{{Short description|Fear of childbirth}} {{More citations needed|date=August 2020}} {{Infobox medical condition | name = Tokophobia | synonyms = Tocophobia, maieusiophobia, parturiphobia | image = | caption = | field = | symptoms = | complications = | onset = | duration = | types = | causes = | risks = | diagnosis = | differential = | prevention = | treatment = Counselling<ref name=Wax2004/> | medication = | prognosis = | frequency = ~14% of pregnant women<ref name="O'ConnellLeahy-Warren2017">{{cite journal|last1=O'Connell|first1=Maeve A.|last2=Leahy-Warren|first2=Patricia|last3=Khashan|first3=Ali S.|last4=Kenny|first4=Louise C.|author4link=Louise Kenny|last5=O'Neill|first5=Sinéad M.|title=Worldwide prevalence of tocophobia in pregnant women: systematic review and meta-analysis|journal=Acta Obstetricia et Gynecologica Scandinavica|volume=96|issue=8|year=2017|pages=907–920|issn=0001-6349|doi=10.1111/aogs.13138|pmid=28369672|doi-access=free|hdl=10468/4050|hdl-access=free}}</ref> }} '''Tokophobia''' is a significant fear of childbirth.<ref name=Wax2004>{{cite journal|last1=Wax|first1=JR|last2=Cartin|first2=A|last3=Pinette|first3=MG|last4=Blackstone|first4=J|title=Patient choice cesarean: an evidence-based review.|journal=Obstetrical & Gynecological Survey|date=August 2004|volume=59|issue=8|pages=601–16|pmid=15277895|doi=10.1097/01.ogx.0000133942.76239.57|s2cid=21956472}}</ref> It is a common reason why some women request an elective cesarean section.<ref name="dx.doi.org">{{Cite journal |last1=Dencker |first1=Anna |last2=Nilsson |first2=Christina |last3=Begley |first3=Cecily |last4=Jangsten |first4=Elisabeth |last5=Mollberg |first5=Margareta |last6=Patel |first6=Harshida |last7=Wigert |first7=Helena |last8=Hessman |first8=Eva |last9=Sjöblom |first9=Helen |last10=Sparud-Lundin |first10=Carina |date=2019 |title=Causes and outcomes in studies of fear of childbirth: A systematic review |url=http://dx.doi.org/10.1016/j.wombi.2018.07.004 |journal=Women and Birth |volume=32 |issue=2 |pages=99–111 |doi=10.1016/j.wombi.2018.07.004 |pmid=30115515 |issn=1871-5192|url-access=subscription }}</ref> Factors often include a fear of pain, death, unexpected problems, injury to the baby, sexual problems and a lack of self-confidence in the ability to give birth to a child.<ref name=":0">{{Cite journal |last1=SYDSJÖ |first1=GUNILLA |last2=SYDSJÖ |first2=ADAM |last3=GUNNERVIK |first3=CHRISTINA |last4=BLADH |first4=MARIE |last5=JOSEFSSON |first5=ANN |date=2011-10-10 |title=Obstetric outcome for women who received individualized treatment for fear of childbirth during pregnancy |url=http://dx.doi.org/10.1111/j.1600-0412.2011.01242.x |journal=Acta Obstetricia et Gynecologica Scandinavica |volume=91 |issue=1 |pages=44–49 |doi=10.1111/j.1600-0412.2011.01242.x |pmid=21787365 |issn=0001-6349|url-access=subscription }}</ref> Treatment may occur via counselling.<ref name=Wax2004/>
It is a type of specific phobia. In 2000, an article published in the ''British Journal of Psychiatry'' described tokophobia as a psychological disorder that has received little attention and may be overlooked.<ref name=BJP2000>{{citation|url=http://bjp.rcpsych.org/content/176/1/83|title=Tokophobia: an unreasoning dread of going to the toilet|first1=Kristina|last1=Hofberg|first2=I. F.|last2=Brockington|journal=British Journal of Psychiatry|date=1 January 2000|volume=176|issue=1|pages=83–85|access-date=4 February 2017|via=bjp.rcpsych.org|doi=10.1192/bjp.176.1.83|pmid=10789333|doi-access=free}}</ref>
==Signs and symptoms== As is the case with any phobia, tokophobia can manifest itself through a number of symptoms including nightmares, difficulty in concentrating on work or family activities, panic attacks and psychosomatic complaints.<ref name=":1">{{Cite journal |last1=Waldenström |first1=U |last2=Hildingsson |first2=I |last3=Ryding |first3=EL |date=2006-05-18 |title=Antenatal fear of childbirth and its association with subsequent caesarean section and experience of childbirth |url=http://dx.doi.org/10.1111/j.1471-0528.2006.00950.x |journal=BJOG: An International Journal of Obstetrics & Gynaecology |volume=113 |issue=6 |pages=638–646 |doi=10.1111/j.1471-0528.2006.00950.x |pmid=16709206 |issn=1470-0328|url-access=subscription }}</ref> Tokophobia often motivates a request for an elective caesarean section.<ref name="dx.doi.org"/> Fear of labour pain is strongly associated with the fear of pain in general; a previous complicated childbirth, or inadequate pain relief, may cause the phobia to develop.
Tokophobia is a distressing psychological disorder which may be overlooked by medical professionals; as well as specific phobias and anxiety disorders, tokophobia may be associated with depression and post-traumatic stress disorder.<ref>{{cite web|last1=Hilpern|first1=Kate|title=Hard labour|url=https://www.theguardian.com/lifeandstyle/2003/may/28/familyandrelationships.health|website=theguardian.com|access-date=13 December 2015|date=28 May 2003}}</ref> Recognition of tokophobia and close liaison with obstetricians or other medical specialists can help to reduce its severity and ensure efficient treatment.<ref>{{cite book|last1=Roland-Price|first1=Anna|last2=Chamberlain|first2=Zara|editor1-last=Karoshi|editor1-first=Mahantesh|editor2-last=Newbold|editor2-first=Sandra|editor3-last=B-Lynch|editor3-first=Christopher|display-editors = 3 |editor4-last=Keith|editor4-first=Louis G.|title=A Textbook of Preconceptional Medicine and Management|date=2012|publisher=Sapiens Publishing Ltd|location=UK|isbn=978-0-9552282-4-7|pages=281–288|url=https://www.glowm.com/pdf/section4_chapter21.pdf|access-date=13 December 2015|chapter=Management of tocophobic women}}</ref><ref>{{YouTube|kkDbRj4IgE0|"Fear of Childbirth, Lecture by Astrid Osbourne, Consultant Midwife"}}</ref> Perinatal psychologists emphasise the importance of listening, validating, exploring, and tailoring interventions, as well as multiprofessional engagement and cooperation in treating tokophobia.<ref>{{Cite journal |last1=Rondung |first1=Elisabet |last2=Lier |first2=Emma |last3=Ternström |first3=Elin |title=Psychologists' experiences of working with fear of childbirth: implications and advice for care providers |url=https://doi.org/10.1080/02646838.2024.2415106 |journal=Journal of Reproductive and Infant Psychology |date=2024 |volume=0 |pages=1–15 |doi=10.1080/02646838.2024.2415106 |issn=0264-6838 |pmid=39404475}}</ref>
==Cause== Reasons for tokophobia can be complex, and are associated with a lack of social support, and with stress, depression and anxiety.<ref name="dx.doi.org"/>
== Risks == Unaddressed tokophobia may lead to a prolonged labour and complications during childbirth. Tokophobia is also associated with postpartum depression and post-traumatic stress disorder (PTSD).<ref name=":1" />
==Terminology== The term tokophobia was introduced in the medical literature in 2000.<ref name=BJP2000/> The word is from the Greek ''tokos'', meaning childbirth and ''phobos'', meaning fear.<ref name=BJP2000/>
It is also known as "maieusiophobia" (though this is certainly a variant of "maieusiophobia", from the Greek "maieusis", literally meaning "delivery of a woman in childbirth"<ref>{{cite web|title=maieusis|url=https://www.perseus.tufts.edu/hopper/morph?l=maieusis&la=greek#Perseus:text:1999.04.0058:entry=mai/eusis-contents|website=www.perseus.tufts.edu|access-date=13 December 2015}}</ref> but referring generally to midwifery), "parturiphobia" (from Latin ''parturire'', meaning "to be pregnant"), and "lockiophobia".<ref>{{cite book|last1=Bainbridge|first1=David|title=Making Babies: The Science of Pregnancy|date=2001|publisher=Harvard University Press|location=Cambridge|isbn=0674006534|page=214}}</ref>
==See also== * Anxiety disorder * List of phobias * Blood-injection-injury type phobia * Psychiatric disorders of childbirth
==References== {{Reflist}} * Erickson NL, Gartstein MA, Dotson JAW. Review of Prenatal Maternal Mental Health and the Development of Infant Temperament. J Obstet Gynecol Neonatal Nurs. 2017 Jul-Aug;46(4):588-600. * Lyberg A, Dahl B, Haruna M, Takegata M, Severinsson E. Links between patient safety and fear of childbirth - A meta-study of qualitative research. Nursing Open 2019;6:18-29 * Moghaddam Hosseini V, Nazarzadeh M, Jahanfar S. Interventions for reducing fear of childbirth: A systematic review and meta-analysis of clinical trials. Women and Birth 2017;31(4):254–62. * Nilsson C, Lundgren I, Karlström A, Hildingsson I. Self-reported fear of childbirth and its association with women's birth experience and mode of delivery: a longitudinal population-based study. Women and Birth 2012;25:114-121 * O'Connell M A, Leahy-Warren P, Khashan A S, Kenny L C, O'Neill SM. Worldwide prevalence of tochophobia in pregnant women: systematic review and meta-analysis. Acta Obstet Gynecol Scand. 2017;96:907-920. * Rondung E, Thomtén J & Sundin Ö. Psychological perspectives on fear of childbirth. Journal of Anxiety Disorders. 2016;44:80–91. * Rouhe H, Salmela-Aro K, Gissler M, Halmesmäki E, Saisto T. Mental health problems common in women with fear of childbirth. British Journal of Obstetrics and Gynaecology 2011; 118:1104-1111. * Striebich S, Mattern E, Ayerle G M. Support for pregnant women identified with fear of childbirth (FOC)/tokophobia – A systematic review of approaches and interventions. Midwifery, 2018, Vol. 61, pp. 97–115 * SFOG. (Svensk förening för Obstetrik och Gynekologi [Swedish Society of Obstetrics & Gynecology]. Förlossningsrädsla [Childbirth fear]. Report No: 77. Stockholm: 2017. * Van den Bergh B R H, Mulder E J H, Mennes M, Glover V. Antenatal maternal anxiety and stress and the neurobehavioural development of the fetus and the child: links and possible mechanisms. A review. Neuroscience and biobehavioral reviews, 2005, Vol. 29 (2), pp. 237–258 * Webb R, Bond R, Romero-Gonzalez B, Mycroft R, Ayers S. Interventions to treat fear of childbirth in pregnancy: a systematic review and meta-analysis. Psychological medicine. 2021;51(12):1964-1977.
==External links== {{Wiktionary|tokophobia}} * [https://www.nct.org.uk/pregnancy/how-you-might-be-feeling/tokophobia-how-get-over-extreme-fear-giving-birth Tokophobia: scared of giving birth?] {{Webarchive|url=https://web.archive.org/web/20220706064643/https://www.nct.org.uk/pregnancy/how-you-might-be-feeling/tokophobia-how-get-over-extreme-fear-giving-birth |date=2022-07-06 }} * [https://theconversation.com/tokophobia-what-its-like-to-have-a-phobia-of-pregnancy-and-childbirth-91271 Tokophobia: what it’s like to have a phobia of pregnancy and childbirth]
Category:Pathology of pregnancy, childbirth and the puerperium Category:Phobias