What is Tokophobia: Meaning, Symptoms And Treatment

Pregnancy and childbirth are the two most essential parts of people's lives. However, while it can create moments of joy, it can also be a source of stress and anxiety. For example, the pain one has to go through during childbirth and the added responsibility develop fear. 

This is all ok when it is limited to minor concerns. However, it is recognised as Tokophobia when it becomes pathological and so severe that an individual wants to avoid pregnancy or give birth. Learn more about it below!

In Tokophobia, people fear childbirth. Due to this, individuals take drastic measures to avoid pregnancy. However, even then, if they become pregnant, they dread it each week instead of enjoying the moment. Nevertheless, this fear is manageable with extra support and therapy. 

As categorised by mental health experts, there are two main types of Tokophobia:

• Primary Tokophobia: This type of fear is experienced by people who have never been pregnant.
• Secondary Tokophobia: Secondary type develops in people after experiencing a traumatic event during labour or pregnancy. This can include stillbirth or labour.

The biggest characteristic that points towards Tokophobia is an intense psychological fear that often overlaps with generalised anxiety and depressive disorders. This results in developing panic attacks, insomnia, and avoidance behaviour. Other symptoms of Tokophobia that may be visible are:

Among Thoughts and Behaviour:

• Having no emotional connection with the unborn child.
• Avoiding intercourse.
• Not feeling happy about the pregnancy.
• Feeling disconnected from the partner.
• Hiding the fact that they are pregnant.

Negative Pregnancy Outcomes:

• Seeking abortion once pregnant.
• Choosing Caesarean birth (C-section) even though vaginal delivery is safer.
• Giving up their baby for adoption.

There can be many causes of Tokophobia, like the ones mentioned below:

• Feeling self-conscious that doctors will put their hands near your vagina during birth.
• Learning about people's bad experiences with childbirth.
• Not having enough knowledge about how low the chances of developing complications in childbirth are.
• Being conscious of lifestyle changes and how they will go out of control.
• Feeling pressured to be pushed into a complicated vaginal childbirth.
• Having a traumatic experience of abuse or rape, thus feeling shameful of pregnancy.

The fear of Tokophobia can stem from many other fears like:

• Iatrophobia: Fear of doctors
• Haphephobia: Fear of someone touching you
• Algophobia: Fear of pain
• Pedophobia: Fear of children
• Obesophobia: Fear of gaining weight
• Trypanophobia: Fear of needles
• Thanatophobia: Fear of dying
• Nosocomephobia: Fear of hospitals

The following are the few risk factors that increase the chances of developing this phobia of giving birth:

• Influential Factors: Someone who has heard negative stories of childbirth, seen a video or appeared during a child's traumatic birth has an increased risk of developing this phobia.
• Gender: Women are more likely to attract this fear than men.
• Psychological Factors: Psychological factors, including low self-esteem, can lead to a higher risk of developing the phobia. Apart from this, the presence of anxiety and depression also adds to the cause.
• Demographic Factors: It is more common to develop in young or very old mothers (above 40), single mothers, uneducated mothers, and socially/economically challenged women.

The phobia of childbirth can give rise to a variety of complications:

1. Pregnancy Denial

Women often enter the stage of denial after getting pregnant with fear. As a result, they do not receive antenatal care. In addition, they register late, do not attend the first few appointments, and go on care sessions irregularly.

2. Maternal Guilt

There is a chance of developing maternal guilt due to this fear. This is because women with a phobia of pregnancy may love children and long to have their offspring, but they are disabled due to the fear. This, in turn, gives rise to guilt. 

3. Depression

Prenatal and postnatal are the two common forms of depression strongly associated with this phobia which can further lead to the risk of maternal suicide. Mothers with Tokophobia often resent their children fiercely and hold them responsible for their suffering. However, since they cannot show anger, it increases their stress and worsens their depression.

4. Post-Traumatic Stress Disorder (PTSD)

Post-traumatic stress disorder is common among women with this phobia. They feel compelled to risk their lives and health if forced to have vaginal deliveries. As a result, it starts affecting their marital life, relationship, child's upbringing, etc. Also, after developing PTSD, it starts affecting a woman's capability to live a normal life. 

5. Child's Emotional Health

Tokophobia can also have long-term consequences, affecting a child's emotional health. But, again, this can be because of the actions of the mother and the overall upbringing.

Like any other psychological condition, a mental health expert will carry the diagnosis of this phobia. This can include a psychiatrist, psychologist and licensed clinical partner. The processes are as follows:

• Those who are not pregnant: When a healthcare professional discusses contraception and family plan during annual exams, one can clear the doubt of having Tokophobia. 
• Those who are pregnant: Pregnant parents going through prenatal exams must answer a few mental health questions. By answering them correctly, professionals can identify the problem of childbirth fear.

The treatment for tokophobia involves lifestyle changes, social support, medication and therapy. Find more details about these healing methods below:

1. Therapy

Therapy is a common procedure doctors suggest to help you control your anxiety. For example, Cognitive Behavioural Therapy (CBT) helps you understand the reason for developing this phobia and its impact on your life. This process is also called building insight. 

However, you will not receive exposure therapy because it exposes people to their fear. The doctors rule out this option since exposing a person to childbirth or pregnancy is impossible. Other alternatives offered in the place of exposure therapy include psychodynamic therapy and eye movement desensitisation and reprocessing (EMDR) method. 

2. Support Group

Another treatment option available to people with tokophobia is joining support groups or connecting to someone who shares a similar fear one-on-one. Many centres provide this facility where you can meet in groups, share experiences, or receive advice. However, if you do not have access to any group, you can also share your feelings with a family member or friends.

3. Medications

Doctors also suggest medications to treat this fear of childbirth. You can get it prescribed by obstetricians, physicians, psychiatric nurses, psychiatrists, or physician assistants. Here, he or she will recommend taking anti-anxiety or antidepressant medicines. 

However, the same may not be safe for pregnant women as it can affect the foetus and result in complications during childbirth.

4. Hypno-Birthing

This is another way of helping women cope with the fear of childbirth. Mental health experts schedule classes to teach women how to self-hypnotise. It involves breathing techniques, practising relaxation and calmness during labour and delivery. This process aims at relaxing both body and mind to help women reduce pain and anxiety. 

You will know it is time to visit a doctor if the fear results in severe depressive disorder, panic attacks, etc. Also, you may consult the doctor when it starts affecting your lifestyle by:

• Avoiding intercourse.
• Insomnia or nightmare.
• Visibility of depression.
• The panic attack, along with other anxiety symptoms like irrational worry, fatigue or nightmare.
• Going to length to avoid pregnancy, like doubling or tripling birth control methods.

If you fear childbirth or giving birth and it is affecting your life, follow the below-coping methods for Tokophobia:

• Forming a Birth Plan

Planning always reduces the fear in half. So, your first step can be to consult a doctor to prepare a birth plan. You must discuss your needs and wants in the session, including your birth and pain management options. A plan that addresses all your problems will help you feel empowered and in control. 

• Share Your Feelings

It's common for people to develop anxiety at the thought of childbirth. However, share the same with your midwife or doctor, as he or she will provide further reassurance and assistance. Here, you can also talk to a loved one or trusted friends. 

It makes you realise that there are people who understand you and are there to help when you feel anxious. 

• Attend a Prenatal Support Class

Prenatal classes educate you about what happens during childbirth. Also, you will get to learn how to manage labour pain and other pregnancy issues. As a result, you feel more capable as the date of childbirth nears. 

• Consult a Mental Health Expert

You can also take the help of a counsellor, psychiatrist, psychologist or other mental health experts for guidance. This is in case the fear is negatively interfering with your life. 

• Start Practising Mindfulness

In addition to treatments, making certain lifestyle changes also helps cope with fear. So, the healthy lifestyle practice that one can adopt is mindfulness meditation. It includes the act of being aware of the present moment. However, to achieve this level of concentration, one needs to practise other habits like yoga, meditation, conducting body scans, etc. 

From the above information, we understand that Tokophobia is an intense and irrational fear of being pregnant or giving childbirth. It is more common in women, but men can also have it. The reason behind it is either added responsibility or fear of labour pain. However, there are ways to overcome it, as mentioned under treatment methods and coping techniques.