Tokophobia: When pregnancy becomes unreasonably scary

“Motherhood is still the biggest gamble in the world. It is the glorious life force. It’s huge and scary – it’s an act of infinite optimism.” – Gilda Radner, late actress and comedian


It has been said that conceiving and giving birth is the most fulfilling experience a woman can go through in her life. But not all women actually have the emotional and mental toughness to go through it.

Thougha relatively new subject in the fields of psychiatry and gynecological medicine, it was found that there is a growing number of women suffering from tokophobia (also spelled as tocophobia in some medical journals) or the extreme, irrational fear of pregnancy and delivery.

The first study on this kind of medical condition was done by doctors Kristina Hofberg and I.F. Brockington published on the British Journal of Psychiatry in 2000.

“Some women dread and avoid childbirth despite desperately wanting a baby. This is called tokophobia,” Hofberg and Brockington said in their study titled “Tokophobia: An unreasoning dread of childbirth”.

Of the 26 women who were subjects of the study, eight exhibited dread of childbirth without having previous experience of pregnancy. The study described this condition as primary tokophobia.

“The dread of childbirth started in adolescence. Sexual relationships were normal but contraceptive use was scrupulous, some of these women using several methods of protection,” the study said, adding that generally, these women wanted to avoid pregnancy due to fear of labor.

Meanwhile, 14 of the women studied by Hofberg and Brockington displayed dread of childbirth after experiencing a traumatic or distressing delivery previously. The study defined this condition as secondary tokophobia.

“One woman who accidentally conceived again organized a termination of pregnancy rather than face another delivery,” Hofberg and Brockington reported.

Meanwhile, four women in the study developed extreme anxiety in the middle of their pregnancy, or in medical terms, during the prenatal period. In these cases, Hofberg and Brockington said tokophobia is considered as a symptom of depression.

“In each woman this was characterized by a recurrent intrusive belief that she was unable to deliver her baby and, if made to, would die," the study reported.

"Of these four women, the first two were primiparous; both felt shocked at the realization of pregnancy and both became depressed," the study said.

"The other began to exercise strenuously in the hope of inducing miscarriage rather than endure a vaginal delivery."

"One sought a termination of pregnancy even though the pregnancy was planned," the study reported.

The study said three of these women decided to push through with delivery after receiving psychological treatment—including antidepressant medication—while the other one pushed through with abortion.

Overall, of the 26 women studied, two terminated their pregnancy. "In both cases, the baby was much wanted,” the study said.

A more recent study published in 2012 on the Industrial Psychiatry Journal (IPJ), a semiannual publication of the Association of Industrial Psychiatry of India, revealed that one out of 10 women in India suffer tokophobia.

In the Philippines, although there is no available figure or case study yet on Filipino women suffering from tokophobia, Dr. Santiago A. Del Rosario, chairman of the Department of Obtetrics and Gynecology at the Makati Medical Center (MMC), noted an increase in the number of women availing the ceasarean form of delivery in the last five years, some of these women availing the service even if they are healthy enough to undergo a normal delivery.

“It was in early 2000s when the Philippines started giving Filipino women the option of delivering their child through ceasarean kahit kaya nila ang normal delivery,” Del Rosario told GMA News Online in a phone interview.

“Before, the ceasarian is only given to women who are unfit for normal delivery due to medical conditions. But after we became more liberal with the service in early 2000s, nagsimulang dumami ang nagpapaceasarean, siguro mga year 2009 or 2010,” he added.

Del Rosario said that for the last five years, with about 120 women giving birth in Makati Medical Center monthly, about 35 percent or 42 women are availing the ceasarean form of delivery. Of this number, about four percent or 17 women choose ceasarean delivery despite being healthy enough to undergo the normal delivery.

“Those who are healthy enough, their most common reason is natatakot mag labor. They have the feeling na hindi nila kakayanin, na baka mamatay sila,” Del Rosario said.

“So we can say that there are really women who have extreme fear of childbirth,” Del Rosario said, though he was quick to add that “we cannot yet categorically say that these women are suffering from tokophobia since we do not yet have a study about it.”

Del Rosario said most women availing the ceasarean form of delivery are the first time expecting mothers and the “repeat ceasarean” or those who have one or more experience of availing the service in their previous pregnancy.

Jel Tupaz, a mother interviewed by GMA News' late night program “Saksi,” believes she suffered tokophobia last year while she was pregnant on her second child.



“Pagkakita ko sa pregnancy test, ang unang una kong naisip is, mamamatay na ko,” Tupaz said, revealing that she even made a last will and testament.

Tupaz said the extreme fear that she experienced was partly due to a very difficult pregnancy with her first child.

“May steroid na binigay sa'kin to speed up yung lung development nung baby. Yung steroid na binigay sa'kin, nag react siya with my body, napuno ng water yung lungs ko, nag heart failure ako tapos yung BP (blood pressure) ko umakyat siya mga 200, tapos yun nga with gestational diabetes pa, so lahat na nagconfound, nag 50-50 na ko,” recounted Tupaz. She and her husband spent almost P1 million in hospital bills.

Meanwhile, “Jopay” (nor her real name), a single woman in her early 20s also interviewed by “Saksi,” said she would rather have a child with a possible husband through a surrogate mother than to undergo labor herself.

“Nung second year high school kasi kami, may pinanood kaming clip dun sa Biology class, yung actual labor. So, nakita ko yung proseso, nakakatakot, parang hindi ko kayang pagdaanan yung ganong pain,” she said.

Del Rosario said that though a study on the proper treatment of tokophobia has yet to be done even by the medical experts abroad, the best way to alleviate the fear and anxiety of childbirth is for pregnant women to have regular check-ups and be part of a strong support group.

Del Rosario advises pregnant women to have pre-natal visits with their obstetrician and gynecologist every month for the first six months of pregnancy, every two weeks for the next two months, and every week for the last month.

“Through regular pre-natal checkups kasi, we monitor the development of the child, yung movement niya, heartbeat, yung condition nung uterus ng mother, lahat. So, prenatal screenings certify the normalcy of the pregnancy—and this is an effective way to alleviate fears and anxiety na nararamdaman nung mother,” Del Rosario said.

He also stressed the importance of moral support and care from the family members, especially the husband of the pregnant woman.

“Nababawasan ang stress ng pregnant woman kung meron laging nagreremind sa kanya that she and the baby are going to be okay, that she is doing great with her pregnancy,” Del Rosario said.

“Finally, kung sobra talaga ang nararamdamang anxiety and depression, a close coordination between the Ob-gynecologist and a psychiatrist is imperative. Psychological counseling and in some instances, medication such as low doses of anti-depressants should be extended to the patient,” Del Rosario said.

In the end, despite her extreme fear and anxiety, Tupaz decided to push through with her pregnancy and gave birth to a healthy baby girl last year.

“Super worth it ang motherhood, I'm going to mold their future, napaka fufilling noon as a mother,” Tupaz, who now has two daughters, said. — VC, GMA News