Tokophobia: Understanding the Fear of Pregnancy

Karen Doll, Author
Updated on September 9, 2021

Most women experience anxiety and fear about pregnancy and childbirth. It’s obviously understandable considering that the process is accompanied by significant pain and discomfort. However, when the fear becomes so severe that it becomes an obsessive dread that interferes with one’s daily functioning, it can be classified as a mental health condition.[1]

pregnant woman

This condition is known as tokophobia (a.k.a tocophobia, maleusiophobia and parturiphobia) and is defined as an intense anxiety or fear of pregnancy and childbirth, with some women avoiding pregnancy and childbirth altogether.

What Causes Tokophobia?

There are two classifications of tokophobia: primary or secondary. Women who have not experienced childbirth, yet still have this extreme fear, are considered to have primary tokophobia.

According to psychologists, this fear can often come from past traumatic experiences, often related to sexual abuse.[2] It can also develop if a woman has witnessed a traumatic birth resulting in death or other disturbing outcomes. This fear can develop from women watching traumatic scenes about childbirth, as it may create vivid images that they replay in their minds. 

Secondary tokophobia refers to women who have had a traumatic birth experience themselves, which may have involved severe pain or a negative outcome for the child.[1]

How Common Is Tokophobia?

It seems occurrences of tokophobia are on the rise. There are a number of hypotheses suggesting why this could be. One being access to the internet where with one Google search, thousands of horror stories of childbirth are at one’s fingertips. These stories can often provide gruesome or graphic details which can easily exacerbate anyone’s fear and anxiety.

The statistics on the frequency of tokophobia are inconsistent. Research estimates that between 3-22% of women suffer from tokophobia. Part of the challenge is the range of symptoms and the broad continuum of the severity of symptoms women experience. Also, the definition of tokophobia varies, as there are not universal, standard criteria.[3]

Who Is Likely to Suffer From Tokophobia?

It is difficult to determine risk factors or accurately predict who is more likely to experience tokophobia. It has been suggested that women who experience it are more likely to demonstrate general symptoms of anxiety and depression prior to becoming pregnant.[4]

Treatment Options

There is no rigorous research supporting a particular treatment methodology or application. However, there is hopeful anecdotal information in psychological literature.

There are various paradigms and approaches to address tokophobia. Popular interventions include psychoeducation, cognitive behavioral therapy, group therapy, peer education, and art therapy. Research indicates that these can be effective at helping women cope with the symptoms.[5]

Group therapy can also be beneficial for women to hear success stories and outcomes from people who have faced similar challenges. Such a setting also provides nurturing and support from women who may not feel understood. Symptoms of anxiety and depression can also be addressed through more general cognitive interventions, non-specific to childbirth.[6]

Summary

Researchers suggest that education, awareness, and discussion in a safe, nurturing environment can help women dealing with tokophobia.[7] If you or someone you know is experiencing such anxiety and fear, it’s advised to reach out to a mental health professional for intervention.


References

  1. Bhatia, M. S., & Jhanjee, A. (2012). Tokophobia: A dread of pregnancyIndustrial psychiatry journal21(2), 158–159. https://doi.org/10.4103/0972-6748.119649
  2. Rabinerson D, Stolovitch N, Gabbay-Benziv R. [Tocophobia–its origin, prevalence and implications]. Harefuah. 2014 May;153(5):292-4, 303. Hebrew. PMID: 25112123.
  3. O’Connell, M. A., Leahy-Warren, P., Khashan, A. S., Kenny, L. C., & O’Neill, S. M. (2017). Worldwide prevalence of Tokophobia in pregnant women: systematic review and meta-analysis. Acta obstetricia et gynecologica Scandinavica, 96(8), 907–920. https://doi.org/10.1111/aogs.13138
  4. Hofberg, K. (2003). Fear of pregnancy and childbirth. Postgraduate Medical Journal, 79(935), 505–510. https://doi.org/10.1136/pmj.79.935.505
  5. O’Connell MA, Khashan AS, Leahy-Warren P, Stewart F, O’Neill SM. Interventions for fear of childbirth including tocophobia. Cochrane Database Syst Rev. 2021 Jul 7;7(7):CD013321. doi: 10.1002/14651858.CD013321.pub2. PMID: 34231203; PMCID: PMC8261458.
  6. Fathi Najafi T, Dashti S, Bolghanabadi N, Rezvanifard M, Andaroon N, Abadibavil D, Tahoonian Golkhatmy F, Bahri N. Evaluation of the effect of cognitive behavioral therapy on tocophobia: A systematic review and meta-analysis. Arch Psychiatr Nurs. 2021 Jun;35(3):255-260. doi: 10.1016/j.apnu.2021.03.009. Epub 2021 Mar 26. PMID: 33966789.
  7. Sioma-Markowska, U., Żur, A., Skrzypulec-Plinta, V., Machura, M., & Czajkowska, M. (2017). Causes and frequency of Tokophobia – own experiences. Ginekologia polska, 88(5), 239–243. https://doi.org/10.5603/GP.a2017.0045
Karen Doll, Author

Karen Doll has been a Licensed Psychologist in the Twin Cities for 20 years, working in organizational consulting. She leverages her education in Clinical Psychology with her leadership assessment expertise in her practice. She is an executive coach focusing on helping people maximize their potential.