Tokophobia: scared of giving birth?
Fear of pregnancy and fear of childbirth are perfectly normal – every pregnant woman, even the most confident - has some degree of concern about what it will feel like, how she will manage, and what might happen. But for a minority of women, the worry is a lot stronger.
The condition, sometimes known as ‘tokophobia’, means fear of childbirth. One study estimates that one in every five women is affected to some extent by fear of childbirth, and six in every hundred are so scared of giving birth that it affects their pregnancy and birth choices. Some women avoid getting pregnant, or they opt for termination, or they feel very strongly they want to have a caesarean section.
Fear of childbirth among first-timers only?
Women who have not had a baby before are more likely to be scared of giving birth than women who are having their second or subsequent baby. However, fears are certainly not confined to first-timers and there are very few women who approach childbirth without fear. Serious fears are more common in women who have already had a baby, usually related to a traumatic experience of birth the first time round.
What aspects make women scared of giving birth?
Women experiencing fear may have various reasons as to why they feel this way. Specific fears may focus on:
- childbirth pain,
- worries related to being in the hands of healthcare professionals,
- not understanding what might happen,
- fear the baby may be hurt or injured,
- fear of injury to themselves,
- dying and/or
- anxiety about being alone or trapped.
In addition, women already fearful of hospitals, injections, or of being exposed or naked, may find their fear of childbirth exacerbated by these pre-existing fears.
One study found that women who suffer from anxiety sensitivity (AS) have a high risk of fear. AS means the sufferer is fearful of sensations caused by anxiety, such as heart racing, dizziness, feeling faint, or breathless. It leads to avoidance of situations where the anxiety sensations might arise. It’s easy to understand that women in this situation might find the idea of giving birth very frightening.
The same applies to women who are anxious about being embarrassed, or who worry about how they will cope in front of others, or who think they might appear silly, stupid or out of control. Women who have these concerns are all at higher risk of fear of childbirth.
What effect does fear have?
If a pregnant woman has fears related to labour and/or vaginal birth, she is more likely to have a caesarean birth, either planned or unplanned; she is more likely to use pain relief and she is more likely to have negative feelings about the whole birth experience. In addition, her risk of postnatal emotional and psychological problems increases.
Dealing with fear of childbirth
Research shows that fears can be reduced with specific psychological and emotional support during pregnancy. Some interventions involve teaching relaxation, and supported group discussions of feelings and fears. If you’re affected by fear, do share this with your midwife. In some areas, there is a special service for women in the same situation. The healthcare professionals caring for you need to know, so they can ensure you are treated sensitively throughout your pregnancy, labour and birth.
If fears are related to a previous birth experience, help with understanding and reducing the effect of the bad memories can be important in treating the current fear.
Many women are also helped and supported through pregnancy and birth by a doula.
Page last updated: October 2014
NCT's helpline offers practical and emotional support in all areas of pregnancy, birth and early parenthood: 0300 330 0700. We also offer antenatal courses which are a great way to find out more about birth, labour and life with a new baby.
Therapeutic group psychoeducation and relaxation in treating fear of childbirth. Acta Obstet Gynecol Scand. 2006;85(11):1315-9., Saisto T, Toivanen R, Salmela-Aro K, Halmesmäki E.
Postgrad Med J 2003;79:505-510 doi:10.1136/pmj.79.935.505, PATHOLOGICAL DREAD AND AVOIDANCE OF CHILDBIRTH (TOKOPHOBIA), Prevalence of fear of pregnancy and childbirth
Hofberg, K., Ward, M.R. Fear of pregnancy and childbirth. Postgrad. Med. J. 2003. doi:10.1136/pmj.79.935.505
Otley, H. Fear of childbirth: understanding the causes, impact and treatment, The British Journal of Midwifery, April 2011, Vol 19, No 4
Spice, K. et al. Journal of Psychosomatic Obstetrics & Gynecology, September 2009; 30(3): 168–174, Prenatal fear of childbirth and anxiety sensitivity
JOGNN, 42, 191-202; 2013. Salomonsson, B. et al. Self-Efficacy in Pregnant Women with Severe Fear of Childbirth