Tokophobia

Tokophobia is an extreme fear or dread of being pregnant and/or giving birth. It is a relatively rare condition and is not the same as the nervousness experienced by many people about the process of being pregnant and giving birth. People who experience tokophobia will go to great lengths to avoid getting pregnant. If they do become pregnant, they often request surgical delivery or abortion. This severe fear can occur even if the person wants to have a child.

It can be a side effect of several other phobias or be caused by a past experience, such as hearing others talking about difficult childbirth occurrences. The best way to minimize the chances of developing tokophobia is to discuss concerns with a trusted medical practitioner and limit contact with people who persist in sharing their own horror stories. If it does develop, it can be treated with hypnotherapy, cognitive behavioral therapy, antidepressants, and stress reduction techniques.

Background

While the condition has likely existed throughout human history, the term tokophobia did not come into use until about the year 2000. It is derived from the Greek words tokos, meaning “childbirth” and phobos, meaning “fear.” In some countries, the word is spelled tocophobia.

Phobias are extreme, uncontrollable, persistent, and often irrational fears of a situation, item, or action. Negative experiences can cause phobias, but many phobias develop without any direct personal experience. Researchers believe this indicates that phobias can be genetic or be caused by something in the person’s environment. They can appear in childhood but most commonly develop between ages fifteen and twenty. Anyone can be affected by a phobia, and experts estimate that about nineteen million people in the United States alone experience some form of a phobia.

People with severe phobias go to great lengths to avoid that which they fear. They may experience panic attacks, reacting as if they are under threat even when not in danger. Phobias can often be treated with cognitive behavioral therapy—a form of talk therapy that helps people change their thought patterns—medication, hypnotherapy, and stress reduction techniques.

Overview

Tokophobia is the clinical term used for the most severe form of fear of being pregnant and having a baby. The term has only been in use since 2000, and as a result, limited studies have been completed on the condition. The fear seems more prevalent in Western cultures, and experts report that the number of cases has increased since first tracked in 2000. The reason for this increase is unclear but may be the result of several factors. As information is published about it, physicians and patients may be gaining awareness of the condition and reporting it more frequently. As a result of their own awareness, physicians may be more directly asking their pregnant patients about their fears, causing more to report them.

While most people suffering from tokophobia are biologically female, it can occur in a small percentage of people who are biologically male, who may be afraid of the pregnancy and childbirth process experienced by their partner. Their fears are for the health of their partner and child, the labor and delivery process, the decision making and financial responsibilities that result from pregnancy and childbirth, and their ability to be a good parent.

Symptoms and Causes

Tokophobia may show up in multiple ways. Depression, anxiety, sleep disturbances, and fears that the baby will be stillborn or suffer birth defects are common. Those suffering from the phobia may avoid sexual intimacy and intercourse to avoid becoming pregnant. They may disconnect from partners and loved ones who promote pregnancy.

Once pregnant, the tokophobic person may hide the condition or deny it to avoid thinking about it. They will often not be excited about the pregnancy and future child. Pregnant people with tokophobia often request a surgical Cesarean birth (C-section) even though there is no medical reason they cannot safely deliver vaginally. Tokophobia also increases the likelihood abortion will be chosen over birth. Those with tokophobia may have difficulty connecting with the child after the birth and may even want to give it up for adoption.

Experts have identified two types of tokophobia. Primary tokophobia happens in people who have never had a child. It often develops in adolescence and can be the result of hearing about the bad birth experiences of others. It can also be the result of sexual assault; for example, the exams and experiences related to pregnancy can trigger memories of previous abuse. Secondary tokophobia happens in people who have been pregnant and have delivered a child. It can be related to a bad experience during that time.

Tokophobia can be caused by other issues, such as the hormonal changes associated with pregnancy. It might also be triggered by other phobias, such as the fear of the following:

• Medical professionals
• Pain
• Death (their own or the child’s)
• The unknown
• Being touched
• Needles or other medical procedures
• Gaining weight

Treatments

As many as 80 percent of women experience some symptoms of tokophobia; this does not mean they have a phobia, only that they have normal concerns about a significant, life-changing experience. For those whose concerns develop into a phobia, the usual treatment of choice is cognitive behavioral therapy, in which a trained professional helps a person change their thought processes about the thing they fear. Having an adequate support system can also help; this can be made up of medical professionals, others who share their fears, or supportive family and friends. In some cases, antidepressants may be prescribed, along with stress reduction and relaxation techniques. These treatment techniques can be very successful in helping overcome the phobia. Other steps that may be taken include:

• Speaking out about fears and concerns with trusted loved ones and medical professionals
• Making a birth plan to increase feelings of control
• Taking prenatal classes to learn more about what to expect
• Avoiding those who share horror stories about their own pregnancy and birth experiences

Bibliography

Bhatia, Manjeet Singh, and Anurag Jhanjee. “Tokophobia: A Dread of Pregnancy.” Indian Psychiatry Journal, July-Dec. 2012, www.ncbi.nlm.nih.gov/pmc/articles/PMC3830168/. Accessed 11 Aug. 2022.

Cherry, Kendra. “Tokophobia: Fear of Pregnancy and Childbirth.” VeryWell Mind, 18 Feb. 2022, www.verywellmind.com/tokophobia-overview-4684507#toc-causes-of-tokophobia. Accessed 11 Aug. 2022.

Graham Jones, Catriona Christine, and Julie Jomeen. “Rapid Response: Re: Sixty Seconds on Tokophobia.” British Medical Journal, 26 Sept. 2019, www.bmj.com/content/362/bmj.k3933/rr-0. Accessed 11 Aug. 2022.

“Phobias.” Johns Hopkins Medicine, www.hopkinsmedicine.org/health/conditions-and-diseases/phobias. Accessed 11 Aug. 2022.

Thomas, Liji. “Causes of Tokophobia.” Medical Life Science News, 27 Feb. 2019,www.news-medical.net/health/Causes-of-Tokophobia.aspx. Accessed 11 Aug. 2022.

“Tokophobia: Fear of Childbirth.” Cleveland Clinic, 12 Apr. 2022, my.clevelandclinic.org/health/diseases/22711-tokophobia-fear-of-childbirth. Accessed 11 Aug. 2022.

“Tokophobia: How to Get Over Extreme Fear of Giving Birth.” National Childbirth Trust, Mar. 2018,www.nct.org.uk/pregnancy/how-you-might-be-feeling/tokophobia-how-get-over-extreme-fear-giving-birth. Accessed 11 Aug. 2022.

Weinberg, Melissa. “How to Treat Tokophobia in Therapy.” Psychology Today, 30 Nov. 2020, www.psychologytoday.com/us/blog/finding-balance-postpartum/202011/how-treat-tokophobia-in-therapy. Accessed 11 Aug. 2022.