Too Scared to Push? Fear of Childbirth/Afraid of Giving Birth?
By Dr Becky Spelman
While it’s perfectly normal for any woman to experience some nervousness or anxiety around childbirth, for some the fear of childbirth becomes so great that it can actually have a huge impact on their lives and the decisions they take. When fear of childbirth becomes so overwhelming, it is considered a phobia known as “tokophobia”. Tokophobia is a psychological disorder whereby the woman’s fear of giving birth involves a dramatic over-estimation of the actual dangers involved. While things certainly can go wrong in childbirth, most women in the developed world have a successful outcome for both mother and baby. With tokophobia, the level of fear associated with childbirth considers it much riskier than it actually is.
Women with this phobia can experience a wide range of symptoms, including difficulty working or focusing on the family, panic attacks, and a range of physical and psychological symptoms that relate to the condition. Many of them, if they decide to have a family, request a caesarean section even when there is no physical reason to have one, putting themselves and their babies at needless elevated risk. Others, even though they want to have a family, fear childbirth so much that they avoid becoming pregnant, possibly by abstaining from sex altogether, or by asking for a hysterectomy so that pregnancy becomes impossible. Sometimes sufferers cannot stand being around pregnant women, and even become distressed if they see pregnant women in the street.
Why are Women Afraid of Childbirth?
Tokophobia often starts in adolescent girls and can be related to stories they have heard about their mothers’ or other women’s experience of childbirth. In older women, having already had a difficult birth experience and/or poor treatment from medical staff can contribute to their developing tokophobia after the birth of their first child.
Anxiety around childbirth is often associated with higher levels of anxiety in general. Women who tend to worry about the future overall are more likely to develop a damaging degree of anxiety associated with childbirth. Frequently, they also come from families in which a tendency to worry is established, making it at least in part a learned behaviour. Subconsciously, chronic worriers often feel that the act of worrying is actually helpful on some level; that it is protecting them from harm. While this can sometimes be true – a healthy degree of worry causes us to consider carefully what we need to do to stay safe – excessive worry can often hold people back from enjoying a fulfilling life. In the case of tokophobia, it can cause women who yearn for a child of their own to do everything they can to prevent it!
Is Fear of Childbirth Getting Worse?
More women suffer than tokophobia now than before. In part, this is because many women are having their first baby later in life, and we all tend to worry more as we get older. Women in their thirties and forties are more prone to experiencing feelings of anxiety about the future, and they are more likely to experience overwhelming feelings of fear associated with childbirth than younger women.
Can Fear of Childbirth be Treated?
Women with anxiety about giving birth can be treated in therapy, just like anyone else with a particular phobia. Cognitive Behavioural Therapy (CBT) provides them with techniques that they can use to manage their anxiety better. There are also some simple techniques that they can use every day to help:
When they find that they are avoiding doing something because of the phobia, it is useful to confront the feeling of fear directly, rather than avoiding thinking or talking about it. It is more helpful to admit to a fear of childbirth than to spend one’s life avoiding thinking about it.
They can mindfully observe how they react to negative thoughts and feelings about childbirth, and focus on returning to the present and setting those negative thoughts aside.
They can accept that excessive worry is not useful, and “allow” themselves to worry for brief, set periods of time such as two minutes. This provides an outlet for the negative feelings, and also contains them within a manageable period of time.
Most women with a fear of childbirth can be successfully treated, and overcome their phobia so that they can enjoy a healthy sex life, the company of pregnant women or women with small babies and – if they wish to – a family of their own. They are usually relieved when the experience of childbirth is less difficult than they expected, and if they plan on having more than one child, they usually typically find that their fear lessens with each experience of childbirth.
Who can I speak to further about the issues in this article?
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