Tokophobia - Paula's story

Figuring out I had tokophobia

I have been terrified about the prospect of pregnancy and childbirth for as long as I can remember, due to fears around pain, needles and losing control.

But it wasn’t until a few years ago that I realised my level of anxiety was abnormal.

If someone started talking about labour or birth I would feel overwhelming panic, on the verge of tears and an intense need to escape the situation. A friend who is a midwife explained that I had tokophobia – an abnormally severe anxiety or phobia about some or all aspects of pregnancy or birth.

She assured me that on this basis it should be possible to request a caesarean and so, as friends around me started to have children, my own desire for kids began to somewhat outweigh my fear and my husband and I decided to try for a baby.

I fell pregnant quickly, but - staring at the little blue line on the test - we both felt more fear and dread than excitement over the rollercoaster that lay ahead.

My booking appointment

At my first midwife appointment, I was initially seen by a student midwife. This triggered intense panic in me and as I began crying hysterically, the student quickly sent for her mentor. Although this situation was a very distressing start to my maternal care, it quickly brought the issue of my anxiety to the fore and demonstrated the level of it to the midwife, meaning that she took my request for a c-section seriously and referred me straight away to a sympathetic consultant to talk it through further.

Thankfully, the consultant was understanding of my situation and agreed to a caesarean without argument.

At around 16 weeks, I was diagnosed with a pulmonary embolism (blood clots in my lungs). I had to start having daily injections and monthly blood tests to prevent further clots and I needed to attend countless hospital appointments to ensure that both baby and I remained healthy for the remainder of the pregnancy.

This led to a huge increase in my anxiety due to my fear of needles, as well as being strongly advised against a caesarean due to increased risk of blood clots (which I chose to go ahead with regardless). In addition, I was seeing numerous different health professionals, some of whom were sympathetic to my anxieties, and others who were less sensitive or simply too busy to understand it.

Facing my fears

Although this made my pregnancy considerably more stressful, it also brought benefits. I made huge headway in facing my fear of needles using ‘exposure therapy’, going from being unable to even look at the syringe to being able to inject myself!

I also became much more familiar with and confident in hospital environments and learned a lot about the exact triggers of my anxiety and how to manage them.

I wrote a short explanation of my anxiety, its triggers and how people could help me manage it, and asked any new medical staff to read it before dealing with me.

Before exposing myself to any potentially ‘high risk’ situation (for example, tour of delivery suite, prenatal pilates class, NCT class, visiting a friend with a newborn etc.), I also contacted relevant people in advance to explain my situation and triggers.

Implementing these strategies meant that by the time my caesarean came around, although still nervous, I was the calmest and most confident I had felt throughout the pregnancy. I felt much more in control of the care I would receive.

My 5 top tips for coping with tokophobia and anxiety

1. Be open with your partner and a few close friends/family members

I found it helpful to send close friends a link to read about tokophobia to help them understand that it was different from normal anxiety about labour.

2. If you have questions, avoid googling or reading forums

They are an anxiety-inducing minefield! Speak to your midwife or ask some understanding friends who have had children.

3. If you don’t feel taken seriously by your midwife or consultant, request (and fight if necessary!) to change to a different one

4. Don’t be afraid to ask for students or other unnecessary staff to leave

5. Be proactive in finding out and accessing what support is available on the NHS

This may involve a lot of phone calls as your community midwife may forget or be unaware of what’s available. For example, I saw a mental health specialist midwife, tried hypnobirthing, did a tour of the delivery suite theatre and postnatal ward, and attended a special clinic for pregnant women who were anxious about birth.

Find out more about tokophobia

Find out more about anxiety in pregnancy