Fear of childbirth
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Fear of childbirth is not an isolated problem but associated with the woman's personal characteristics, mainly general anxiety, low self-esteem, and clinical depression, as well as dissatisfaction with their partnership, and lack of support. Also the partners of women with fear have a certain pattern of low psychological well-being, resulting in low life-satisfaction, dissatisfaction with partnerships, and depression. A vivid debate about the woman's right to choose the mode of delivery is going on in obstetric literature, but the discussion on the reasons for women to request a caesarean section, or on the possibilities to help them overcome the fear of vaginal childbirth is insufficient. Preliminary Swedish and Finnish reports demonstrated the results of treatment during pregnancy, when more than half of the women withdrew their request after being able to discuss their anxiety and fear, and vaginal deliveries after treatment were successful.
[edit] Psychological disorder
In 2000 an article was British Journal of Psychiatry (2000) 176: 83-85 which considered fear of childbirth as a psychological disorder previously receiving no attention as such, introducing the term tokophobia (from the Greek tokos (childbirth) + phobos (fear))
Other coinages for the condition are tocophobia and parturiphobia.
Phobia of childbirth can manifest as nightmares, physical complaints, and difficulties in concentrating on work or on family activities. Very often fear of childbirth leads to a request for an elective caesarean section. Fear of labor pain is strongly associated with the fear of pain in general, and a previous complicated childbirth or inadequate pain relief are the most common reasons for requesting a caesarean section among pregnant women. Previous psychological morbidity and a great number of daily stressors expose a woman to a great risk of fear of childbirth.
Tokophobia is a distressing psychological disorder that may be overlooked. It is associated with anxiety, depression, post-traumatic stress disorder and bonding disorders. Recognition of tokophobia and close liaison with obstetricians may reduce the morbidity associated with tokophobia.
[edit] Primary and secondary tokophobia
Primary tokophobia is the dread of childbirth that pre-dates pregnancy and can start in adolescence.
Secondary tokophobia is due to a previous experience of traumatic birth, poor obstetric practice or medical attention, previous postpartum depression, or other personal concerns and anxieties.
Both of these can be resolved by obtaining assistance from an experienced clinician.
[edit] References
Acta Obstetrica et Gynecologica Scandinavica; 82(3), pp. 201-8; 2003 Mar-208, 8p
"Tokophobia: an unreasoning dread of childbirth: A series of 26 cases" by KRISTINA HOFBERG, MRCPsych Queen Elizabeth Psychiatric Hospital, Birmingham. Department of Psychiatry, University of Birmingham [1]
