This file was produced by Laure Deflandre, psychologist

Many women are apprehensive about childbirth, especially when it is their first child. Among the most frequent fears during childbirth, we find1 :

The fear of the Unknown : “I’m afraid the childbirth will not go well”

Faced with what she does not know, the woman sometimes remembers the most negative stories from those around her and she feels a certain apprehension about them. According to psychoanalyst Monique Bidlowsky2, part of these childbirth fears comes from the family: “We are not immune to the discourse of our mothers and grandmothers”she explains. “The women in the family who had very complicated deliveries passed on this story. “

The fear of death: “I’m afraid of dying during childbirth”

This fear is linked to the past and popular representation, when childbirth was one of the leading causes of death in women. Nowadays, medical advances have greatly reduced the risk of death in childbirth and this situation has become extremely rare. The presence of a medical team made up of doctors and midwives contributes to the smooth progress of childbirth by monitoring any bleeding or complications.

The fear of the death of the baby: “I’m afraid my baby will die”

Doctors also closely monitor the health of the baby throughout the delivery. If, for example, he is in fetal distress, all means are implemented to provide him with the care he needs. Also, during the first days after childbirth, the medical team checks for any possible complications.

The fear of pain: “I’m afraid of suffering during childbirth”

The pain experienced during childbirth is unknown during a first pregnancy, it can scare future mothers. Nevertheless, there are many techniques to relieve this pain, such as an epidural.

Fear of giving birth to a malformed or unhealthy baby

Prenatal examinations are carried out throughout the pregnancy in order to ensure the proper development of the pregnancy (ultrasounds, listening to the baby’s heart “Doppler”, proposal of a screening test for Down’s syndrome, etc.). goes perfectly, there is no reason to worry about a deformity or disease.

The fear of becoming a mother: “I’m afraid of not being a good mother”

It is legitimate that the future mother can question her ability to become a mother: “Would I be up to it? “,” Would I be able to take care of it? “,” Would I have the capacity not to make the same mistakes as my own mother? “. But she needs to be reassured, the maternal instinct will take over as soon as she takes her baby in her arms.

Fear of giving birth prematurely: “I’m afraid the baby will arrive too early”

The risk of prematurity can be caused by medical factors (so-called “at-risk” pregnancies),social (weakening and stressful life), and psychic (difficulties in adapting to bodily changes, absence of a feeling of fullness during pregnancy, difficult relations with one’s own parents, conflicts with the spouse, etc.). Currently, technical progress makes it possible to provide essential care for premature babies.

The fear that complications will arise during childbirth: “I’m afraid of having a caesarean section or of having a hemorrhage”

The vast majority of births go very well for the mother, as well as for the baby. However, there is always an element of the unforeseen: emergency cesarean section, use of forceps, practice of an episiotomy. These acts are performed in order to protect the health of the mother and the life of the baby.

The fear of not arriving on time at the maternity ward: “I’m afraid to give birth too early”

The onset of labor is the longest phase3, the future mother really has time to reach motherhood before giving birth to her child.

The fear of not knowing how to love your baby: “I’m afraid of not having the maternal instinct”

Psychologists explain this by the gap that exists between the child imagined and dreamed during the 9 months of pregnancy and the real baby that is born. Questioning oneself about one’s maternal instinct is already projecting oneself as a mother, these doubts are legitimate and generally disappear from the birth of the baby when maternal ties are put in place (skin-to-skin contact, breastfeeding, emotional attachment, etc. etc …)

Several causes would contribute to the fear of childbirth:

In pregnant women, this fear can come from a mental disorder of pregnancy : women who are afraid of childbirth are women who have not finished their psychic work being done throughout pregnancy and who are worried about loss / separation from the child at birth. Childbirth is then perceived as a real ordeal of separation.

Hear negative stories about childbirth from those around you, can scare a woman who has not yet experienced the ordeal of childbirth.

Go on the Internet and consult discussion forums where mothers testify to a difficult and painful childbirth, can cause some women to panic.

Watch TV series or movies which involve extremely painful childbirth where the mother dies in childbirth for example, can really distress some women.

We call the childbirth phobia, “Tokophobia”. The word comes from the Greek “tokos”: “childbirth” and from “phobos”: “fear”. It is indeed an unreasonable fear of giving birth. We speak of tokophobia in cases where women fear and avoid childbirth despite their desire to have a baby. A team of English researchers1made a study concerning tokophobia and distinguished 3 types of tokophobia according to the circumstances of triggering of this phobia:

Primary tokophobia occurs before 1er childbirth. It is the fear of childbirth that usually appears in adolescence. Intercourse is considered “normal”, but women with “primary tokophobia”, due to intense fear of pregnancy and childbirth, use more than one method of contraception at the same time. These are frequently women who have allegedly suffered sexual trauma in their past.

Secondary tokophobia. The phobic avoidance of pregnancy is the result of a previous difficult, painful or even traumatic childbirth. They may have had an operative delivery due to fetal suffering, experienced severe pain during labor, or believed that their baby was going to die or even that it was already dead.

Tokophobia as a symptom of prenatal depression : Believing that they are not able to give birth, or even that they would die, some women develop a phobic fear of childbirth. When these women become pregnant, they are very disturbed by their pregnancy, which can lead to prenatal depression. In order to avoid childbirth, they are then able to request a voluntary termination of pregnancy (abortion), or they can also voluntarily cause a miscarriage by doing, for example, high-level sport or involving high risks. traumatic (jogging, team sport, board sports or combat), or by consuming tobacco and alcohol.

The possible consequences of tokophobia:

In women suffering from “tokophobia”, the anxiety of childbirth, pain and possible complications take on unreasonable and phobic dimensions such that they can:

• Refuse motherhood, until you avoid getting pregnant (anxiety, considerable anxiety attacks)
• Using voluntary termination of pregnancy (Abortion), even if the child is desired.
• Schedule a Caesarean to avoid vaginal birth.
• Develop a real post-traumatic stress disorder (PTSD) after childbirth (recurrent vomiting, repetitive memories and dreams related to the traumatic event, appearance of high intensity anxiety symptoms, etc.)
• Sink into a depression due to a refusal by the medical team to apply the delivery method desired by the expectant mother, to a voluntary termination of pregnancy (abortion), to an induced miscarriage, or even to a traumatic childbirth.
• Request sterilization in order to have a permanent contraceptive method.

Management of tokophobia

Tokophobia is a distressing psychological disorder that must be managed by a psychologist or psychiatrist. Psychotherapy can allow the woman to express her anxiety and to know its origin.

If the woman is already pregnant, the therapy can also be combined with monitoring by the medical team, midwives, gynecologists, in order to optimize psychological support as much as possible.

Several steps allow pregnant women to better understand their childbirth:

Go to childbirth preparation classes. Preparation by a midwife is essential, especially during a first childbirth, to experience this event as serenely as possible. The sessions make it possible to prepare the mother-to-be physically and psychologically for childbirth and to inform her about the progress of the pregnancy. She will be able to better manage her anxieties and the tensions caused by the fear of giving birth, which will reassure her.

Do prenatal sophrology sessions. These sessions prepare for childbirth through physical exercises, work on the breath and letting go. During the sessions, future mothers will be confronted with the visualization of childbirth (contractions, time of expulsion, experience of the baby), which will familiarize her with the different stages of childbirth. The father can be involved, as far as possible, in the preparation by helping the mother-to-be to relax.

Choose a maternity hospital and a medical team in accordance with your wishes. A team of gynecologists, obstetricians, midwives and nurses can answer any questions you may have about the course of pregnancy and childbirth.

Request a epidural. It is an anesthesia technique for a painless childbirth.

If reposer during pregnancy and avoid stressful situations.

Practice relaxation techniques. Yoga, relaxation and water exercises can reduce stress and anxiety.