Tokophobia

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Tokophobia
Other namesTocophobia, maieusiophobia, parturiphobia
TreatmentCounselling[1]
Frequency~14% of pregnant women[2]

Tokophobia is a significant fear of childbirth.[1] It is a common reason why some women request an elective cesarean section.[3] Factors often include a fear of pain, death, unexpected problems, injury to the baby, sexual problems and a lack of self-belief of the capacity to birth a child.[4] Treatment may occur via counselling.[1]

It is a type of specific phobia. In 2000, an article published in the British Journal of Psychiatry described the fear of childbirth as a psychological disorder that has received little attention and may be overlooked.[5]

Signs and symptoms

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Phobia of childbirth, as with any phobia, can manifest through a number of symptoms including nightmares, difficulty in concentrating on work or family activities, panic attacks and psychosomatic complaints.[6] Often the fear of childbirth motivates a request for an elective caesarean section.[3] Fear of labor 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 phobia and anxiety disorders, tokophobia may be associated with depression and post-traumatic stress disorder.[7] Recognition of tokophobia and close liaison with obstetricians or other medical specialists can help to reduce its severity and ensure efficient treatment.[8][9] Perinatal psychologists emphazises the importance to listen, validate, explore, and tailor interventions as well as a multiprofessional engagement and cooperation in treating tokophobia.[10]

Cause

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Reasons for tokophobia can be complex, and are associated with a lack of social support, and with stress, depression and anxiety.[3]

Risks

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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).[6]

Terminology

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The term tokophobia was introduced in the medical literature in 2000.[5] The word is from the Greek tokos, meaning childbirth and phobos, meaning fear.[5]

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"[11] but referring generally to midwifery), "parturiphobia" (from Latin parturire, meaning "to be pregnant"), and "lockiophobia".[12]

See also

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References

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  1. ^ a b c Wax, JR; Cartin, A; Pinette, MG; Blackstone, J (August 2004). "Patient choice cesarean: an evidence-based review". Obstetrical & Gynecological Survey. 59 (8): 601–16. doi:10.1097/01.ogx.0000133942.76239.57. PMID 15277895. S2CID 21956472.
  2. ^ O'Connell, Maeve A.; Leahy-Warren, Patricia; Khashan, Ali S.; Kenny, Louise C.; O'Neill, Sinéad M. (2017). "Worldwide prevalence of tocophobia in pregnant women: systematic review and meta-analysis". Acta Obstetricia et Gynecologica Scandinavica. 96 (8): 907–920. doi:10.1111/aogs.13138. hdl:10468/4050. ISSN 0001-6349. PMID 28369672.
  3. ^ a b c Dencker, Anna; Nilsson, Christina; Begley, Cecily; Jangsten, Elisabeth; Mollberg, Margareta; Patel, Harshida; Wigert, Helena; Hessman, Eva; Sjöblom, Helen; Sparud-Lundin, Carina (2019). "Causes and outcomes in studies of fear of childbirth: A systematic review". Women and Birth. 32 (2): 99–111. doi:10.1016/j.wombi.2018.07.004. ISSN 1871-5192. PMID 30115515.
  4. ^ SYDSJÖ, GUNILLA; SYDSJÖ, ADAM; GUNNERVIK, CHRISTINA; BLADH, MARIE; JOSEFSSON, ANN (2011-10-10). "Obstetric outcome for women who received individualized treatment for fear of childbirth during pregnancy". Acta Obstetricia et Gynecologica Scandinavica. 91 (1): 44–49. doi:10.1111/j.1600-0412.2011.01242.x. ISSN 0001-6349. PMID 21787365.
  5. ^ a b c Hofberg, Kristina; Brockington, I. F. (1 January 2000), "Tokophobia: an unreasoning dread of going to the toilet", British Journal of Psychiatry, 176 (1): 83–85, doi:10.1192/bjp.176.1.83, PMID 10789333, retrieved 4 February 2017 – via bjp.rcpsych.org
  6. ^ a b Waldenström, U; Hildingsson, I; Ryding, EL (2006-05-18). "Antenatal fear of childbirth and its association with subsequent caesarean section and experience of childbirth". BJOG: An International Journal of Obstetrics & Gynaecology. 113 (6): 638–646. doi:10.1111/j.1471-0528.2006.00950.x. ISSN 1470-0328. PMID 16709206.
  7. ^ Hilpern, Kate (28 May 2003). "Hard labour". theguardian.com. Retrieved 13 December 2015.
  8. ^ Roland-Price, Anna; Chamberlain, Zara (2012). "Management of tocophobic women". In Karoshi, Mahantesh; Newbold, Sandra; B-Lynch, Christopher; et al. (eds.). A Textbook of Preconceptional Medicine and Management (PDF). UK: Sapiens Publishing Ltd. pp. 281–288. ISBN 978-0-9552282-4-7. Retrieved 13 December 2015.
  9. ^ "Fear of Childbirth, Lecture by Astrid Osbourne, Consultant Midwife" on YouTube
  10. ^ Rondung, Elisabet; Lier, Emma; Ternström, Elin (2024). "Psychologists' experiences of working with fear of childbirth: implications and advice for care providers". Journal of Reproductive and Infant Psychology. 0: 1–15. doi:10.1080/02646838.2024.2415106. ISSN 0264-6838. PMID 39404475.
  11. ^ "maieusis". www.perseus.tufts.edu. Retrieved 13 December 2015.
  12. ^ Bainbridge, David (2001). Making Babies: The Science of Pregnancy. Cambridge: Harvard University Press. p. 214. ISBN 0674006534.
  • 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.
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