Parturiphobia or tocophobia is the pathological fear of labour . Far from being an isolated experience, parturiphobia is a fairly common phenomenon among women of reproductive age. For this reason, several psychiatric and psychological studies have addressed it.

Below we explain how parturiphobia is defined, what types exist and how it is usually treated.

What is parturiphobia?

Parturiphobia is the pathological fear of childbirth. It is also known as tocophobia, which comes from the Greek “tokos” meaning “birth”. It has recently been described in terms of pathology, however, it is an experience that has accompanied many women over time.

Parturiphobia has at its core an uneasiness caused by the contradiction between the expectation of being a biological mother and the desire not to be one . For the same reason, parturiphobia is considered a multidimensional phenomenon that involves biological as well as psychological and social factors.

This phobia has had important consequences on the morbidity of pregnant women and also on the development of the children, so it is a phenomenon that needs to be studied and worked on from different areas.

Irrational Fear of Childbirth: A Pioneering Study

Psychiatrists Kristina Hofberg and Ian Brockington have been two of the main references in the description of parturiphobia. In 2000 they conducted a qualitative study with 26 women who had an apparently unjustified fear of childbirth.

These authors have defined this phenomenon as a phobic state characterized by a specific anxiety or fear of death during childbirth that precedes pregnancy , and which leads to avoiding labor by all possible means, even when the woman intensely desires to have a baby.

The study they conducted was with 26 women between the ages of 24 and 41, who were referred by obstetricians and psychiatrists from different hospitals in England. Some of them were married, others were not, most of the women had children without disabilities.

The women had given birth and experienced depressive episodes, anxiety disorders or post-traumatic stress disorders. They had been under the care of a psychiatrist for approximately two years.

They were interviewed using an unstructured guide that focused on knowing the women’s life history related to their sexuality, their obstetric history (which included past pregnancies, the possibility of abusive experiences and the use of contraceptive methods).

Through the interviews, the researchers found similarities in the women’s experiences and fear of childbirth. Some reasons found behind parturiphobia are the fear of dying during labour, the expectation of unknown pain or suffering, the memory of pain from previous births, among others.

Types of parturiphobia

As part of the results of their study, Kristina Hofberg and Ian Brockington divided the manifestations of parturiphobia into two types: primary tocophobia and secondary tocophobia.

They also concluded that tocophobia can be considered not as a clinical picture in itself but as one of the symptoms of prenatal depression , generally caused by the woman’s belief that she is not capable of going into labour, at least without dying in the attempt.

Primary parturiphobia

Primary tocophobia is when the fear of childbirth begins before pregnancy, even in the teenage years. In this case, sexual relations are usually carried out normally, i.e. without abuse, and different contraceptive methods are regularly used.

Usually, despite the fear they feel, the pregnancy is planned and carried out, which can aggravate the experience until it becomes a phobia. Women describe motherhood as a reason for being and have an overwhelming desire to be mothers , where the need to avoid pregnancy and childbirth is combined with the demand and expectation of being a mother.

Some of the means by which they have assuaged this fear has been through scheduled cesarean sections or terminations.

Secondary parturiphobia

Secondary tocophobia is that which occurs after a traumatic or significantly stressful experience. In other words, it is the phobia of having had an unpleasant experience in a previous birth. For example, severe labor pains, perineal tearing, complications of labor due to fetal distress.

Around these experiences women have expressed that they thought they or the baby would die. In spite of this, many women seek another pregnancy, sometimes under the idea that the family is incomplete (for example, to give a brother to the only child).

In many of these cases there have been miscarriages , abortions carried out for medical needs, induced abortions, or programmed caesarean sections, which has produced relief for the women.

Also, several of the women began a process of sterilization after delivery and some women who completed the pregnancy showed symptoms of post-traumatic stress, and even some difficulties in establishing care bonds with their children.

Some approaches

Parturiphobia is currently one of the major fields of psychiatric and psychological research , which has resulted in the development of specific psychotherapies that decrease the negative birth experience.

Likewise, the contradictions generated by motherhood (especially biological) as a sometimes overwhelming demand have been addressed from different perspectives of psychology and other social sciences. In any case, it is a topic that has gained relevance in the last two decades and that can generate very important knowledge for women and reproductive activity.

Bibliographic references:

  • Bilert, H. (2007). Tokophobia – a multidisciplinary problem. Ginekologica, 78(10): 807-811.
  • Hofberg, K. & Brockington, I. (2000). Tokophobia: an unreasoning dread of childbirth. 176: 83-85.
  • Singh, M. & Jhanjee, A. (2012). Tokophobia: A dread of pregnancy. Industrial Psychiatry Journal, 21(2): 158-159.