Fear of Giving Birth & How to Overcome It

By Lisa H And Margarita K

Last updated on 25 September 2024

The journey to parenthood is often portrayed as a time of joy and anticipation, but for some new and expecting parents, it can be overshadowed by intense fear and anxiety. 

The fear of giving birth, known as tokophobia, is a reality that can affect expecting mothers, yet it is seldom discussed openly. If you’re struggling with this fear, know that you’re not alone!

Today, we’re fortunate to hear from Margarita Koleva, a psychologist dedicated to helping mothers navigate the complex emotional landscape of parenthood. Through her work with Momsanity, a startup focused on postpartum mental health, and her podcast "The Colours of Parenthood," Margarita gives us insights into the real, raw, and often untold stories of parenthood.

Together, we'll explore what tokophobia is, why it occurs, and how those affected can find the help they need.

How is fear of giving birth defined?

Firstly, an extreme fear of giving birth or even being pregnant is a health condition called tokophobia. This condition could make people do anything even to avoid getting pregnant. 

There are two types of tokophobia – primary and secondary. The primary one occurs when one has never gotten pregnant, whereas the secondary one is present after a mom has had a traumatic event either during pregnancy or during labor.  

What may cause tokophobia and what are some of the signs that a pregnant person may be experiencing it?

Usually, people who have experienced abuse, or rape, or have learned about many traumatic birth experiences, are more likely to experience tokophobia. 

Also, if a mom is pressured into having a natural birth when she is not mentally prepared, she is more likely to experience tokophobia, as anxiety and stress levels are increasing. 

There is also a chance that this phobia could stem from other phobias. Some examples are algophobia (fear of pain), haphephobia (fear of being touched), nosocomephobia (fear of hospitals), and others. 

It is not uncommon to be anxious before getting pregnant and before the delivery. However, if a mom is hiding her pregnancy and is not excited at all, this could be due to tokophobia. It is prevalent for people who have tokophobia to experience depression as well. 

Usually, when one experiences any type of phobia, their behavior changes because their thoughts are changing due to the irrational fear. In the case of tokophobia, some examples of thoughts and behavioral changes are avoiding sexual intercourse, and not feeling emotionally attached to your partner or loved ones.   

Are there any numbers around how many pregnant people may experience a fear of giving birth?

It is found that around 5-15% of pregnant women are experiencing tokophobia. It has to be noted, though, that one of the hardest things to research is pregnant women or new moms. 

Therefore, this area is still quite under researched in the literature, and one should keep this in mind when looking at the numbers. 

Additionally, 13% of women who experience fear of childbirth / tokophobia are delaying their pregnancy or do not want to have kids. 

What are some of the ways to address (and overcome) this fear? Whom can pregnant people turn to?

The most common therapy for this issue is Cognitive Behavioral Therapy as it focuses on reshaping those irrational thoughts and fears so the mom’s behavior would change as well. 

Also, this therapy can help the patient to realize what fears are fueling this phobia. 

Other treatments that are quite often mentioned are pharmacological - thus prescribing antidepressants, or relaxation techniques such as meditation or breathing techniques. 

What can a pregnant person do when they feel like they are not being taken seriously by their healthcare providers in regards to their fears?

Unfortunately, tokophobia is often not taken seriously and many medical professionals do not feel the need to educate young parents.

If you don’t feel like you are well taken care of, consider changing your OBGYN, or midwife, look for a birthplace that will support you, and/or consider working with a doula. 

The place you are giving birth can also affect your early parenthood. With that being said, it is essential that you, as an expecting parent, feel comfortable with your doctors and your hospital environment. 

Also, preparing yourself beforehand by visiting your planned place of birth and letting the staff know about your fears can be helpful as it makes you feel much more prepared. Meaning, if something unplanned happens, you won’t be taken aback by surprise.

It is also helpful to be aware that whatever happens in the hospital or your chosen place of birth does not represent your ability to parent. Believe that you are not failing as a parent and that the nature of these issues is beyond your control.

Anything else you would like to share?

I have encountered mothers who have had a traumatic birth experience and this affects their decision to get pregnant again. However, one thing that can be done to prevent this fear is to inform young people about the reality of becoming a parent. Only some things are written in the books that new parents are reading. 

Usually, what happens is that parents are prepared to take care of the children, but not to take care of themselves. They believe what media and TV are showing - an endless satisfaction and fulfillment after you see your first baby. 

But what appears to be the reality behind the curtains is usually disappointing and induces guilt in the parents. Thus, education, more information, and support could potentially prevent this fear and make parents feel like they have control over their decisions, not like their anxiety is deciding instead of them. 

Thanks Margarita!

Sources:

https://my.clevelandclinic.org/health/diseases/22711-tokophobia-fear-of-childbirth

Mandal, S., Bhadoriy, S. S., Shiva, K., Ahirwar, R. S., Sharma, S., Kumar, N., ... & Rajput, K. (2022). A review on prevalence of tokophobia: Fear of childbirth, diagnosis & its management approaches. NeuroQuantology, 20(8), 5918.

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