Understanding Tokophobia: The Fear Of Pregnancy

The pathological fear of pregnancy, Tokophobia affects around 14% of women. Yet despite being a very real and potentially debilitating condition, it is often disregarded by both the media and the general public.

Jordan Davis, however, knows all too well just how real the condition is. In 2016 she became a newly qualified midwife and started working at The Royal Free Hospital. Prior to this, she spent 2 and a half years in challenging training, working in delivery suites, the local community and at home births.

Since the start, she tells me while taking a break from her shift on the post-natal ward, Jordan has seen tokophobia take a firm hold many a time.

“Even when I very first started working in the community, I was assigned some women to look after who were totally set against vaginal births. Others didn’t want to give birth, or be pregnant altogether, in spite of the fact that they already were.”

Tokophobia has received increased coverage in the media in recent years. Earlier this year, Catriona Jones, senior research fellow in maternal and reproductive health and lecturer in midwifery at the University of Hull, was misquoted in the Guardian as saying that there had been a rise in the number of women suffering from the condition. This was attributed, in part, to scary stories being shared online and via social media.

She later clarified in the Independent that her research had infect found that online birth stories could have both a cathartic and negative effect. “We were never saying that social media causes tokophobia, and we’re not telling women to stop telling their stories,” she added.

This is just one example of stigmatised thinking of the condition, and how it manifests.

Tokophobia takes two distinct forms. The term primary Tokophobia is assigned to women who have no prior experience of pregnancy. Secondary Tokophobia refers to a condition experienced by women who have suffered a traumatic prior pregnancy.

Jordan has worked with women with both primary and secondary tokophobia, each of who have varying reasons for their fears. In some cases, a mother is overwhelmed by the fear that her body will not be able to deliver her baby naturally.

“Some are convinced that their pelvis will not be wide enough, and that this will cause the baby to become trapped. It’s an understandable fear as an obstructive labour may end in an instrumental delivery by doctors, via forceps or ventouse, which can be painful. If these don’t work, an emergency caesarean may be booked.”

As a result of this fear, some women insist on having a C-section at their very first appointment with Jordan. For some, physical problems or even a history of sexual abuse can be the reason why a non-vaginal birth is requested.

Yet Jordan is keen to stress that for many women, overcoming their fear and having a natural vaginal birth is in many ways preferable.

“C-sections can lead to infections, urinary incontinence and ongoing pain after the birth. It also makes you higher risk for future births, as the healing process can result in thick scar tissue. Lots of women are afraid of tearing, and some do, but in fact, many don’t.”

It seems, then, that the fact that a C-section is in fact major abdominal surgery, and not simply an easy way to give birth, is sometimes forgotten.

Myths around how hard it is to be assigned a C-section also exist.

“It is often reported in the media that lots of women are denied C-sections, but that’s not true. Any woman I am assigned who presents a legitimate fear of birth and asks for a C-section would be referred to a consultant obstetrician or consultant midwife to discuss further.”

If a woman does not need referring to an individual in these roles in order to overcome their fears, Jordan can offer her own forms of support.

As a midwife, Jordan’s role is not just the birth itself, but also a great deal of the before and after.

“Time and again, whether I meet women in the hospital or out in the community, women tell me that they fear not being in control. So, I help to prepare them for labour as best I can.”

This preparation can consist of multiple different elements, Jordan explains.

“Firstly, I am very frank with them about certain realities.”

While the movies make the induction process look like it lasts a couple of hours, Jordan says it can fact take up to three days.

Interestingly, Jordan somewhat resents birth plans, and insists that mothers getting too hooked on them is a bad thing.

“Birth plans are necessary in some ways, as it is useful for midwives and doctors to know preferences,” Jordan explains. “For instance, they will need to know how the mother wants the placenta delivered, and deciding this in advance makes life easier for everyone.”

However, there are other elements that women insist upon that simply aren’t realistic.

“Some women will say I definitely do want this and I definitely don’t want that. I’ve had women saying they don’t even want people talking in the room. That just isn’t realistic.”

However, recognises that often, mothers act in this way in an attempt to regain some control. Knowing this helps her to help them.

“I, therefore, work with mothers on being less close-minded, by resetting their expectations in a gentle but firm way,” she explains. “So, for example, in this scenario I might explain why midwives and doctors will need permission to talk during the delivery, in order to keep communication open and the baby and mother safe.”

As if coaching mothers through the journey of childbirth wasn’t work enough, Jordan has recently been able to add the title ‘entrepreneur’ to her CV where she is a consultant for the creation of the natural mother and baby skincare range Curate Babies.

“It’s a range of products with natural ingredients, no parabens and entirely vegan-based. The product range includes nappy rash cream, bathtime and body lotions, plus items for the mother, such as stretch mark cream,” Jordan explains.

Jordan, who has Jamaican and Guyanese heritage, was excited to participate in the creation of of the, because to her knowledge of the natural herbs and spices used in daily remedies and medicines in these countries.

“My heritage has meant, that I have come to learn the importance of natural remedies for skin and hair care as well as basic cures for ailments,” she adds.

Speaking on her ongoing role as a midwife, Jordan is keen to keep correcting the myths that surround pregnancy, childbirth and specifically, tokophobia. With all of that tenacity and knowledge, she should have no problem at all.