear of sexual intercourse

Tokophobia causes

Women who have a history of depression, anxiety, or another neurological disorder may be more likely to develop an intense phobia like tokophobia. 

Sometimes the cause of someone’s tokophobia is not evident or immediately apparent. It may be a result of a person’s lifelong accumulation of ideas, anxieties, encounters, and preconceived notions about birthing.

You can get an idea about a few important factors that have been linked to a higher risk of tokophobia.

1. Medical Anxiety

If you have suffered from primary tokophobia or have more intense fears related to the medical industry as a whole, then your symptoms can get worse in no time.

Your irrational fears will include physicians, pain or losing control, and undergoing medical treatments. 

It results in not having enough confidence in the skill of medical professionals because you have experienced medical negligence or mistreatment at the hands of healthcare providers.

Whether it happened as an adult or as a child, painful sexual experiences in the past might serve as the root of childbirth phobias.

2. Traumatic birth experiences

If you have secondary tokophobia, that is, you’ve already given birth and your previous delivery was particularly traumatic, difficult, or complicated, your anxieties may be similar to those of post-traumatic stress disorder (PTSD).

This may also occur if you have an abortion, stillbirth, or miscarriage. Nevertheless, after “normal” or healthy past births, women might also acquire secondary tokophobia.

3. Anxiety and depression in the past

Tokophobia may be more prone to occur if a person has a history of mental health issues, such as depression and anxiety. 

Although tokophobia is not particularly common, there is some evidence that having prenatal depression, in particular, may raise the likelihood of developing the condition.

4. Other factors

Psychological elements such as low self-esteem, the recurrence of traumatic childhood experiences, or mental conditions like depression or anxiety can cause tokophobia.

Primary or secondary tokophobia may also be influenced by a history of sexual assault or rape.  When exposed or handled in the vaginal area, women who have experienced sexual abuse may feel uneasy.

These old memories can be brought back by the idea of childbirth. 

When imagining being a mother, women who have experienced sexual abuse may experience intrusive thoughts or flashbacks to the abuse. Posttraumatic stress disorder may also be indicated by this (PTSD).

Who is likely to get affected by tokophobia?

Tokophobia can occur in women of child-bearing age. Women and young girls may suffer from tokophobia due to their fear of facing reality. 

Sometimes misinformation about sexuality, childbirth, and pregnancy can contribute to developing the symptoms. Secondary tokophobia is common for women who are second-time mothers having a history of complicated childbirth.

They have suffered intense pain and suffering and are thus forbidden from experiencing it again. 

Sometimes cesarean section pain, the use of forceps, or vacuum technique during the birthing process can also lead to fear of getting pregnant again.

Tokophobia treatment

Although phobias are an intense form of anxiety, they are also treatable. The two main avenues for treating tokophobia are therapy and medication.

1. Therapy

Phobias and other anxiety-related disorders can be successfully treated using cognitive behavioral therapy (CBT), psychotherapy, and exposure therapy. 

You need to find a therapist who has expertise in treating women or providing care for pregnant women, as well as training in their preferred treatment approach.

2. Individual and group counseling support through support groups

You can overcome your tokophobia by receiving support from others, whether it is through joining a support group or talking to someone one-on-one.

Support groups provide you the chance to interact with other women who experience pregnancy and childbirth similarly to you. 

Members of the group can give and receive advice, as well as share their experiences. A mental health professional or another woman who has overcome tokophobia may lead support groups.

3. Support of friends and family

Speaking with loved ones, friends, or other women about your thoughts and feelings and hearing their advice can help you feel supported if you’re a woman without access to a tokophobia support group. 

When combined with therapy, in cases of moderate tokophobia, on their own, support groups and one-on-one counseling can be beneficial. 

The evidence base shows that receiving support reduced the risk of cesarean births for psychosocial reasons by approximately 50%.

4. Hypno-birthing

Another method for assisting women in overcoming their pregnancy dread is hypnobirthing. 

Here you may learn how to employ self-hypnosis during hypnobirthing programs to relax and maintain your composure while giving birth. 

Thus you may feel less pain and worry when your body and mind are relaxed and stress-free.

According to one study, women who took a hypnobirthing program to overcome their fears of childbirth felt more optimistic and prepared for labor.

5. Medication

Medical reviewers suggest benzodiazepines, beta-blockers, selective serotonin reuptake inhibitors (SSRIs), and monoamine oxidase inhibitors are some examples of medications for anxiety disorders (MAOIs). 

There is no one right way to administer medication to someone with an anxiety disorder; treatment methods are highly individualized procedures.

You would most likely need to see a psychiatrist or your primary care physician in order to get a prescription for antidepressant medication, though, as social workers and psychologists typically cannot write prescriptions for patients.

6. Coping 

Talking about your anxieties with a kind and sympathetic healthcare practitioner is one of the greatest methods to deal with a fear of tokophobia.

The majority of women do experience anxieties and worries about giving birth, even if most do not have a diagnosable phobia of delivery. 

An OBGYN or midwife should have some experience explaining to you the realities of giving birth safely, including both positive and bad aspects, as well as your options for pain treatment throughout labor which can be helpful if fear of pain is behind your tokophobia.

A mental health expert might be able to assist you in resolving any unresolved issues and reducing or eliminating your phobia if your fear of birthing is linked to another issue, such as past sexual abuse, mistrust of the medical community, or traumatic birth.

How to overcome Tokophobia? (8 Self-help tips to consider)

Patients with tokophobia live with crippling fear every day. If the woman is already pregnant, the fear can be all-consuming as well. It starts impacting each and every area of the person’s life.

Living with phobias is not easy as the dread and uneasiness get bigger every day. Thus, the woman needs to arm herself with coping skills so that the fear doesn’t look gross over a period of time.

The coping skills and self-help strategies are the armor that helps the patients face their fears confidently.

Some of the few ways to do it right are as follows:

1. Start doing Mindfulness 

You can alter your lifestyle in addition to receiving treatment to help you overcome your pregnancy phobia. One such exercise that can help ladies with tokophobia is mindfulness meditation. 

Maintaining present-moment awareness is the practice of mindfulness. You can practice mindfulness in many different ways, for example by doing yoga poses, guided meditations, or body scans.

Finding a meditation class, viewing an online video, or downloading a meditation app is a good practice for beginners to start. 

You can feel more at ease, relaxed, and in control of your anxiety by regularly practicing mindfulness meditation.

2. Use Coping Skills to Manage Your Anxiety

By focusing on other pleasant feelings, coping techniques enable you to divert your attention from your anxiety. 

Think of coping mechanisms that have previously worked for you or novel ones that you are open to trying, such as yoga, mindfulness, physical activity, or art.

3. Take a Childbirth Class

The National Institute of Health suggests that a class on labor and delivery can make you feel better prepared and allay your dread of the unknown, regardless of whether you opt for Lamaze, hypnobirthing, or another method.

4. Create a birth plan

In a birth plan, you specify who you want to be there during your labor and delivery as well as how you want your pain to be handled. 

A birth plan can help you feel less anxious about the procedure and make sure that your doctor and midwife are aware of your wishes, even though it may occasionally need to be modified if necessary.

5. Remember that help is available around the corner

Even before becoming pregnant or in the early stages of your pregnancy, you can get help for tokophobia. 

By seeking assistance sooner, you’ll have more time to deal with your worry and conquer your phobia.

6. Avoid hearing horror experiences of others

You should keep in mind that every woman is different and you cannot compare your pregnancy journey with someone else. 

If some other woman had a tough delivery or her labor was prolonged and painful, it doesn’t mean that you will also have a similar experience.

Rather your journey could be smooth and happier. Thus, avoid women who get busy discussing their birth complications with you. 

Listening to such stories can impact you negatively and you may show more dread and fear in days to come.

Seek out good doctors to guide you through the journey and focus on positive information only. Do not unnecessarily overwhelm yourself with negative information.

You can also tell people to stop pouring in if you are not comfortable. After all, you know what suits you best.

7. Stay connected with friends and family

Tokophobia is a manageable condition if you share your fears and concerns with your loved ones. You can also seek their antenatal care advice and incorporate them into your daily life. 

Sharing your concerns lessens the woes and makes you feel in control of the situation.

8. Visit a mental health professional

The least self-help technique is to visit a therapist or trained psychologist who will teach you good coping skills so that your overwhelming emotions get controlled slowly. 

If you are feeling too anxious and nervous, seek support from them instantly to feel better. Remember that early treatment leads to a good recovery.

How common is tokophobia?

Tokophobia is common and can affect women of child-bearing age. Some women show minor discomfort and uneasiness while there are many who show moderate to severe symptoms of tokophobia. 

Research reports show that 78% of women have some form of uneasiness and fear related to pregnancy and childbirth.

About 13% want to put off or postpone their pregnancy or show complete reluctance to ever bear a child.

It has also proved that women who have never experienced childbirth are more scared about pregnancy and its processes compared to those who have already gone through the process.

Impact of Tokophobia

Tokophobia can become a big problem if the woman is already carrying a baby. She may actively avoid antenatal care or visiting the doctor for regular health checkups. 

Sometimes, the worsening fear can interfere with basic self-care such as eating healthy or having a good night’s sleep.

Despite her longing to have children, the woman suffers from the crippling fear of dying due to childbirth or suffers excessive pain that is intolerable.

Another impact is developing gloom and sadness, social withdrawal, excessive anxiety, and panic attacks.

Some of the negative impacts of tokophobia are discussed below:

  • Maternal guilt – they want kids but are restricted by their crippling fear. This causes remorse and guilt that makes them feel depressed.
  • Anxiety – this may relate to additional responsibility, financial stress, lack of support at home
  • Birthing process – labor pains, forceps delivery, complications of a cesarean section, etc
  • Fear of death – this fear is related to fear of death of themselves or the unborn child
  • They don’t welcome pregnancy
  • Shows resentment towards the unborn baby
  • No self-care and may not visit for antenatal checkups
  • Always stress on having a c-section delivery even if natural birth is possible
  • Prenatal and postnatal depression is also common
  • Fear of starting a new phase of life may increase the risk for postpartum depression
  • Fear of getting into a labor
  • Sleeplessness
  • Fatigue and mental restlessness
  • Lack of happiness and inner peace related to being pregnant

Tokophobia in men

The incidence of tokophobia is seen in first-time fathers and several types of research have confirmed this fact. 

The fathers are scared about the smooth run of pregnancy. Maybe they are concerned about the well-being of their partners and unborn child.

You will be surprised to know that tokophobia is a common mental health problem in men. Research done has revealed that about 11% of expecting fathers suffer from tokophobia symptoms.

Tokophobia statistics

Summing Up from ‘ThePleasantMind’

Women who are pregnant or nursing frequently experience emotional distress. However, issues like tokophobia could not have any clear causes before they occur and may also go undiagnosed. 

 It’s largely influenced by socio-demographic factors like educational and socioeconomic status.

Thus improvement in these two conditions and psycho-education could reduce tokophobia and help women fight their fears in a better way.

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