A proposed psychological model for understanding and supporting individuals living with tokophobia
Tokophobia is an overwhelming fear of pregnancy and birth that can lead to severe mental health difficulties in the perinatal period. The condition can be experienced by men as well as women and has implications for physical and mental health wellbeing in pregnancy and the postnatal period. Individuals with tokophobia are likely to have experienced previous traumatic events, which can trigger the condition and are also vulnerable to experiencing traumatic stress. This article proposes an adapted psychologically informed trauma model to help health professionals to understand and support pregnant women (and men) living with this condition. The aim of this is to raise awareness of the condition, as well as offer a guide for professionals to support and validate those living with this condition, as well as help them to feel safe and secure with the professional supporting them. It is hoped that this will lead those with tokophobia to experience a sense of safety, calmness, self-efficacy, connectedness and hope in working with professionals supporting them. This may, in turn, lead to them feeling more empowered and connected to becoming a parent and in planning their birth journey for those that are pregnant and living with this condition.
All living beings are entitled to the desire to start a family, and the physical action of falling pregnant and giving birth to a baby is a human right. However, for individuals living with tokophobia, this right can feel conflicting. Tokophobia is experienced as an extreme fear of pregnancy and birth (Ayers, 2014; Demšar et al, 2018; Nath et al, 2020). It can develop at any point across adolescence and adulthood and can affect men as well as women (Scollato and Lampasona, 2013; Ganapathy, 2015; Masoumi and Elyasi, 2021). Individuals living with tokophobia may feel an overwhelming fear of pregnancy and birth, despite the desire to become a mother or a father (Hofberg and Brockington, 2000; Hofberg and Ward, 2007; Anniverno et al, 2013). The fear can feel so extreme that some individuals may not feel able to entertain thoughts or discussions about starting a family. This can have significant implications on their relationships with their partners, potentially leading to relationship breakdowns (Ayers et al, 2006; Ayers, 2014; Fenech and Thomson, 2014; Delicate et al, 2020). Some women's fear of birth can be so severe it can lead to termination of pregnancy, despite their baby being wanted (Hofberg and Brockington, 2000; Hofberg and Ward, 2007; Nanjundaswamy et al, 2019; Jomeen et al, 2021).
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