Tokophobia (Fear of Childbirth)

What is tokophobia?

Tokophobia is an extreme fear of childbirth. This condition primarily affects people designated female at birth, but a small number of people designated male at birth also experience it. Tokophobia is a specific phobia that causes fear of a particular situation.

There are two types of tokophobia:

• Primary tokophobia occurs in people who've never been pregnant.
• Secondary tokophobia develops after a traumatic event during pregnancy or labor. These may include difficult labor or stillbirth.

Tokophobia may stem from other fears, including:

• Algophobia: Fear of pain.
• Haphephobia: Fear of being touched.
• Iatrophobia: Fear of doctors.
• Nosocomephobia: Fear of hospitals.
• Obesophobia: Fear of gaining weight.
• Pedophobia: Fear of children.
• Thanatophobia: Fear of dying.
• Trypanophobia: Fear of needles.

What are phobias?

It’s natural to fear things that feel dangerous or uncomfortable. For many people, this includes pregnancy and childbirth. But these thoughts rarely disrupt daily activities.

Phobias cause intense fear that makes you go out of your way to avoid certain situations. You may experience irrational thoughts and behaviors that are difficult to control. In some cases, phobias get in the way of achieving life goals, like having children or expanding your family.

Do I have tokophobia?

Many people feel anxious about childbirth. Tokophobia causes some people to avoid getting pregnant. People who become pregnant might not feel excited about it and try to hide their growing baby.

There’s no reason to feel embarrassed about tokophobia. And you shouldn’t have to experience these feelings alone. Talking to your healthcare provider can be one of the first steps toward getting relief. Treatment can make being pregnant and planning for childbirth less stressful.

What causes tokophobia?

Causes of tokophobia include:

• Having a history of abuse or rape that makes you feel shameful about being pregnant.
• Feeling pressured into having an uncomplicated vaginal birth.
• Learning of other people’s bad experiences during childbirth.
• Being self-conscious about healthcare providers putting their hands near your vagina during childbirth.
• Not knowing that the likelihood of complications during childbirth is low.
• Anticipating lifestyle changes, like not being able to control your schedule.

What are tokophobia symptoms?

Tokophobia affects your thoughts and behaviors. Many people with tokophobia suffer from depression. They’re are also likely to experience negative outcomes.

Thoughts and behaviors

Fear of pregnancy may cause you to:

• Avoid sexual intercourse.
• Not feel emotionally connected to your unborn child.
• Not feel excited about pregnancy.
• Try to hide the fact that you’re pregnant.
• Feel disconnected from your partner or loved ones.

Negative pregnancy outcomes

People who have an extreme fear of giving birth are more likely to:

• Choose a Cesarean birth (C-section), even though a safe vaginal delivery is possible.
• Seek an abortion if they become pregnant.
• Put their baby up for adoption.

How is tokophobia diagnosed?

Tokophobia is often diagnosed during healthcare provider visits for other reasons.

• People who aren't pregnant: During annual exams, healthcare providers ask about contraception and plans to start a family. This is an excellent opportunity to discuss your concerns about childbirth.
• People who are pregnant: Regular prenatal exams include questions about your mental health. Answering these questions honestly helps healthcare providers detect tokophobia.

How is tokophobia treated?

A common tokophobia treatment is cognitive behavioral therapy (CBT). Undergoing CBT helps you identify the aspects of childbirth that are fueling the phobia. You can also learn healthy coping methods by working with a mental health professional.

Can other treatments help me cope with tokophobia?

Additional methods for overcoming tokophobia may include:

• Antidepressants: If you have depression, antidepressants can help. These medications balance brain chemicals responsible for regulating mood.
• Hypnotherapy: Hypnotherapy uses focused relaxation to achieve a heightened sense of awareness. While in this state, a mental health provider helps you explore subconscious thoughts that are holding you back.
• Stress reduction: Yoga, meditation and other relaxation techniques clear your mind. This may make you feel more confident about childbirth.

Is there anything I can do to prevent tokophobia?

While tokophobia can’t be prevented, there are several ways you can reduce its influence on your life. It’s natural to be fearful about childbirth. But this doesn’t have to hold you back from starting or expanding your family. If you feel anxious, it’s never too early to discuss your concerns with your healthcare provider.

You may also wish to shut out stories of other people’s negative childbirth experiences. Just because things don’t go as planned for other people doesn't mean the same will happen to you.

Can tokophobia be cured?

With successful treatment, anticipating childbirth is less likely to feel overwhelming. You may still have anxiety about it. But knowing how to calm your mind prevents these feelings from escalating.

What else is important to know about overcoming tokophobia?

Having a support network can make it easier to cope with tokophobia. Identify friends and loved ones who are a positive influence in your life. These people may or may not have experienced pregnancy. But you can count on them for kind words and encouragement.

You can also learn more about childbirth by:

• Attending prenatal classes: These classes guide you through what to expect during childbirth. They take place toward the end of your pregnancy.
• Taking early pregnancy classes: These classes are for people in the early stages of pregnancy or who wish to become pregnant.
• Touring a hospital or birthing center: Most facilities offer guided tours and give you the opportunity to ask questions.
• Joining a support group: There are many online pregnancy forums, including options for people trying to conceive. Your hospital may also host an in-person group.

A note from Cleveland Clinic

Tokophobia is an extreme fear of childbirth. It’s natural to be anxious about the many unknowns that come with delivering a baby. But you shouldn’t let this hold you back from starting or expanding your family. Talk to your healthcare provider about your concerns. There are many methods for overcoming this fear. Doing so can help you appreciate the joys of pregnancy and welcoming a new baby.