Tokophobia: when the fear of giving birth paralyzes you.

When a woman suffers from nightmares, has catastrophic thoughts and is terrified of childbirth, and the anxiety-related symptoms are so strong that they make it difficult for her to function in everyday life, we are dealing with tokophobia . Paralyzing fears include the death of oneself and/or a child, and the birth of a child who is sick, handicapped and/or has a disability. It is often associated with a lack of trust in doctors, midwives and nurses, which in Poland, according to reports published every year by the Rodzi Po Ludzku Foundation, has solid foundations and is still associated with insufficiently rigorous compliance with perinatal care standards. Perhaps this factor can explain the fact that in Poland the percentage of cesarean sections performed is one of the highest in Europe and amounts to 43% . For comparison, in Iceland it is 14.8% and is one of the lowest on the continent. The average is 25%, and the World Health Organization recommends that this number be a maximum of 10-15% of all births .

How to recognize tokophobia?

The symptoms of tokophobia are similar to those of other anxiety disorders, but fears related only to childbirth can begin both during and before pregnancy . A distinction is made between primary and secondary tokophobia. The former concerns women who have never given birth early and/or those who have heard stories from close women about difficult, painful childbirths, while the latter concerns women who have already given birth and recall childbirth as a traumatic experience. It also often occurs in women who have experienced a miscarriage or have given birth to a stillborn child.

According to the Rodzi po Ludzku Foundation, women who suffer from tokophobia (primary) do everything to avoid getting pregnant. Therefore, they use several methods of contraception at the same time or give up sex - at least until they receive a guarantee from the doctor that they will be able to perform a cesarean section. Moreover, tokophobia is a common indication for planning a cesarean section, and the appropriate certificate, which is a condition for obtaining the consent of the attending physician (if there are no other medical indications), is issued by the psychiatrist who diagnoses this disorder in the patient. The literature on the subject also contains information that tokophobia is sometimes the reason for sterilization or vasectomy, and it happens that women are so afraid of pregnancy and childbirth that they decide to have an abortion or adoption procedure (if they want to become mothers).

Every fourth pregnant woman experiences serious fear of giving birth.

As written by Dr. n.med. Anna Kajdy, head of obstetrics at the Żelazna Medical Center, 80% of pregnant women declare that they feel anxious about childbirth and are worried about its course, pain, and their own and the baby's health . Various medical publications state different percentages of women experiencing pathological fears, and - writes the doctor - it depends on the adopted definition. Anxiety disorders related to childbirth are said to affect 2 to 15% of women, but there are also statistics showing that serious anxiety may affect up to a quarter of women giving birth. The Rodzi po Ludzku Foundation, in turn, provides the following data: 80% experience mild fear, 20% experience intense fear, 6 to 10% of women experience pathological fear of very intense intensity, and in 2% of women doctors recognize extreme fear of childbirth. intensity.

Specialist help is necessary.

In a woman who is so afraid of childbirth that the fear makes it difficult (or impossible) for her to function in everyday life, tokophobia is an indication for a cesarean section, because there is a serious fear that her mental condition will make natural childbirth difficult or impossible. The occurrence of tokophobia may also be related to depression during pregnancy, which - according to various estimates - affects approximately 10-15% of pregnant women. As specialists emphasize, psychotherapy, especially cognitive-behavioral therapy, brings good results in the treatment of tokophobia. However, it is always necessary to visit a psychiatrist who will determine the woman's condition and find the best therapeutic method. It is definitely worth seeing a specialist if you suspect you may have tokophobia. Professional consultation or therapy can help you get rid of fear and concerns or reduce them enough to make natural childbirth possible. You can learn about the benefits of a natural solution in this article .

Bibliography:

1. “Tokophobia”, Rodzic po Ludzku Foundation, accessed December 28, 2021.
2. “Tokophobia part 3”, Żelazna Medical Center, accessed December 28, 2021.
3. Nowosielska P., Klinger K., “Poland breaks records for cesarean sections. One of the highest rates in Europe”, Gazeta Prawna, August 19, 2021.