Tokophobia, or fear of pregnancy

Where does tokophobia come from?

If you study well, you will go to a good university, unless you fail!

Kowalska's daughter walks with a belly, who would have thought she was such a tramp. And her mother - instead of watching her - went to work at night.

You're not stupid, so maybe you won't get pregnant and waste your life.

This dating thing will land you in a single mother's home someday.

These types of aggressive and disgusting comments about pregnancy are often fired like a machine gun by random people around you. As a child or teenager, you can ignore them (even though they wreak havoc on an unimaginable scale), care about them , or – even worse – believe them . You grow up believing that pregnancy is a blessing only if you have a college degree, a husband, and a good job.

What's next?

Let's say you meet the right person. A candidate for all kinds of lovemaking. Kisses, caresses... STOP.

Suddenly your head goes crazy. You feel a strong fear, the atmosphere of closeness disappears.

What is happening? Perhaps this is the first experience of closeness and the tension in your body is so great that your thoughts are racing. Or perhaps what you are feeling is a fear of pregnancy . A fear rooted in long ago that is now bearing fruit.

It's not uncommon for people with a uterus to have a fear of pregnancy and childbirth. As long as it doesn't get out of hand.

Tokophobia – what is it?

Tokophobia is a fear of childbirth and pregnancy, which most often has a neurotic basis and may be primary or secondary .

Primary tokophobia

Primary tokophobia affects people who have never been pregnant, for example as a result of traumatic sexual experiences - such as rape or molestation - or as a result of hearing stories from other people (or even one's own mother) after a dramatic birth.

Interestingly, it happens that primary tokophobia prevents pregnancy . However, if "caught" early enough, it gives a chance to minimize the symptoms, which would allow pregnancy and its normal course. The most important thing here is therefore psychotherapy .

As supporting methods, relaxation and desensitization method are mentioned (desensitization, desensitization). In extreme cases, pharmacology is used .

Unfortunately, reporting to a doctor with symptoms of tokophobia in the third trimester of pregnancy does not give you much room to maneuver when it comes to dealing with the problem. That is why it is so important to be aware of the possibilities related to relieving the symptoms.

Lack of improvement after psychotherapy is a contraindication to natural childbirth. Many people use this information to "get" a caesarean section by simulating tokophobia (which is not easy at all!), but there are also people who want to face natural childbirth, leaving themselves a loophole in the form of a caesarean section if natural childbirth turns out to be too much of a challenge for the psyche and body.

Secondary tokophobia

Secondary tokophobia, on the other hand, develops in people who have personally experienced complications during their first childbirth, or as a result of the shock associated with it.

It is worth emphasizing that, firstly, symptoms of tokophobia can occur not only in people after a dramatic delivery or stillbirth, but also after a completely normal delivery . Secondly, both symptoms of tokophobia before another delivery and panicky, pathological fear in people during their first pregnancy are natural .

The symptoms of tokophobia usually increase with the duration of pregnancy, and are particularly pronounced in the third trimester, and are often associated with postpartum depression .

Symptoms of tokophobia

• pressure surges,
• diarrhea,
• hyperemesis gravidarum,
• abdominal pain,
• shortness of breath,
• appetite disorders,
• heart palpitations,
• headaches,
• lack of concentration and difficulty in performing activities requiring concentration and precision.

How do you distinguish between normal fear and anxiety about the course of labor, as well as fear of the unknown or pain, and tokophobia?

What matters is the strength of the fear and how it affects the life of the pregnant person (whether it disrupts normal functioning).

Panic anxiety triggers a stress response and activation of the hypothalamic-pituitary-adrenal axis (HPA axis). The body is in a constant state of high arousal.

They appear:

• bow,
• anxiety,
• nightmares,
• sleep disorders,
• somatic complaints and disturbing psychotic states that may make functioning difficult (for example tachycardia , i.e. accelerated heart rate).

A pregnant person often feels irritability , anxiety , helplessness , lack of control over the situation or their own life , but also fear of losing the strength necessary for giving birth . Characteristic are also dark thoughts concerning both the delivery and their own or the child's future, often also visions of the death of the child or the person giving birth .

All of this contributes to tokophobia – a panicky fear of childbirth.

Tokophobia can cause an obsessive need for contraception - people with this fear decide to use severalcontraceptive methods at the same time or simply give up sexual intercourse , even though they really want a child.

Severe symptoms of tokophobia are often the reason why pregnant people insist on a caesarean section - the awareness of "reliable" anesthesia during labor and the presence of numerous staff during the operation reduce the level of fear of childbirth.

Treatment for tokophobia

In the treatment of tokophobia, integrated support on many levels is important : both in terms of the pregnant person's immediate environment (partner, family and loved ones) and therapeutic work (cognitive-behavioral psychotherapy).

A very important element of dealing with tokophobia is constant contact with the obstetrician and midwife , i.e. people who know how to guide a given person through this difficult period of pregnancy, childbirth and the postpartum period .

Currently, the standard of perinatal care is attending a childbirth class , which also prepares future parents for their new role and reduces fear of the unknown. It is a chance not only to familiarize yourself with the course of the entire pregnancy , but also to practice labor or the first steps in caring for a newborn child . You can learn different ways of dealing with discomfort and talk to other parents about your fears or concerns.

Tokophobia is diagnosed by a psychiatrist . He or she may prescribe pharmacotherapy if the fear of pregnancy prevents a person from functioning normally or to stabilize mental health before trying for a child.

Can tokophobia lead to miscarriage?

In cases of severe tokophobia , a natural miscarriage may occur or the birthing person may decide to terminate the pregnancy (if the regulations of the given country allow it).

The brain is the source of our fear and it controls the entire organism, the central nervous system controls the peripheral system. It is important to be aware of the strong emotions we are dealing with. Emotions that influence the perception of reality and cause us to direct our own behavior in accordance with this distorted image.

Avoiding CC?

Although feigning tokophobia is a common ploy to obtain permission to deliver a cesarean section, it is not easy at all . However, detecting these real cases by a doctor is of great importance, because the lack of cooperation between the person giving birth and the staff during delivery can be tragic in its consequences. Fear paralyzes, eliminates the possibility of rational thinking and limits the ability to take quick action. For this reason, it is important that each problem during pregnancy is assessed individually , so that the person can share their concerns and receive the highest level of support. A pregnant person needs special care. In addition, it must be remembered that not every report of tokophobia symptoms is an attempt to force a cesarean section . If a person declares that natural childbirth is beyond their strength, they should be referred to a psychotherapist and psychiatrist for a possible diagnosis of tokophobia or diagnosis of a high level of anxiety that needs to be worked through during therapy.

How to fight tokophobia?

Psychotherapy and working on your own beliefs is definitely a great idea to organize your thoughts and worldview when rational arguments are not enough to calm the fear of pregnancy.

Conversation

And best of all, millions of conversations! Don't hide your fear from your partner. Try to normalize it together - after all, it's a real revolution for both of you. You have the right to feel a whole range of emotions, and fear is just one of them.

It is also worth emphasizing that talking to other people who have experienced childbirth can be helpful. It is therefore worth asking your mother, friend or even a midwife for help, to get first-hand information .

The first lesson of home-based family life education should include: knowledge of the menstrual cycle , calculation of fertile days , analysis of the fertilization process , pre-ejaculate and sperm viability .

Once you have organized your knowledge, talk about emotions . It is important to express your concerns and consider where they come from.

It is important that you both take responsibility for such an important decision and the possible consequences - because, as we know, contraception can be unreliable. You also need to decide together which one is most appropriate for you.

Giving up risky sexual behavior

If you are very afraid of getting pregnant, you cannot afford to be careless about contraception ( withdrawal coitus is NOT a method of contraception! ) or unaware of your own cycle.

Having sex under the influence of large amounts of alcohol is also not a good idea, because it increases the likelihood that something will go wrong (from putting the condom on incorrectly to vomiting up the contraceptive pill ) .

Late period and pre-pregnancy stress

Whoever hasn't calculated the potential date of a child's birth when their period is late , cast the first stone! :) Yes, I did it, as did many of my friends. And it's kind of great because it means you "take it on the chin". But if you're really worried about your late period and you're actually scared of a potential pregnancy, CALM DOWN ! Periods are late for many reasons: from stress or other strong emotions, to infections, to lack of sleep. So seriously, allow yourself to relax .

Maybe a bath? Or meet up with your friends and talk about it (just don't forget to wear white pants! :P). If that's not enough, take a test. Or three tests, if that helps. They say that a negative result is like glue for a late period.

You just have to remember that different tests have different sensitivities when it comes to detecting pregnancy . The most sensitive ones detect beta HCG from 7 days after intercourse, although this still does not give us a 100% guarantee.

Standard urine tests are done about 14 days after ovulation , which is around the time of your period, while blood tests detect pregnancy at the earliest, although there are cases of false negatives. Where does this confusion come from?

It all depends on whenovulation actually took place , when intercourse took place, and when fertilization occurred (as we know, both sperm and egg have their own viability – fertilization does not have to occur exactly during ovulation).

If all this does not convince you, you can always go to a gynecologist, talk about your concerns, ask for a referral for an examination and repeat it after some time.

Getting pregnant – it's not that easy

Fear of pregnancy can take away the pleasure of intimacy, but this is a mistake in thinking , consisting of the belief that pregnancy is something wishful . A state in which one can find oneself without the slightest effort, practically unintentionally. Meanwhile, infertility statistics are inexorable.

More and more people, regardless of gender, are struggling with infertility. When I was in high school or college, I was very afraid of pregnancy – until I heard from a doctor that I was currently unable to get pregnant. Two other doctors confirmed this. And everything changed! When I realized that I did not have the privilege of choosing to be or not to be pregnant, there was no trace of fear left. Have you ever thought about it this way?

How to support a person suffering from tokophobia?

Don't undermine or devalue feelings . Don't throw around slogans like: "oh, you're not the first and you won't be the last to give birth to a child"; "every woman dies of fear, and it's no big deal"; "women are afraid of childbirth, it's natural, get a grip" or "it used to be, now it's still great". Such reactions don't have a good effect on either self-esteem or your assessment of your parenting skills .

Much better in this situation will be accepting feelings and offering support : conversation, companionship in difficult moments or even care for the child after birth. These may be ordinary, natural fears about pregnancy and childbirth, or it may be tokophobia. Suggest consulting a specialist (preferably a psychotherapist) and... just be nearby .

Don't be afraid to be scared, cry when you want

… but never be alone with your emotions . You are in this together. And you have a solid support group #mensTRUEacja by Your KAYA . See you soon! :)

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S. Striebich, E. Mattern, GM Ayerle, Support for pregnant women identified with fear of childbirth (FOC)/tokophobia – A systematic review of approaches and interventions , "Midwifery" 2018, vol. 61, p. 97-115.