Tokophobia-Extreme Fear of Pregnancy and Birth and Implications for Care: A Case Report

The extreme or pathological fear of pregnancy and childbirth, also known as tokophobia, was first described in the mid-to-late 1800s but then rarely discussed in the literature until the turn of the 21st century. However, information remains scarce. Therefore, the goals of this case study are to describe the clinical presentation and management options of extreme fear of pregnancy and/or birth. The patient in our study is from the United States. She presented with tokophobia at her first prenatal appointment, requesting a cesarean surgery immediately, but experienced discontinuous care throughout her pregnancy. She became frustrated by the need to repeat her desire for a cesarean surgery and eventually was verbally disruptive at her 38-week visit, crying and yelling at providers and staff. If this patient had received continuous care and earlier intervention and education, her pregnancy may have been a more positive experience. This case highlights the importance of establishing a standard of care for women with tokophobia and then adapting that standard to fit each woman's individual needs.