For many motherhood is considered a very happy occasion. Some might think that there is nothing to fear about. But there is a hidden psychological terror called Tokophobia or fear of childbirth. 1 in 7 pregnant women have experienced it.
Tokophobia is classified under the WHO’s ICD-11 as a Specific Phobia (6B03) and is defined as an intense, persistent, and disproportionate fear of childbirth that often leads to avoidance behaviors
What are its Types?
It is mostly of two types: primary, affecting first time mothers with nightmares of pain and fear of loss of control and secondary, which are painful experiences from past birth.
What are the risk factors?
Tokophobia is complex to diagnose as it doesn’t exist alone. It interacts with depression, PTSD, eating disorders from previous traumatic experiences. that demands both obstetric and psychiatric attention.
It’s mostly the younger mothers under the age of 25, having low education, unplanned pregnancies or with a history of psychological anxiety disorders[3].
Risk factors are multifaceted: sociodemographic (age below 25, low education), obstetric (unplanned pregnancy, prior complications), and psychological (anxiety, depression, poor social support)[3].
How to Diagnose it?
Professionals typically uses the Wijma Delivery Expectancy Questionnaire (W-DEQ), scoring 0-165, with high scores indicating severe fear
How to Manage it?
Management includes midwifery-led interventions: psychoeducation, antenatal classes, and counseling reduce fear and promote vaginal births, averting cesareans and saving costs. Cognitive behavioral therapy (CBT), antidepressants for comorbid depression, and relaxation techniques like yoga are effective. Early screening in prenatal care is crucial for positive outcomes
Have you ever encountered or heard about Tokophobia in clinical or personal experience?
MBH/PS