Parturiphobia (birth phobia): symptoms, causes and treatment
Parturiphobia or tocophobia is the pathological fear of labor . Far from being an isolated experience, parturiphobia is a fairly common phenomenon among women of reproductive age. For this reason there have been several psychiatric and psychological studies that have addressed it.
Below we explain how parturiphobia is defined, what types exist and how it is usually treated.
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What is parturiphobia?
Parturiphobia is the pathological fear of childbirth. It is also known as tocophobia, which comes from the Greek "tokos" which means "childbirth". It has been recently described in terms of pathology, however, it is an experience that has accompanied many women over time.
The parturiphobia has in the background an upset caused by the contradiction between the expectation of being a biological mother and the desire not to be . For the same reason, parturiphobia is considered a multidimensional phenomenon that involves both biological and psychological and social factors.
This phobia has had important consequences in the morbidity of pregnant women and also in the development of children, which is a phenomenon that needs to be studied and worked from various areas.
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Irrational fear of childbirth: a pioneering study
The psychiatrists Kristina Hofberg and Ian Brockington have been two of the main references in the description of parturiphobia. In 2000 they conducted a qualitative study with 26 women who had a seemingly unjustified fear of childbirth.
These authors have defined this phenomenon as the phobic state characterized by a specific anxiety or fear of death during childbirth that precedes pregnancy , and that leads to avoid by all possible means the labor, even when the woman wants intensely to have a baby.
The study they did was with 26 women between 24 and 41 years old, who were referred by obstetrician doctors and psychiatrists from different hospitals in England. Some of them were married, others were not, most of the women had children without disabilities.
The women had had a delivery and had presented with depressive episodes, anxiety disorders or post-traumatic stress disorders. They had been treated by a psychiatrist for approximately two years.
They were interviewed through an unstructured guide focused on knowing the life history of women related to their sexuality, their obstetric history (which included past pregnancies, the possibility of abuse experiences and the use of contraceptive methods).
Through the interviews, the researchers found similarities in women's experiences and fear of childbirth. Some reasons that were found behind the parturiphobia are the fear of dying during labor, the expectation of pain or unknown suffering, the memory of pain from previous births, among others.
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Types of parturiphobia
As part of the results of their study, Kristina Hofberg and Ian Brockington divided the manifestations of the parturiphobia into two types: primary tocophobia and secondary tocophobia.
They also concluded that tocophery can be considered not as a clinical picture in itself but as one of the symptoms of prenatal depression , usually caused by the belief of the woman that she is not capable of carrying out labor, at least without dying in the attempt.
Primary tocophobia is when the fear of childbirth begins before pregnancy, even from the period of adolescence. In this case, sexual relations are usually carried out normally, that is, without abuse, and different contraceptive methods are used regularly.
Normally and in spite of the fear they feel, pregnancy is planned and carried out, which can aggravate the experience until it becomes a phobia. Women describe motherhood as a reason for being and present an overwhelming desire to be mothers , where they combine the need to avoid pregnancy and childbirth, with the demand and expectation of being mothers.
Some of the means by which they have calmed this fear has been through scheduled cesareans or interruptions of pregnancy.
Secondary tocophobia is what happens after a traumatic or significantly stressful experience. That is, it is the phobia that results from having had an unpleasant experience in a previous birth. For example, severe labor pains, perineal tear, complications of childbirth due to fetal distress.
Around these experiences women have expressed that they thought that they or the baby were going to die.Despite this, many women seek another pregnancy, sometimes under the idea that the family is incomplete (for example, to give a brother to the one child).
In many of these cases, miscarriages have occurred , abortions practiced for medical needs, induced abortions, or scheduled cesareans, which has produced relief for women.
Likewise, several of the women began a process of sterilization after childbirth and some women who came to complete the pregnancy showed symptoms of post-traumatic stress, and even some difficulties to establish care links with the children.
The parturiphobia is currently one of the great fields of psychiatric and psychological research , which has resulted in the development of specific psychotherapies that decrease the negative delivery experience.
Likewise, the contradictions generated by motherhood (especially biological) as a sometimes overwhelming demand have been addressed from different perspectives of psychology and other social sciences. In any case, it is an issue that has gained relevance in the last two decades and that can generate very important knowledge for women and reproductive activity.
- Bilert, H. (2007). Tokophobia - a multidisciplinary problem. Ginekologica, 78 (10): 807-811.
- Hofberg, K. & Brockington, I. (2000). Tokophobia: an unreasoning dread of childbirth. 176: 83-85.
- Singh, M. & Jhanjee, A. (2012). Tokophobia: A dread of pregnancy. Industrial Psychiatry Journal, 21 (2): 158-159.