Tokophobia: an unreasoning dread of childbirth

A series of 26 cases

HOFBERG, KRISTINA
BROCKINGTON, IAN

KRISTINA HOFBERG, MRCPsych, 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 BI5 2QZ; e-mail: [email protected]

(First received 30 November 1998, final revision 15 June 1999, accepted 16 June 1999)

British Journal of Psychiatry 176:p 83-85, January 2000.

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.

Declaration of interest

None.