Tocophobia, or Fear of Childbirth, on the Rise

Some young women are terrified of pain or alien growth in their bodies.

December 2, 2010, 3:14 PM

Dec. 3, 2010— -- Karen DuVall, a 23-year-old college student from Vacaville, Calif., was surprised there was a word for her unrelenting fear of childbirth -- tocophobia.

DuVall's aunt had told her about a "third degree tear" after having her first child. Later, in a sexuality class, she was horrified by a photo of a woman giving birth.

"The more I learned about childbirth, the more afraid of it I've actually become," DuVall, a college theater major, told "I'm afraid of my body being ruined. I'm afraid of having an aneurysm and dying. I'm even afraid that when I get married, my husband won't be attracted to me anymore after giving birth. I'm afraid that I just won't be me anymore."

It's not that DuVall doesn't want children -- she would eventually like to adopt.

Some people are afraid of snakes, others bridges and tunnels, but a small number of women are phobic about the very notion of giving birth.

Tocophobia (also spelled tokophobia) is derived from the Greek "tocos" (childbirth) and "phobos" (fear).

There are no statistics available in the United States, but British reports have shown that as many as 1 in 6 women have extraordinary anxiety, and the number may be growing.

At its worst, tocophobia can be so profound that some women, even those who yearn for children, choose not to get pregnant.

Oscar-winning actress Helen Mirren admitted to it in a 2007 interview, telling an Australian television show that her fear began as a 13-year-old when she saw a graphic video.

"I swear it traumatized me to this day," said Mirren, 65. "I haven't had children and now I can't look at anything to do with childbirth. It absolutely disgusts me."

A study of 26 women published in the 2000 issue of the British Journal of Psychiatry said phobic avoidance of pregnancy is a "harrowing condition" that may date from adolescence or be secondary to a traumatic delivery.

It can also be a symptom of prenatal depression. Researchers emphasized the need for doctors to acknowledge the condition.

"It's more common than one would think," said Erica Lyon, author of "The Big Birth Book," who is a consultant for New York City's Tribeca Parenting.

She counsels many older women who have waited to have children.

"I think it tends to be a woman with a type-A personality," said Lyon. "She may have a previous history of anxiety or depression or struggled with an eating disorder. We don't understand the brain enough to know why."

Pregnant Women Afraid of Loss of Control

Many women say they are afraid of losing control of their bodies during labor and an "unknown amount of pain."

"In your 20s, you feel invincible and you have not yet heard all your girlfriends' horror stories," she said. "There is the double whammy of slightly more risk and being adult longer to hear the negative stuff."

Phobias are a type of anxiety disorder, a strong irrational fear of something that poses little or no actual danger, according to the National Institutes of Health (NIH).

Many common phobias include fear of heights, public places or being in closed-in places. People with phobias avoid what they are afraid of and if they cannot, they experience panic, rapid heartbeat, shortness of breath, trembling and a strong desire to get away.

Some women say even the sight of another pregnant woman can trigger crying, hyperventilation, sweating and nausea.

"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.

Tocophobic Starts Facebook Group for Phobias

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."