Tokophobia, or the fear of childbirth, is on the list of specific phobias (ie phobias in which the fear is caused by a specific factor or situation). Tokophobia may affect not only the choice of childbirth, but also the whole life of the patient who experiences her - in extreme cases the fear experienced by a woman is so strong that, in order not to become pregnant, she may avoid sexual intercourse altogether.

Tokophobiadescribes an extremely strong, uncontrolled fear of getting pregnant and giving birth to a child. The term is derived from Greek (from the words tokos (childbirth) and phobos (strong fear of a phenomenon). In psychiatric-psychological terminology, the term first appeared in an article in the British Journal of Psychiatry in 2000. % of women worldwide experience tokophobia.

Tokophobia (fear of childbirth): symptoms

The existence of tocophobia in a patient may result in a number of behaviors that affect her entire life. Women with this disorder can take any steps to prevent conceiving a child - sometimes they use several different methods of contraception at the same time. In extreme cases, with an extremely high level of fear of childbirth, patients tend to avoid sexual contact altogether.

No method of contraception is 100% effective, so sometimes - even if the patient takes all steps to prevent it - pregnancy develops anyway.

A woman with tocophobia during fetal development may experience:

  • nightmares,
  • persistent thoughts about pain during childbirth or any possible complications during childbirth (regarding both the he alth of mother and baby),
  • fear of death during childbirth,
  • irritability and anxiety that increases with the duration of pregnancy,
  • somatic complaints in the form of, for example, unexplained headaches or abdominal pain, palpitations, shortness of breath,
  • panic episodes,
  • significant concentration disorders that hinder everyday family or professional functioning (they are associated with the constant fear of childbirth).

A patient with tocophobia may strongly insist on closingdelivering by cesarean section, which according to her would be less painful (for example due to the anesthesia used during the procedure) than giving birth by natural forces.

Tokophobia (fear of childbirth): causes

As with other anxiety disorders, fear of childbirth also has a complex etiology.

Causes of primary tocophobia

Tokophobia (referred to as primary in the situation described below) can occur in women who have not given birth so far, and in such cases it is associated with:

  • being a victim of physical abuse (e.g. rape or sexual harassment),
  • traumatic events such as miscarriages or abortions,
  • death of the patient's mother during childbirth.

Another factor that can trigger a woman's fear of childbirth is the memories of her own mother. A greater risk of the problem appears in those patients with whom their parents shared negative memories, whether they were exceptional difficulties related to pregnancy or problems of the perinatal period, such as e.g. significant pain.

Causes of secondary tocophobia

Another form of tocophobia is the secondary fear of childbirth that occurs in women who are already mothers. It is caused by events experienced by the patient in the past, such as a difficult course of labor (e.g. associated with severe pain) or being under the care of insufficiently caring medical personnel. The risk of secondary tocophobia is also increased in patients who have had an episode of postpartum depression.

Tokophobia (fear of childbirth): treatment

Therapeutic interactions in patients with tocophobia include two main methods: psychotherapy and pharmacotherapy. The first one plays a primary role as it focuses on identifying the source of the problem and then helping the patient to deal with it. Pharmacological treatment of tocophobia is only initiated when a woman has other mental he alth problems, such as depression.

It is important to emphasize here that, if a pregnant woman needs medication, it is extremely important to choose the right antidepressant - be guided by which measures are safe for the he alth of the developing child.

Taking care of a patient with tocophobia should involve not only a psychiatrist or psychotherapist, but also an obstetrician. The second specialist will be able to confront the patient's fears with reality (e.g. explain whether complicationsshe is afraid, they may indeed be threatened. Additionally, an obstetrician who knows about the fear of childbirth in his / her ward will be able to provide her with special care.

There is one more aspect that needs to be clarified regarding the performance of voluntary cesarean sections in women with tocophobia. Such practice as a routine procedure, even in the case of a significant fear of childbirth in the patient, should definitely not be recommended. Although the number of cesarean sections in the world (also in Poland) is systematically increasing, it does not mean that this is a better way of terminating pregnancy than natural childbirth.

In the case of medical indications (e.g. threat to the life of the fetus), caesarean section is obviously beneficial, however, its performance is associated with a risk of complications four to five times higher than in the case of natural childbirth.

ExpertBow. Tomasz NęckiA graduate of medicine at the Medical University of Poznań. An admirer of the Polish sea (most willingly strolling along its shores with headphones in his ears), cats and books. In working with patients, he focuses on always listening to them and spending as much time as they need.

Category:

Psychiatry