Fear of pregnancy and childbirth (tokophobia)

En español: lee sobre este miedo en Fobias.org.

Tokophobia is a fear of pregnancy or giving birth. It can make the idea of starting a family frightening, or make a pregnancy feel overwhelming.

Understanding this fear

Tokophobia is an intense fear of giving birth, and for some people of pregnancy itself. Most pregnant women feel some worry about labour, such as pain or whether the baby will be well. With tokophobia the fear goes much further, bringing ongoing anxiety, poor sleep and a strong urge to avoid anything to do with birth. For some it means putting off or avoiding pregnancy even when they very much want a child.

Doctors often describe two types. Primary tokophobia affects people who have not given birth before and can date back to childhood or the teenage years, sometimes fed by frightening stories or images. Secondary tokophobia develops after a birth that felt traumatic, and NHS guidance suggests it is the more common of the two. Some estimates suggest around one in seven women may have a severe fear of childbirth, though figures vary a great deal depending on how it is measured.

Common triggers

A positive pregnancy test
Hearing other people’s birth stories
TV programmes or films showing labour
Antenatal appointments and scans
Talk of birth plans
The due date getting closer
Friends announcing pregnancies
Reminders of a previous difficult birth
Hospital smells, gowns or monitors

Where it shows up

Antenatal clinics and scan rooms
Labour wards and birth centres
Antenatal classes
Baby showers and time with pregnant friends
GP or family planning appointments
Online parenting forums and social media

Symptoms

In your body

Trembling or shaking when birth is mentioned
Palpitations or a pounding heart
A knot or churning in the stomach
Trouble sleeping, sometimes with nightmares
Sudden tearfulness
Feeling breathless or panicky

In your mind

I will not get through it, or my baby will be harmed
I cannot cope with the pain
Feeling trapped now that birth cannot be avoided
Flashbacks or intrusive memories of a past birth
Feeling out of control
Guilt about not feeling excited

What you might do

Avoiding pregnancy despite wanting children
Skipping antenatal classes or birth talk
Avoiding pregnant friends or birth stories
Searching online for worst case scenarios
Repeatedly asking professionals for reassurance
Going over every possible birth option to stay in control

What causes it

For some people the fear starts early, from frightening stories, images or family attitudes about birth. For others it follows a birth that felt traumatic, or a loss such as miscarriage or stillbirth, and in that case it can share features with post traumatic stress. A history of anxiety, a lack of support or past experiences of abuse can add to the risk. Fear of pain, tearing or harm to the baby are common worries that can grow into a phobia when they are not talked through. Avoiding information and conversations about birth eases anxiety in the moment, but leaves the fear unchallenged, so it can grow as the due date nears.

How it can affect your life

Tokophobia can shape big life decisions, including whether and when to have a family. During pregnancy it can make what should be a hopeful time feel overwhelming, and it can affect sleep, work and relationships. NHS guidance notes that it can also affect how connected someone feels to their baby, which is one reason getting support early matters. Partners often feel helpless and may need support too.

Things that can help day to day

Tell your midwife or GP about your fear as early as you can, so it can be planned for
Ask whether your hospital offers a visit to the labour ward or birth centre
Be choosy about which birth stories you read, watch or listen to
Write down your questions for your care team, so you feel more informed
Use slow breathing to settle your body when anxious thoughts start

When to get help

If you are pregnant, please tell your midwife or GP about your fear, even if it feels hard to say out loud. They can refer you to specialist support, such as a perinatal mental health team, and talk through your birth options with you. If you are not pregnant but the fear is affecting your plans or your mood, your GP is still the right first port of call. If you have had a difficult birth before, many hospitals offer a chance to talk it through with a midwife.

How I can help

Adam Cox, clinical hypnotherapist known as the Phobia Guru

When I work with a fear of childbirth, I always work alongside your midwife and medical team, never instead of them. We start by finding out exactly what the fear is about, whether that is pain, losing control, a past birth or something you saw or heard. Over Zoom, I use hypnotherapy and NLP to help your body learn a calmer response, and we rehearse appointments and the birth itself in your mind while you feel steady. Many clients find the recording helps them feel more settled in the run up to their due date.

If you’re pregnant, please tell your midwife or GP about your fear. They can offer support and talk through your birth options. Hypnotherapy works alongside your care.

Common questions

What is the difference between primary and secondary tokophobia?

Primary tokophobia affects people who have never given birth and often goes back to childhood or the teenage years. Secondary tokophobia develops after a previous birth that felt traumatic and can include flashbacks or nightmares.

Should I tell my midwife about my fear of childbirth?

Yes. Midwives are used to hearing about fears like this, and telling them early means your care can be planned around it. They can arrange extra support and make sure your birth plan reflects what you need.

Can I have a fear of childbirth and still want a baby?

Very much so. Many people with tokophobia want children deeply, which is part of what makes the fear so upsetting. Getting support can help the choice feel like yours again, rather than one made by fear.

Where does it come from?

Some people develop it after a difficult birth, their own or someone else’s. For others it comes from stories, films or a wider fear of medical settings.

How do sessions work?

I use hypnotherapy and NLP to change how your mind responds to pregnancy and birth. Sessions are one to one over Zoom, and you get a recording of the hypnosis to listen to afterwards.

How many sessions will I need?

Many clients notice a real difference after one 90 minute session. If the fear goes back a long way, three sessions gives us room to make the change stick.

Further reading: Patient.info: How to cope with a fear of childbirth · NHS Pan-London Perinatal Mental Health Networks: Tokophobia toolkit · NHS: Phobias