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Tokophobia: an unreasoning dread of childbirth. A series of 26 cases
1Queen Elizabeth Psychiatric Hospital, Birmingham. kristina.hofberg@virgin.net
Background:
Some women dread and avoid childbirth despite desperately wanting a baby. This is called tokophobia.
Aims:
To classify tokophobia for the first time in the medical literature.
Method:
Twenty-six women noted to have an unreasoning dread of childbirth were interviewed by the same psychiatrist, who was not the treating doctor. A qualitative analysis of these psychiatric interviews was performed.
Results:
Phobic avoidance of pregnancy may date from adolescence (primary tokophobia), be secondary to a traumatic delivery (secondary tokophobia) or be a symptom of prenatal depression (tokophobia as a symptom of depression). Pregnant women with tokophobia who were refused their choice of delivery method suffered higher rates of psychological morbidity than those who achieved their desired delivery method.
Conclusions:
Tokophobia is a specific and harrowing condition that needs acknowledging. Close liaison between the obstetrician and the psychiatrist in order to assess the balance between surgical and psychiatric morbidity is imperative with tokophobia.