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Tokophobia: an unreasoning dread of childbirth

A series of 26 cases

Queen Elizabeth Psychiatric Hospital, Birmingham

I. F. BROCKINGTON, FRCP

Department of Psychiatry, University of Birmingham

Correspondence: Dr K. Hofberg, Department of Psychiatry, University of Birmingham, Queen Elizabeth Psychiatric Hospital, Mindelsohn Way, Birmingham B15 2QZ; e-mail: kristina.hofberg{at}virgin.net

Declaration of interest None.

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.

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