Fear of Childbirth: When will we talk about this?

fear of childbirth

By Savitri Mann, PS-WA Intern

As someone who has yet to give birth, I am scared. How will I be able to deal with the pain? Will I be surrounded by people who will support me in the way that I need? Surprisingly, it seems as though fear of childbirth is rarely discussed yet it remains prevalent in many people’s lives. The uncertainty of it all is terrifying — at best you have a wonderful newborn baby and at worst you undergo fatal complications. This led me to do my undergraduate psychology thesis on tokophobia.

It is common for pregnant individuals to experience fear and anxiety associated with pregnancy and childbirth. However, when symptoms of fear and anxiety become exacerbated, this can lead to tokophobia. What I learned throughout the course of my research is that tokophobia continues to be under researched and under prioritized within health care. For instance, only ONE research article on tokophobia has been published within the United States with most of the research being published in Sweden and the United Kingdom. Additionally, out of 48 studies on tokophobia, all of them included white women and only two of them included a proportion of Black women. 

Given the medical racism and adverse birth outcomes that Black individuals face, it is quite likely that tokophobia is prevalent within this particular community. And yet the research remains scarce. Despite the lack of information surrounding this disorder, the effects of tokophobia on an individuals’ mental and physical health, and overall well-being can manifest in different ways and be severe. For one woman, simply hearing about the complications of pregnancy from her gynecologist led her to develop a severe fear of childbirth. As this fear continued to grow, she avoided all sexual contact, experienced feelings of hopelelessness and worthlessness, and developed suicidal ideation. After consulting with two obstetricians and undergoing a mental state examination, she was diagnosed with primary tokophobia and major depressive disorder. Only after she was diagnosed and treated did she begin to feel a reduction in her debilitating symptoms. 

By shining a light on the normalcy of fearing birth, my hope is that people can obtain the help they need and deserve. Midwives, clinicians, and peer providers who are working closely with pregnant individuals may find it useful to screen for tokophobia—especially if one is giving birth for the first time. Cognitive behavioral therapy (CBT) and childbirth psychoeducation have been found to be effective in reducing fear and increasing a sense of preparedness when facing the unpredictableness of birth. Those with a fear of childbirth should know they are not alone. Up to 14% of the worldwide population has tokophobia which is higher than depression, bipolar, and schizophrenia combined. If you are feeling afraid to give birth, reach out to a mental health professional for help.