Fear of childbirth (tokophobia)

Having some anxiety about giving birth is natural. But if you feel so afraid that you don’t want to do it, it’s important to ask for help.

I’m feeling anxious about giving birth. Is this normal?

Many women and birthing people feel anxious or afraid of giving birth. Pregnancy and childbirth are major life events, so don’t be hard on yourself for having these feelings. 

You may find it helpful to:

  • tell your midwife how you feel. They may be able to reassure you.
  • talk to someone you trust. This could be your partner, a friend or family member.
  • start thinking about how you want to give birth, and make a birth plan. This can help you feel more prepared and in control.
  • have an online tour of the place where you plan to give birth.
  • find a local antenatal class. This will give you chance to meet others in a similar situation and find out more about what happens in labour
  • try hypnobirthing. This can help you relax
  • try our tips for improving mental wellbeing in pregnancy to reduce stress.

You may meet people who want to share their birth stories before you even ask. It’s OK to ask them to stop if it’s not helpful.

Find out more about how to prepare for labour.  

Tokophobia

Some people are so afraid of pregnancy or giving birth that they don’t want to go through with it, even if they really want a baby. A severe fear of childbirth may also affect how they decide to give birth to their baby. This is called tokophobia and it can happen in any pregnancy. 

Women with a severe fear of childbirth often have depression or anxiety too.

It can be hard for other people to understand how you feel, but tokophobia is a mental health condition that needs treatment and support.

Symptoms of tokophobia

If you have tokophobia, you may: 

  • feel alone, guilty or ashamed 
  • feel out of control or trapped
  • not admit to yourself or other people that you are pregnant 
  • think about ending the pregnancy to avoid childbirth
  • avoid reading or talking about pregnancy
  • have panic attacks.

What causes tokophobia?

Different things can cause tokophobia. It can affect people who have never been pregnant, in which case it may start in the teenage years or early adulthood. Or it may happen if someone has had a difficult birth in the past. This is a type of post-traumatic stress disorder (PTSD).

Tokophobia can happen if you have:

“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.

What should I do if I’m afraid of childbirth?

Tell your midwife or doctor about your fears, as early in your pregnancy as you can. They should refer you to a mental health specialist for pregnant women. Ideally, this should be someone with experience of childbirth fears. 

You should be given advice on how to cope with your feelings of fear and any other symptoms you may have. You may also be offered cognitive behavioural therapy (CBT).

Your specialist should also discuss your options for giving birth that may help lessen your fears. They may go with you to visit the place where you plan to give birth. This might help to ease some of your fears or worries.

If you have a fear of childbirth due to post-traumatic stress disorder (PTSD) you may be offered eye movement desensitisation reprocessing (EDMR). This therapy uses eye movements to dampen the power of the memories and the emotions linked to them.

Is tokophobia a reason for having a c-section?

Having tokophobia or severe anxiety about birth does not mean you will need to have a caesarean section (c-section). But if you feel you would like one, speak to your pregnancy mental health specialist. They will talk to you about your birth options and offer you support.

If you would still like to have a c-section after talking to your specialist, you will be able to have one at your chosen hospital.

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

Paula, read her full story.

More information and support

Anxiety UK has information and support for perinatal anxiety.

The National Association for People Abused in Childhood supports adult survivors of child abuse.

Rape Crisis provides information and support for people affected by domestic violence and abuse.
 

O'Connell, MA, Khashan, AS, et al (2021) ‘Interventions for fear of childbirth including tocophobia’. The Cochrane database of systematic reviews, 7(7), CD013321. https://doi.org/10.1002/14651858.CD013321.pub2

Patient.info (2019) How to cope with a fear of childbirth. Available at: https://patient.info/news-and-features/how-to-cope-with-a-fear-of-childbirth (Accessed February 2024) (Page last reviewed: 24/10/2019)

NHS Wales (2023) Guideline for tokophobia. Available at: https://wisdom.nhs.wales/a-z-guidelines/t/tokophobia-guideline-pdf1/ (Accessed February 2024) (Page last reviewed 04/2023)

NICE (2024) Caesarean birth: NICE guideline 192. Available at: https://www.nice.org.uk/guidance/ng192 (Accessed February 2024) (Page last reviewed 30/01/2024)
 

Review dates
Reviewed: 21 February 2024
Next review: 22 February 2027