"Fears can come in many forms," said Dr. Catherine Birndorf, a reproductive psychiatrist at New York-Presbyterian Hospital/Weill Cornell Medical Center.
Birndorf said one pregnant patient was so frightened she insisted on a Caesarian with full anesthesia. "She didn't want to be there," she said.
Another was so terrified of the anesthesia that she had to be slowly introduced to the operating room. Another had a phobia about vomiting, and wouldn't get pregnant because she was afraid of morning sickness.
Sometimes those who are tocophobic have had an eating disorder or have been sexually abused as children. Phobias often run in families, but are triggered by events or traumas in people's lives.
Tocophobia, like other phobias, can be treated with cognitive behavioral therapy using exposure and fear reduction techniques or anti-anxiety or anti-depressant medication.
"I always try to go the nonpharmalogical route and use behavioral therapy first," she said.
Karen Butler, a 19-year-old from Warwick, R.I., who hopes to attend college in musical performance, said she had been tocophobic ever since she was an early pre-teen.
"The thought of having some parasitic organism living and growing inside of me never seemed to settle with my mind -- that, and the prospect of that organism tearing my body apart from the inside out never seemed too appealing," she said. "I realize that it is somewhat irrational to think this way, but I cannot get over those thoughts when thinking about getting pregnant or having a baby."
Butler has never sought treatment, even though she admits to a few other fears -- moths, the dark, heights and drowning.
Butler founded a Facebook group, Tokophobia: For Those Who Afraid of Childbirth, which now has 54 members.
"I wanted a safe haven for people with this condition...and for them to know that they weren't alone," she said. "The more people that are aware of it -- and understand it and accept it -- the easier it will be for people like me with tocophobia to interact on a better level with the rest of society."
A report in Britain's Guardian newspaper blamed the rising fear of childbirth on the jump in women asking for Caesarian deliveries, a phenomenon that is also seen in the United States.
The Caesarean rate rose by 53 percent from 1996 to 2007, reaching 32 percent, the highest rate ever reported in the U.S., according to the Centers for Disease Control and Prevention (CDC).
The reasons are varied: an increase in multiple births due to in vitro fertilization, advanced age, more maternal choice and legal pressures, said the CDC.
"While the number of women requesting a Caesarean delivery without a medical indication has increased in recent years, this still represents a minority of women," said Dr. Deirdre Lyell, associate professor of maternal-fetal medicine at Stanford University.
Lyell said she had not seen a "significant" rise in Caesareans because of tocophobia.
"Hospital environments that are supportive of women's choices offer excellent labor support and pain control options, and don't unnecessarily increase the number of medical interventions are important," she said.
As for Karen DuVall, she said she feels thankful that adoption is a possibility and that her boyfriend, Dante Charlton, has been supportive.
"In talking with her about this, what it came down to was either choosing her for my love of her, or not choosing her because of something culture expected of her," said Charlton, 24, who is also a theater major.
"I had never in all my years of thinking of having my own children think that I would be challenged in my desire to have a woman bear them for me...In the end I chose her, because there's no alternative to her."
DuVall said friends say she will change her mind, but she is steadfast.
"This is the way I am," she said. "I think adoption is a wonderful avenue for becoming a parent. I don't think I am any less of a woman for not choosing to have a baby."