Fear of childbirth (tokophobia)

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

You may feel a bit anxious about or afraid of giving birth. This is very common. 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, friend or family member.
• Start thinking about how you want to give birth and make a birth plan. This can help you feel more organised and in control.
• Find a local antenatal class. This will give you the opportunity to meet others in a similar situation and find out more about what happens in labour.
• Try hypnobirthing. This may help you relax.
• Try our tips for improving mental wellbeing in pregnancy to reduce stress.
• You may come across people who are willing 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 positive things to prepare for labour.

Tokophobia

It is rare, but some women are so afraid of giving birth that they don’t want to go through with it, even if they really want to have the baby. A severe fear of childbirth may also affect their decision on how to give birth to their baby. This is called Tokophobia and it can happen in any pregnancy. Some women have it in early adulthood or even as a teenager.

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

It can be difficult for other people to understand how someone can be so frightened about something they see as ‘so natural’. But tokophobia is a mental health condition and women who have it need treatment and support.

What causes tokophobia?

Tokophobia can happen if you have:

• a fear of childbirth in your family
• heard frightening birth stories from people in your family
• or have had an anxiety disorder
• experienced sexual abuse, assault or rape
• had gynaecological problems (problems with the female reproductive organs).

“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.

Some women have a severe fear of childbirth because they have had a traumatic birth experience. In this case, they may have post-traumatic stress disorder. This is a different condition to tokophobia and needs different treatment.

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

Tell your midwife or doctor about your fears, as early in your pregnancy as possible. 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.

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

Make a wellbeing plan

Our online Wellbeing Plan is a tool that helps you start thinking about how you feel and what support you might need in your pregnancy and after the birth.

You can use it to help you talk to your partner, family, friends or midwife about how you are feeling.

Requesting a planned caesarean section

If you feel like your treatment isn’t working, 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.

The National Institute for Health and Care Excellence states that you should be offered a planned caesarean section if you have had treatment and support but are still too afraid to have a vaginal birth. If an obstetrician is unwilling to perform a caesarean section you should be referred to one who will.

'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.

More information and support

• Anxiety UK
• No Panic
• The National Association for People Abused in Childhood
• Rape Crisis