Tokophobia in pregnancy

Most pregnant women have some anxieties about how they will cope with childbirth, but for some women it causes extreme distress.

Tokophobia is the name for this condition of having a fear of giving birth so bad that you don’t want to go through with it, even if you really want to have the baby.

Tokophobia is more common in women who have already had a baby. It often, but not always, follows a traumatic first birth. This is referred to as secondary tokophobia.

Primary tokophobia is a fear of childbirth in someone who has had no experience of it. It can be very difficult for other people to understand how someone can be so frightened about a process that is, to others ‘so natural’, but it is a mental health condition. For those with primary tokophobia, the dread of childbirth may start before the pregnancy, as early as adolescence.

“I always knew I would struggle being pregnant because I have a massive fear of childbirth. It comes from being sexually abused as a child, so things like smear tests are always very traumatic for me.”  Julie, mum of one, read her full story.

 Risk factors of tokophobia

Lots of women have some fears about giving birth, but you are more likely to have tokophobia if:

  • you have had extensive gynaecological problems
  • fear of childbirth is in your family and you have heard frightening stories about birth from family
  • you have had an anxiety disorder
  • you have a strong need to remain in control at all times
  • you have had a previous traumatic birth
  • you experienced sexual abuse as a child
  • you have experienced sexual assault or rape
  • you have depression.

What should I do?

Tell your midwife or doctor about your fears, as early in your pregnancy as possible. They should refer you to talk with a healthcare professional who is trained to provide mental health support for pregnant women, and specifically someone with experience of childbirth fears. For many women with tokophobia, this helps them to overcome their fears about giving birth.

If you are still deeply afraid of giving birth as you get near your due date, you can talk to your midwife or doctor about having a planned caesarean section. They will discuss the risks and benefits of having a caesarean compared to a vaginal birth. You should be supported to make your own decision, and if the thought of having a vaginal birth is too distressing, even after treatment, your healthcare team should offer a caesarean section. This may not be available at your local hospital.

You can read the guidelines on how a hospital should respond to a request for a caesarean because of tokophobia.

'I wrote a short explanation of my anxiety, its triggers and how people could help me manage it, and asked any new medical staff to read it before dealing with me.' Paula, read her full story.

How can I help myself?

More information and support

Anxiety UK: Helpline: 08444 775 774. Organisation run by and for people with anxiety disorders, offering information, support and therapies for people experiencing anxiety.

No Panic: Helpline: 0800 138 8889. Online and telephone support for people suffering from panic attacks, phobias, Obsessive Compulsive Disorder, and anxiety disorders.

The National Association for People Abused in Childhood: Helpline: 0808 801 0331Telephone support for survivors of abuse.

Rape Crisis: Helpline: 0808 802 9999. Telephone support for survivors of rape.

Read about other people's experience of tokophobia

Read more about mental wellbeing in pregnancy


  1. Hofberg K, Ward, MR (2003) Fear of pregnancy and childbirth, Postgrad Med J 2003;79:505-510 doi:10.1136/pmj.79.935.50
  2. Hofberg K, Ward, MR (2003) Fear of pregnancy and childbirth, Postgrad Med J 2003;79:505-510 doi:10.1136/pmj.79.935.50
  3.  Hofberg K, Ward, MR (2003) Fear of pregnancy and childbirth, Postgrad Med J 2003;79:505-510 doi:10.1136/pmj.79.935.50
  4. Hofberg K, Ward, MR (2003) Fear of pregnancy and childbirth, Postgrad Med J 2003;79:505-510 doi:10.1136/pmj.79.935.50
  5.  Hofberg K, Ward, MR (2003) Fear of pregnancy and childbirth, Postgrad Med J 2003;79:505-510 doi:10.1136/pmj.79.935.50
  6. NICE (2014) Antenatal and postnatal mental health: clinical and service management guidance, clinical guideline 192, National Institute for Health and Care Excellence.  London, Available at:
  7. NICE (2011). Caesarean section, clinical guideline 132. National Institute for Health and Care Excellence London Available at
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Last reviewed on February 1st, 2015. Next review date February 1st, 2018.

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  • By Midwife @Tommys on 28 Sep 2016 - 13:49

    Thank you for sharing your experience of living with tokophobia and the limited prospects for having children of your own. It is a phobia that many people will have no idea exists, let alone how it impacts a woman's life.

  • By Kylie (not verified) on 28 Sep 2016 - 01:14

    I suffer tokophobia iv known this since a young age and once in a serious relationship children have become a concern due to my partners age. It is an extreme fear I cannot watch childbirth and am repulsed by the thought of myself being pregnant. I have had many compliments about how I would be a great parent. I feel that I am okay with my phobia but I feel enough isn't done to help people in my situation. The only way I can ever have children is ivf surrogacy. The problem with that is the ivf and legal costs and if it doesn't go as planned I could still be childless. The laws don't cover myself very well but work more in benifit of the surrogate. This scares me. My tokophobia is so bad i have had thought's about having sterilisation so I do not conceive. But I do want children but I feel that there isn't help except mentally for people in my situation. Like I said I'm okay with my phobia it's the help of having a child I need but the options arnt there for people in my situation.

  • By Midwife @Tommys on 21 Sep 2016 - 13:55

    Thank you for posting. Tokophobia is a very complicated condition and as the loss of your friend illustrates should be treated seriously. I am very sorry for your loss.

  • By Anonymous (not verified) on 18 Jul 2016 - 22:25

    Focus more in your mind than your body. You will get through it

  • By Anonymous (not verified) on 20 Sep 2016 - 19:29

    It is a mind thing, but you definitely do not just 'get over it'. How ignorant! Even with help it can be a long and painful road, and therapy/support doesn't solve or even ease the problem for everyone. One of my best friends was in therapy for months and ended up killing herself because the therapist had convinced her to 'keep trying' until she had passed the cut-off for an abortion. This is NOT something to be taken lightly!

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