childbirth
Childbirth, also known as labour and delivery, is the ending of pregnancy where one or more babies exits the internal environment of the mother via vaginal delivery or caesarean section. In 2019, there were about 140.11 million births globall ...
. It is a common reason why some women request an elective cesarean section. The fear often includes fear of injury to the baby,
genital tract
The female reproductive system is made up of the internal and external sex organs that function in the reproduction of new offspring. In humans, the female reproductive system is immature at birth and develops to maturity at puberty to be abl ...
, or death. Treatment may occur via
counselling
Counseling is the professional guidance of the individual by utilizing psychological methods especially in collecting case history data, using various techniques of the personal interview, and testing interests and aptitudes.
This is a list of co ...
.
It is a type of
specific phobia
Specific phobia is an anxiety disorder, characterized by an extreme, unreasonable, and irrational fear associated with a specific object, situation, or concept which poses little or no actual danger. Specific phobia can lead to avoidance of the o ...
. In 2000, an article published in the ''
British Journal of Psychiatry
The ''British Journal of Psychiatry'' is a peer-reviewed medical journal covering all branches of psychiatry with a particular emphasis on the clinical aspects of each topic.
The journal is owned by the Royal College of Psychiatrists and publis ...
'' described the fear of childbirth as a
psychological disorder
A mental disorder, also referred to as a mental illness or psychiatric disorder, is a behavioral or mental pattern that causes significant distress or impairment of personal functioning. Such features may be persistent, relapsing and remitti ...
that has received little attention and may be overlooked.
Signs and symptoms
Phobia
A phobia is an anxiety disorder defined by a persistent and excessive fear of an object or situation. Phobias typically result in a rapid onset of fear and are usually present for more than six months. Those affected go to great lengths to avo ...
of
childbirth
Childbirth, also known as labour and delivery, is the ending of pregnancy where one or more babies exits the internal environment of the mother via vaginal delivery or caesarean section. In 2019, there were about 140.11 million births globall ...
, as with any phobia, can manifest through a number of symptoms including
nightmares
A nightmare, also known as a bad dream, Retrieved 11 July 2016. is an unpleasant dream that can cause a strong emotional response from the mind, typically fear but also despair, anxiety or great sadness. The dream may contain situations of d ...
, difficulty in concentrating on work or family activities,
panic attacks
Panic attacks are sudden periods of intense fear and discomfort that may include palpitations, sweating, chest pain or chest discomfort, shortness of breath, trembling, dizziness, numbness, confusion, or a feeling of impending doom or of losing ...
and
psychosomatic
A somatic symptom disorder, formerly known as a somatoform disorder,(2013) elective caesarean section. Fear of labor pain is strongly associated with the fear of
pain
Pain is a distressing feeling often caused by intense or damaging stimuli. The International Association for the Study of Pain defines pain as "an unpleasant sensory and emotional experience associated with, or resembling that associated with, ...
in general; a previous complicated childbirth, or inadequate
pain relief
Pain management is an aspect of medicine and health care involving relief of pain (pain relief, analgesia, pain control) in various dimensions, from acute and simple to chronic and challenging. Most physicians and other health professionals pr ...
, may cause the phobia to develop. A fear of
pregnancy
Pregnancy is the time during which one or more offspring develops ( gestates) inside a woman's uterus (womb). A multiple pregnancy involves more than one offspring, such as with twins.
Pregnancy usually occurs by sexual intercourse, but ca ...
itself can result in an avoidance of pregnancy or even, as
birth control
Birth control, also known as contraception, anticonception, and fertility control, is the use of methods or devices to prevent unwanted pregnancy. Birth control has been used since ancient times, but effective and safe methods of birth contr ...
methods are never 100% effective, an avoidance of sexual intercourse or asking for sterilization, e.g. via
hysterectomy
Hysterectomy is the surgical removal of the uterus. It may also involve removal of the cervix, ovaries (oophorectomy), Fallopian tubes (salpingectomy), and other surrounding structures.
Usually performed by a gynecologist, a hysterectomy may b ...
.
Tokophobia is a distressing psychological disorder which may be overlooked by medical professionals; as well as
specific phobia
Specific phobia is an anxiety disorder, characterized by an extreme, unreasonable, and irrational fear associated with a specific object, situation, or concept which poses little or no actual danger. Specific phobia can lead to avoidance of the o ...
and
anxiety disorders
Anxiety disorders are a cluster of mental disorders characterized by significant and uncontrollable feelings of anxiety and fear such that a person's social, occupational, and personal function are significantly impaired. Anxiety may cause physi ...
, tokophobia may be associated with depression and
post-traumatic stress disorder
Post-traumatic stress disorder (PTSD) is a mental and behavioral disorder that can develop because of exposure to a traumatic event, such as sexual assault, warfare, traffic collisions, child abuse, domestic violence, or other threats on ...
. Recognition of tokophobia and close liaison with
obstetricians
Obstetrics is the field of study concentrated on pregnancy, childbirth and the postpartum period. As a medical specialty, obstetrics is combined with gynecology under the discipline known as obstetrics and gynecology (OB/GYN), which is a sur ...
or other medical specialists can help to reduce its severity and ensure efficient treatment.
Cause
Reasons for tokophobia can be complex. Women may fear for the infant's life, fear the unknown and fear the uncertainty of the labour and birth process. Women may develop tokophobia based on previous traumatic birth and delivery processes. Women may lack trust in obstetric services, or fear being left alone while in labour.
Primary
Primary tokophobia is the fear and deep-seated dread of childbirth in women who have never experienced birth. It may pre-date
pregnancy
Pregnancy is the time during which one or more offspring develops ( gestates) inside a woman's uterus (womb). A multiple pregnancy involves more than one offspring, such as with twins.
Pregnancy usually occurs by sexual intercourse, but ca ...
and can start in
adolescence
Adolescence () is a transitional stage of physical and psychological development that generally occurs during the period from puberty to adulthood (typically corresponding to the age of majority). Adolescence is usually associated with the t ...
or begin in pregnancy. This may relate back to their own mother's experience or be triggered by exposure to childbirth without adequate explanation at a young age. It may also be experienced by women who have been sexually abused or raped; childbirth could trigger flashbacks in women who are traumatised.
Secondary
Secondary tokophobia occurs in women who have experienced childbirth. The previous experience of birth may have been traumatic, or women may have experienced other traumatic life events and abuse.
Terminology
The term tokophobia was introduced in the medical literature in 2000. The word is from the
Greek
Greek may refer to:
Greece
Anything of, from, or related to Greece, a country in Southern Europe:
*Greeks, an ethnic group.
*Greek language, a branch of the Indo-European language family.
**Proto-Greek language, the assumed last common ancestor ...
''tokos'', meaning childbirth and ''phobos'', meaning fear.
It is also known as "maleusiophobia" (though this is certainly a variant of "maieusiophobia", from the Greek "maieusis", literally meaning "delivery of a woman in childbirth" but referring generally to midwifery), "parturiphobia" (from Latin '' parturire'', meaning "to be pregnant"), and "lockiophobia".
See also
*
List of phobias
The English suffixes -phobia, -phobic, -phobe (from Greek φόβος ''phobos'', "fear") occur in technical usage in psychiatry to construct words that describe irrational, abnormal, unwarranted, persistent, or disabling fear as a mental diso ...
*
Blood-injection-injury type phobia
Blood-injection-injury (BII) type phobia is a type of specific phobia characterized by the display of excessive, irrational fear in response to the sight of blood, injury, or injection, or in anticipation of an injection, injury, or exposure to bl ...
*
Psychiatric disorders of childbirth
Psychiatric disorders of childbirth ( parturition, labor, delivery), as opposed to those of pregnancy or the postpartum period, are psychiatric complications that develop during or immediately following childbirth. Despite modern obstetrics and ...
*
Anxiety disorder
Anxiety disorders are a cluster of mental disorders characterized by significant and uncontrollable feelings of anxiety and fear such that a person's social, occupational, and personal function are significantly impaired. Anxiety may cause physi ...