It’s undeniable that there are ups and downs whether you’re trying to conceive or already navigating pregnancy. There’s rediscovering intimacy after fertility struggles, dealing with first-trimester fatigue, or fielding the oftentimes uncomfortable comments made with regards to family planning.
Amidst all of these is also tokophobia (sometimes spelled tocophobia), a pathological fear of pregnancy or childbirth. The term comes from the Greek words ‘tokos,’ meaning childbirth, and ‘phobos,’ meaning fear. Tokophobia can be present before pregnancy, and involve a fear of getting pregnant, or it can manifest as a fear of giving birth once someone is already pregnant.
Related: Where to give birth: Here are your labor and delivery options
What is tokophobia?
While fear of childbirth can exist on a spectrum, tokophobia is a rare, albeit severe form. It’s classified under the umbrella of specific phobias under the DSM-5, and according to a study published in the Industrial Psychiatry Journal, tokophobia can exist as a primary or secondary condition.
Primary tokophobia is reserved for women who are afraid of pregnancy or childbirth, but have never experienced labor prior, and secondary tokophobia is focused on women who are afraid of childbirth after having a traumatic experience related to childbirth. There may also be a third form, social tokophobia, which is not medically recognized, but could potentially happen when friends and connections share their own traumatic birth stories with you, triggering a severe anticipatory fear of pregnancy or birth.
“Navigating tokophobia can be difficult as it is mostly overlooked by the medical community,” explains Tatiana Grant, LMHC, therapist at Alma. “The lack of education regarding tokophobia leaves prospective mothers isolated and unsure how to express their concerns.”
If you’re unsure if what you’re experiencing is tokophobia, Grant shared a short list of symptoms that can help you start the conversation with your medical professional.
Tokophobia is generally described as an overwhelming or debilitating fear of childbirth, which can be so intense that childbirth is actively avoided, note the authors of an article in the British Medical Journal. It goes beyond everyday fear and worry and may impede your daily life and activities, causing psychological distress.
Symptoms of tokophobia may include:
- Intense anxiety or fear when thinking about or imagining childbirth
- Sleep disturbances
- Panic attacks
“Avoidance behaviors are also characteristic, such as requesting an elective cesarean procedure or avoiding pregnancy [altogether],” Grant shares.
Tokophobia can sometimes be conflated with post-traumatic stress disorder (PTSD), particularly if women have heard of, experienced or witnessed a traumatic birth in the past.
Because tokophobia can oftentimes manifest in symptoms that resemble general anxiety, PTSD or other mental health conditions, it’s important to seek help from a medical professional for an official diagnosis.
Causes and risk factors
Tokophobia doesn’t have only one root cause, which can make it difficult to identify who is more or less likely to live with it. Those who struggle with anxiety or depression may be just as likely to struggle with tokophobia as those who happened to watch a traumatic birth, either in real time or in a video.
While research on the prevalence and communities tokophobia impacts is still limited, some research shows that anywhere between 2% to 15% of women may experience a more pathological fear of childbirth.
“Many of the fears associated with tokophobia are related to the fear of pain, fear of complication and/or losing control,” explains Grant. “Working together with your provider to create a birthing plan can help to offset concerns about the delivery experience.”
Some studies have found that the pathological fear of pregnancy can decrease from the second trimester to the third. The Journal of the Australian College of Midwives found that the prevalence of tokophobia decreased from 22% in mid pregnancy to 19% in late pregnancy.
While there isn’t a single “cure” for tokophobia, its symptoms can be treated in an attempt to lessen its mental or physical impact in a person’s day-to-day routine.
Grant recommends those struggling with tokophobia seek support wherever they can, whether that be with a therapist, partner, or other support network.
“I highly encourage my clients to work with a doula or birthing coach who will be onsite providing support during the delivery,” explains Grant. “If hiring a professional is not an option, review the birthing plan with your support person who will be with you in the delivery room. Childbirth Classes and online support groups are also valuable sources of information and support.”
Finding a support group of people who are navigating the same fear may also be helpful, especially if trying to get pregnant is an eventual goal. Similar groups for those who are trying to conceive can also make space for those who are navigating the persistent fears of childbearing, just as much as the ebbs and flows of fertility challenges.
A note from Motherly
Even though tokophobia may not be a well-known condition, it doesn’t mean what you’re experiencing is any less real. It’s so important to advocate for yourself and discuss your worries with a licensed provider to get the help and support you deserve.