What Is Tokophobia?

Medically Reviewed by Poonam Sachdev on October 12, 2022
4 min read

If you are an expecting mom, it’s normal to feel anxious as you wait to meet your little one—or maybe you’re not planning to have children yet, but the thought still makes you a little nervous when looking to the future. 

Having a baby changes your life in so many ways, and it’s normal to feel a little scared since you don’t know what to expect. This normal nervousness, though, is very different from the extreme fear of pregnancy and childbirth, which is known as tokophobia.

Tokophobia is a severe fear of childbirth. There are two kinds: primary and secondary. Primary tokophobia affects women who have never given birth but are extremely frightened by the thought of it. These negative feelings are sometimes linked to past experiences going as far back as childhood.

Secondary tokophobia occurs in women who have given birth. It is considered a form of post-traumatic stress disorder (PTSD). It is more common than primary tokophobia and is the result of a traumatic birthing experience.

Current studies suggest that this phobia affects 2.5% to 14% of all women, though more research will need to be done to pinpoint the exact number. 

Women who are affected by tokophobia are also more likely to have other mental health problems.

For example, people who have tokophobia normally have depression as well. These conditions can take over your thoughts and behaviors, which then leads to high levels of stress and anxiety that can negatively affect both mother and baby.

Women who have both depression and tokophobia often experience intrusive thoughts that they will die if they have to deliver a baby. These recurring thoughts can prompt certain behaviors like avoiding sexual intercourse. Even if you do have intercourse, you might try to delay or avoid pregnancy by using contraceptives.

Sometimes, you can experience tokophobia even if you really want to have a baby and become pregnant. The fear of giving birth can take away some of your excitement throughout the pregnancy or make you feel disconnected from your partner, family, and friends. You may try to hide your pregnancy from others so that you don’t have to talk about it. Once your baby arrives, you may feel unconnected to them.

It’s more common for women with tokophobia to look into abortion to terminate the pregnancy or consider adoption afterward. Many people with tokophobia request a C-section to avoid vaginal birth, even when vaginal delivery is safe for them.

Other symptoms can also develop as a result of tokophobia, including:

  • Anxiety
  • Insomnia and sleeplessness
  • Eating disorders
  • Antenatal depression
  • A higher risk of developing postnatal depression

You might develop tokophobia for several reasons, including:

  • Hearing stories of challenging or traumatic births from family or friends
  • A family history of tokophobia
  • Hormonal changes during pregnancy that make it hard to cope with feelings of stress or anxiety
  • Socioeconomic status (for instance, not having proper access to supportive resources and treatment during pregnancy)
  • Age (younger women are usually more affected)
  • Past sexual abuse, trauma, or rape

Tokophobia can similarly develop if you’ve had gynecological problems in the past. You might feel self-conscious or uncomfortable with the idea of your doctor or midwife putting their hands near your vagina to help you deliver.

Some professionals believe that tokophobia can stem from the idea that you will have a loss of control over your life, as motherhood completely changes it. It could feel like a loss of dignity or independence, and some women also worry that they might not receive proper social support.

If you are afraid of childbirth, you should talk to your doctor or midwife. To diagnose tokophobia, many healthcare professionals use assessment tools like the Wijma Delivery Expectancy Questionnaire, Fear of Birth Scale, or the Childbirth Attitudes Questionnaire. If your doctor determines that you have tokophobia, they can help design a treatment plan for you, whether you are currently pregnant or not.

While speaking with your doctor, you can talk about your fears about childbirth. Your doctor or midwife can then give you advice and let you know what to expect. You will likely receive a referral to a mental health specialist to discuss tokophobia therapy.

Cognitive behavioral therapy (CBT) is a very effective treatment. You and your therapist will talk about your fears to try pinpointing where your anxiety is coming from. Your therapist will then equip you with the skills you need to overcome your anxieties about pregnancy and giving birth.

Your doctor might recommend medication to help you manage any depression, anxiety, or other mental health issues. If your tokophobia comes from PTSD, some doctors also recommend eye movement and desensitization and reprocessing (EMDR). This is a kind of therapy that uses eye movements to weaken the power of the emotions tied to certain memories.

While tokophobia is a scary thing, many people find that it’s a lot easier to deal with if you have the right support system. This includes having a treatment plan from your doctor or mental health professional, but it also means surrounding yourself with people you trust and can talk to. These can be your family, friends, co-workers, other pregnant women, or your partner. Studies show that women with tokophobia who received prenatal and psychological support during their pregnancy are 50% less likely to need a C-section than those who don’t.

Besides the treatment plan laid out by your doctor, you can also consider joining a support group or taking prenatal classes. That way, you can learn more about childbirth and surround yourself with others who might be going through a similar experience. With more information and support, you'll be able to overcome your fear and have a safe, healthy pregnancy if that is what you want.