When fear takes over in pregnancy
11 January 2002
By Deirdre Lee
Hearing that labor is like “every bone in your body is breaking” does little
to alleviate apprehensions about childbirth. But what if understandable
reservations develop into a dread of such proportions that a woman postpones or
avoids pregnancy altogether?
And what if, in cases where a woman does conceive, she tries to jeopardize the
pregnancy with excessive alcohol or drug abuse, or resorts to an abortion?
Fear of pregnancy or giving birth is called tokophobia. It’s not well known
– details of the phobia were only published in the British Journal of
Psychiatry in January 2000. But according to research reported recently in The
Observer the condition may affect a high proportion of women.
The study, conducted by Dr Kristina Hofberg, the UK’s leading expert on the
syndrome, discovered that, when pregnant for the first time, one in five women
reported extreme fear of childbirth and 6 per cent reported a fear that was
“disabling”.
Nicky Lidbetter, senior manager at the National Phobics Society, says the
society gets five calls a week from women with the condition but suspects the
problem is more widespread than that.
Women affected tend to have a history of underlying generalized anxiety, says
Nicky. Also, women who experience panic attacks might worry that their attacks
will get out of control if they become pregnant, causing the panic to spiral.
Fear of losing control and fear of the unknown seem to be major contributing
factors.
There are different degrees of the syndrome, says Nicky. “We speak to people
here who are at the severe end, who do actually everything possible to stop
themselves ever becoming pregnant,” she says.
“We have quite a lot of women who have had several abortions because they just
cannot cope with the level of anxiety and panic they are experiencing as a
result of becoming pregnant.”
Women who go to such lengths should obviously seek counseling for their
condition. But Nicky says she is worried the support for such women isn’t
available in the NHS – that midwives and GPs are not alerted to the condition
and mental health and midwifery services aren’t joined up.
Melanie Every, of the Royal College of Midwives, disputes this, saying there are
psychotherapists and counselors available at maternity units who could see women
with concerns. But she notes that women may have to take some initiative in
seeking out help.
Melanie also says the high figures for tokophobia may not be a true reflection
of the situation. “I think we have to be very careful over what we call a
phobia and what we call a fear of labor,” she says. “There are women who are
naturally concerned, but women experiencing tokophobia, that is actually fairly
rare.”
Midwives may not know the full figures because they don’t see all of the cases
– after all, these women do not become pregnant and therefore do not require
midwife assistance. “But on the other hand, birth rates aren’t dropping to
such an extent that would lead you to think there are all these women who are
terrified of becoming pregnant.”
Part of the problem lies with women’s isolation from pregnancy these days,
Melanie says. “Of course, an awful lot of women who become pregnant today have
had no contact with anybody who’s had babies.”
And the portrayal of childbirth in dramas is always painful and traumatic, she
says. “If that is the only experience that women have of childbirth, then that
is going to be their image.”
Further information:
National Phobics Society
www.phobics-society.org.uk
Royal College of Midwives
www.rcm.org.uk
© Health Media Ltd 2002
http://www.health-news.co.uk