Pregnancy / 7 November, 2022 / Ellie Thompson
For any mothers-to-be or women thinking about starting a family, labour can be a daunting, sometimes even all-consuming concept. Some can find the sheer thought of childbirth so frightening that it can affect their pregnancy and birthing choices – this may mean they are suffering from Tokophobia – fear of childbirth.
Tokophobia exists on such a spectrum that it is difficult to judge how many women suffer from the phobia, however, previous studies have found around 80% of women worldwide experience worries and fears in relation to childbirth (Livi, August 2021). For this reason, it’s imperative that mothers-to-be are aware that if they are anxious or fearful about childbirth, a midwife can provide the necessary help and support. Expectant mothers should let their midwife know of their concerns so the condition can be alleviated with tips and advice to combat the common anxieties associated with Tokophobia.
In the below, Roisin Browne and Laura Murray, Midwives at The Portland Hospital, part of HCA Healthcare UK, share their top tips on overcoming the fear of childbirth.
Tokophobia is the extreme fear of childbirth. In its most severe cases, this fear can become so significant that women might choose to avoid pregnancy altogether, even if they are desperate to have a child. Most commonly, the fears surrounding tokophobia are related to pain and injury. For other women, it can be the fear of being out of control throughout the experience of labour and uncertainty about what will occur.
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Tokophobia can be broken down into two types:
This form of tokophobia occurs in someone who has no experience of pregnancy. The fear can occur at any given time, most commonly before pregnancy (occasionally in adolescence) but in some cases, during.
This form occurs in women who have experienced pregnancy and childbirth before. It can be a response to a traumatic birth experience or tragically, after a stillbirth or miscarriage.
Tokophobia can manifest itself in several ways – from panic attacks to excessive anxiety to feelings of intense dread and many of these women also suffer form Post Traumatic Stress Disorder. Below are some useful tips to help overcome the fear of childbirth.
Therapy can be hugely effective in treating Tokophobia. In some cases, talking to a specialist about your fears surrounding the pregnancy, identifying the root cause, and using methods to overcome this can be very helpful. In other cases, Cognitive Behavioural Therapy (CBT) and psychotherapy can be effective treatments- the short-term duration and focus on specific symptoms can lead to a reduction in fear and acceptance of both pregnancy and childbirth.
As mentioned earlier, one of the common fears surrounding Tokophobia is the lack of control over what will happen and the anxiety associated with uncertainty. For this reason, maintaining elements of control is very important in managing Tokophobia. Discussing with your doctor a birthing plan, including factors such as pain management and partner contribution, can help create feelings of empowerment and having more of an influence over the birth.
Ante-natal classes can also help reduce the fear of childbirth. Classes can help grow knowledge, skills and support networks that can contribute to feeling more prepared and confident when preparing for birth. Attending these classes and connecting with other women who share similar feelings about childbirth and pregnancy and listening to medical professionals provide advice is hugely beneficial in relieving Tokophobia.
Antenatal classes can provide helpful coping mechanisms, birthing plans and emotional support, so many women find themselves comforted about how to cope with vagina labour and less likely to opt for caesareans due to fears alone.
CBT focuses on relationships thoughts and feelings, it targets current problems and symptoms and focuses on changing patterns of behaviour that lead to difficulties in functioning.
Cognitive Behaviour Therapy is well recognised for helping people with Post Traumatic Stress Disorders so it would be beneficial for those women suffering from secondary Tokophobia.
Breathing exercises are well known for relieving feelings of anxiety, panic, and worry. Deep abdominal breathing helps to relax, act as a distraction and to reverse some of the physical symptoms that accompany anxiety. By getting a sufficient amount of oxygen around the body, the heart rate is reduced assisting the body to relax, as opposed to anxiously breathing from the upper part of the chest. Concentrating on breathing exercises diverts the focus of what is causing the anxiety and also learns helpful coping mechanisms to use when in labour. This alleviates nerves and reduces the likelihood of anxiety attacks when giving birth.
Hypnobirthing (The Mongan Method) is a birthing method that teaches expectant mothers how to give birth naturally by using self-hypnosis techniques. Hypnobirthing is about deep relaxation during childbirth. The techniques have been shown to positively impact hormones which can increase pain tolerance and calm nerves significantly. In turn, this can make for a quicker and more relaxed labour. It is becoming increasingly popular, with more and more women taking up the dedicated classes.
Women who decide to use hypnosis to help them cope in labour usually start practising during their pregnancy as it takes a while to perfect. This is particularly helpful for those with Tokophobia as it can really reduce stress and anxiety, and provide a more enjoyable experience.
For any mothers-to-be feeling out of control and experiencing distressing symptoms, the above tips can help reduce the psychological and physiological symptoms of Tokophobia. However, joining informative apps and teaching yourself about childbirth and labour can help women to understand what to expect and what options are available.
If you have Tokophobia, it’s important to get professional help – please do not hesitate to get in touch with a midwife and ask them for advice and support throughout pregnancy. Ultimately if the women feels that the therapy she has used is not working, she can discuss her birth with her midwife or consultant.
The National Institute for Health and Care Excellence states that a woman should be involved in her birth choices and offered an elective Caesarean if she feels a vaginal birth will be too traumatic.
Article by Roisin Browne and Laura Murray, Midwives at The Portland Hospital, part of HCA Healthcare UK.
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