A guide to tokophobia

Mental Health

Bringing a child into the world is a huge responsibility and can be a daunting prospect, but for some women the anxiety around becoming a mum runs much deeper. Tokophobia, an extreme fear of pregnancy and childbirth, is debilitating and can influence the way women choose to give birth – or even put them off pregnancy altogether…

Studies show that up to three-quarters of women may struggle with anxiety when pregnant, but a much smaller minority experience this in the form of tokophobia. A crippling fear of pregnancy and childbirth can take two forms: primary tokophobia (where women who have not previously experienced pregnancy have a fear of either getting pregnant or giving birth), or secondary tokophobia (which develops in those who have already given birth).

While the data may suggest tokophobia is relatively rare, psychotherapist Natasha Crowe sees many women with it.

“It’s more common than you might think. Often clients present with varying degrees of fear and anxiety,” Natasha says. “Some worry about becoming pregnant and the inevitable birth, so many avoid pregnancy or put it off for years.”

Dr Ellie Rayner, an obstetrician, gynaecologist and founder of The Maternity Collective agrees: “Tokophobia is one of the most common reasons we see low-risk pregnant women in the hospital antenatal clinic. In both forms, women can experience high levels of anxiety and depression, and therefore it’s really important it’s recognised and treated as soon as possible.”

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Primary tokophobia

A study published in Industrial Psychiatry Journal found that around 13% of non-pregnant women reported they had tokophobia severe enough for them to avoid or postpone pregnancy altogether. And to be clear, this isn’t simply a case of not wanting to have children, but an extreme fear of pregnancy and labour itself. Often this phobia can exist from childhood and the triggers vary, but are usually related to the stories we see and hear about giving birth.

“Our imaginations are a powerful tool, and when birth is often framed with language which is so negative, our minds subconsciously want to avoid discomfort or pain – it’s natural human survival,” explains psychotherapist Natasha.

This happened to Louise Walsh, who developed tokophobia after seeing her mum give birth to her brother, when she was aged 10.

“I heard her screams and saw her in so much pain,” explains Louise, a registered dermatology and cosmetic nurse, and founder of theskinnurse.co.uk.

Louise’s fears escalated as she grew older, until she fell pregnant unexpectedly. “From four weeks onwards I dealt with anxiety and sleepless nights until I was diagnosed with tokophobia. I was booked in for an elective C-section that allowed me to relax somewhat, but I was still very nervous of going into natural labour, and my fear hasn’t gone away since having a child.”

Booking an elective caesarean can ease worries about childbirth, but it’s worth noting that this isn’t always a solution. For some, the fear is so extreme that they are too afraid to get pregnant in the first place, and may even avoid watching television programmes that involve pregnancy in any way.

Mum-of-one Rachel Allen, who runs Making Business Social, was desperate to start a family, but just couldn’t contemplate pregnancy. “I’ve never felt that birthing ‘naturally’ was something I could do. The thought of ripping or tearing makes me feel physically sick, so I had a year’s worth of cognitive behavioural therapy (CBT) which helped me get to a point where I could tolerate the thought of a pregnancy. Part of my treatment was to watch shows such as One Born Every Minute,” she explains.

Rachel was eventually referred to a consultant who supported her in having a C-section. “The birth through elective caesarean was excellent, obviously not pleasant, but I was comfortable and happy with my choice. Without that, I would not be mum to my beautiful funny boy today.”

Secondary Tokophobia

Usually developed after a traumatic birth experience, secondary tokophobia is thought to be more common than primary tokophobia. For mum-of-two Stina Cannon, secondary tokophobia developed after a painful 12-hour labour with her first child, which impacted on her husband, too.

“I knew I wanted another child, but it took me six years to get over my first experience, and my husband was still mentally scarred,” says Stina, who runs Juste Nature Skincare.

Mum-of-three Jenna Lockwood, went through a similar experience after not being allowed pain relief with her second child. When she fell pregnant again, tokophobia paralysed her.

“The week before giving birth, I went to the hospital hysterically crying saying I couldn’t do it!” she explains. Jenna believes her tokophobia made her so stressed that it stopped her body going into natural labour, forcing her to be induced – which then resulted in a stressful third birth experience.

“Women with tokophobia can often feel very disconnected from their own bodies; the fear can feel very physical and frightening,” explains psychotherapist Natasha Crowe. “But working with a therapist or a hypnobirthing practitioner can really help the individual explore their concerns and worries.”

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How to overcome tokophobia

The good news is that tokophobia can be treated, and there are numerous support options available – so the sooner it can be diagnosed, the better. The following five essential tips may be a useful starting point…

Get a proper diagnosis.

It’s important to separate tokophobia from general pregnancy anxiety in order to be taken seriously. Try to spell out just how much it is affecting you to your GP or midwife as soon as you can.

“It’s important to know that even if you are fearful of childbirth, you will be listened to and supported in whichever way you need to be to ensure you have a healthy pregnancy and positive start to motherhood,” adds Dr Ellie Rayner.

Consider CBT.

This can be useful to help you change the negative thought processes you might have around childbirth and pregnancy, as well as challenging the faulty thought patterns you might have developed from a traumatic event or from hearing other people’s birth stories.

Find a support group.

A supportive antenatal group or pregnancy yoga class may give you some practical strategies, and allow you to feel more in control of your body during labour.

“Relaxation is so important when it comes to pregnancy hormones and reducing stress. Pregnancy yoga and relaxation classes are great for helping with physical tension and stress,” says psychotherapist Natasha.

Create some helpful pregnancy affirmations.

Practising pregnancy affirmations can also help to manage stress and anxiety. This may even help reduce some of the fear and pain you experience in childbirth. Why not try affirmations such as “My body knows exactly how to do this,” and “Birth is completely safe for me and my baby.”

Learn about positive birth experiences.

We only tend to read about worst-case scenarios, so why not open your mind and learn about positive experiences. The Facebook group Positive Birth Community is designed for women to share empowering birth stories.

There is no doubt that tokophobia is a very real phobia. However, early diagnosis, counselling, and working with your medical team can all help to reframe pregnancy and childbirth in a more positive way.


Natasha Crowe provides one-to-one counselling, psychotherapy, and hypnotherapy for those struggling with anxiety, bereavement, confidence, phobias, and perinatal and postnatal issues. Find out more and get in contact with Natasha via counselling-directory.org.uk

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