I need your help and advice regarding tokophobia

(66 Posts)
WantsToBeFree Thu 02-Aug-12 23:00:38

Hello there!

I'd like to do a full disclosure first: I am 24 years old and I am not pregnant. I am however battling with severe tokophobia since many years now and I would really appreciate some support and advice from anyone who has been through the same.
I am not exaggerating when I say that this phobia has taken over my life. Anything can trigger sudden depression and anxiety attacks- the sight of a small child, babies, pregnant women, married couples.
This is something I rarely admit to even myself, but I have failed my examinations last year because I was experiencing severe anxiety and panic attacks during that time. Unfortunately, I am so embarrassed of this condition that there was no way I could have written to my university about it in order for them to consider mitigating circumstances.

To be clear it is not labour pains that I am frightened of. I have a very high threshold of pain and I am quite sure that if push comes to shove I can handle contractions even without pain relief.
My phobia pertains to the potential after effects of childbirth which I have seen several women close to me suffer from. I am referring to pelvic organ prolapse, incontinence, severe tears, broken tailbones, broken symphysis, pudendal nerve damage, and obstetric fistulas.
I do realise that these conditions are not common and that I may be able to avoid them. However, I have seen how devastating and life altering they can be and I am certain that I will never be strong enough to handle them should they arise. I would want to avoid even a 1% chance of ending up with these conditions and I live in constant fear that I will be forced to deliver vaginally and be part of the unfortunate few who face these horrible problems.
In an effort to overcome my phobia, I have done a lot of research to compare c sections with normal deliveries. While I understand that an uncomplicated normal delivery is probably easiest to recover from, I also know that it cannot be guaranteed. The idea of an emergency c section, a forceps/ventouse delivery or an episiotomy makes me sick with panic.

I know c sections come with risks, and I am familiar with those risks. I just feel that I can emotionally cope better with those risks as opposed to the ones associated with vaginal deliveries.

I feel that I could be comfortable with the idea of having children so as long as a c section was assured.
What haunts me on a daily basis is the fact that this cannot be assured. My lifestyle involves a lot of moving around and I have no way of knowing which country I will deliver in as and when I fall pregnant. This is what worries me continuously because every country has different policies on elective c sections. I have no way of knowing if I will be in a sympathetic environment when I do decide to get pregnant.

It sounds very crazy and messed up I am sure, but I just had to share my feelings with other women out there who may have been through the same.
I was sexually abused as a child and this may also have something to do with my tokophobia.

The logical part of brain tells me that with a valid mental health disorder, I should be able to get a c section but a part of me is constantly terrifiedsad What if they refuse when the time comes? What if I have to live the kind of life I have seen some women leading (with fecal incontinence, uterine prolapse, SPD and in one case even a colostomy)?

If there are any women out there who have been through the same, please get in touch with me. I'd love to know how you managed to get over this awful phobia.

It has now come to a point where I have started disliking childrensadsad I used to love them to bitssad

givemeaclue Wed 02-Jan-13 23:30:29

You should be able to get a c section on nhs. I know someone who had one due to fear of childbirth. However you are not pregnant at moment so perhaps that is why when you speak to consultants they ale dismissive of it.

How about hypnotherapy or counseling?

Good luck, youeare not being silly in any way and I hope you get proper support when time comes

Ariel24 Wed 02-Jan-13 23:21:46

Rain congrats to you too, so glad you had a good experience with the NHS like I did. I hope we can at least help the OP by showing there definitely can be positive outcomes and it is possible to get help but I agree the OP needs some professional help as well.

rainrainandmorerain Wed 02-Jan-13 22:20:53

PS - ariel24, lovely to hear your good news! That's so encouraging to read - huge congratulations.

rainrainandmorerain Wed 02-Jan-13 22:19:38

I had a cs (on the nhs) recently for primary tokophobia - care was great and it was a wonderful experience, with feelings of huge relief and gratitude from me!

But OP - with the best will in the world, posting on this board is not helping you.

No one here can say anything to help you. If you have to post, try the Mental Health boards, where people are usually sympathetic and there to listen. Here, you just tend to get a bunfight between pro-cs on demand and anti-cs on demand people.

this won't be of any use to to someone with a phobia. You need professional help, whether that is to support you in getting a c section or to take another approach to your phobia. You do have some say in this.

This thread shows how 'stuck' you are in your thinking and emotion - you are clearly in a lot of distresss, have a lot of problems, and as a tokophobic, I do sympathise - but seriously - posting here is not helping you. My (untrained) opinion is that you have other issues as well as tokophobia, tbh.

Please - get proper help.

Ariel24 Wed 02-Jan-13 18:42:19

I haven't posted on MN for a while but wanted to update on my earlier posts on this thread...

I have severe tokophobia, in fact my consultant said I had the worst case he had seen in over 20 years of obstetrics. I was granted a c section by him and had wonderful pre natal care but I was incredibly anxious all throughout my pregnancy, I was convinced the baby would come early. To my great relief she didn't and I had an amazing experience having my baby by c section 12 weeks ago, the staff in hospital were fantastic and I have had a great recovery. I had brilliant care from the NHS and feel very lucky. I won't lie, even when the c section was granted, my phobia was so severe and my anxiety at times was horrendous. But as I cuddle my daughter now I am so so glad I got through it.

Primafacie Tue 01-Jan-13 19:34:46

Raluca, I am not scaremongering, indeed I think a CS is the most likely scenario, and a vaginal delivery is no more than a residual risk, as I made clear in my post.

However, the OP seems to want to be guaranteed a CS. I am afraid no one can guarantee that, which is why the OP continues to be anxious about it and is running all sorts of 'what if?' scenarios in her head.

I don't think it is helpful to dismiss the OP's anxiety by saying there is 'no way in hell' she won't get a CS. The OP said she travels a lot and may not be in the UK at the time of birth. She may also go into premature labour and not be able to implement her birthing plan. We also don't know that the OP could afford to go private. These are all small risks, but it is not true that the risk does not exist.

I think the OP is exaggerating these risks, and needs some perspective, but there is nothing we can say that would convince her that the risk is not there at all, because neither of us has a crystal ball that would allow us to read the OP's future.

I understand that you want to reassure the OP, but it may be more productive for her to have her concerns acknowledged than dismissed.

RalucaV Tue 01-Jan-13 18:36:53

Primafacie,

I strongly disagree with you on many points.
If Wants saves up for private care, there is no way in hell she could not give birth with CS. The only possibility is that she gives birth so fast that she can't make it to the hospital which happens very rarely in first pregnancies, so the chances of this are very, very low. So please stop scaremongering.
Also, it would be kind of stupid of her to be out of reach of her chosen hospital at her due date, right? That's not even a possibility. I bet she will be the closest to the hospital that she can be.
If she wants CS and takes all the precautions, she will have it, as many others did on these threads.

1944girl Tue 01-Jan-13 18:30:33

Hello WantsToBeFree
I think you need help with your problem.Professional help.Please for your own sake get some.You cannot live your life like this.

Primafacie Tue 01-Jan-13 16:57:49

Wants,

Glad to hear you are better.

The likelihood is that you will be able to have a CS, either on the NHS or privately. However, the reality is that there will always be a residual risk that a CS is not available and you have to deliver vaginally. This could be because you are out of the country, because the rules have changed, or because you go into premature labour. This is probably a small risk, however if you feel unable to face that risk, then I think your only options are not to get pregnant, or to seek treatment for your tokophobia so that you can live with that possiblity.

However, I agree with other posters that having such a deep seated anxiety, about hypothetical events which may or may not happen in 7 to 10 years, that it is interfering with your degree, suggests you need to address not just your tokophobia, but your mental health in a more general way.

RalucaV Mon 31-Dec-12 10:22:15

Wants,

Honestly, I think that no one is going to ban CDMR, but it's true they are trying quite hard. However, the rising numbers of CS are not due to CDMR, but other factors, so it wouldn't exactly help to curb the statistics if they banned them.

Anyway, Wants, the best thing you can do is to save up and go private! They can't ban CDMR in private hospitals, right?

WantsToBeFree Sat 29-Dec-12 20:45:24

Hello again!!

I just wanted to say that I've been better the past few months, but lately I feel like tokophobic thoughts are consuming my mind again.

It is so embarrassing for me to even admit this, but I have this terrible fear that by the time I have children in 7-10 years from now, they would have banned CDMR. sad

Going by the momentum the NCB movement is gaining, and how mainstream it has become, I wouldn't be surprised if c sections on request become a thing of the past. What will I do then?

RalucaV Mon 08-Oct-12 15:43:35

Wants,

you are welcome smile
I really think that maybe this anxiety that you suffer from comes from the pressure from outside, your family, your peers, the expectations of others etc. that expect you to be a mother when you are not ready to deal with that.

Besides, if your only concern is vaginal birth, then you have plenty of time to save up to go private when the time comes.

WantsToBeFree Fri 05-Oct-12 20:19:13

RalucaV
thanks so much for your support! Your post reflects so any of my feelings on the matter.

I'll be honest- I'm not exactly crazy about the idea of motherhood. But given my background, culture etc. its highly unlikely that I'll ever find a man who will be agreeable to remaining childless by choice. So I've sort of resigned myself to the idea that I will have a child, mostly because I genuinely do want a stable, committed relationship. I've never come across a man who doesn't eventually want children.
Moreover, I may change my mind about motherhood (although I'll never change my mind about vaginal birth), so having a baby is a possibility.

everyone

You've all been so patient and helpfulsmile There isn't anyone in real life who I can talk to about this, so I'm really grateful to all of you for being there. It really does help.

I've started a new academic year here in the UK and I am terrified of making the same mistake again.
I genuinely want to do well and get a good job, but I'm still constantly traumatised by tokophobic thoughts. I haven't really tried the NHS for counselling because I was put off by the long waiting lists. Any advice on how I can go about requesting a referral for therapy? Do you think I should even bother?

RalucaV Sun 23-Sep-12 13:58:47

Wants,
I've been thinking that maybe if I describe my experience it might be also helpful to you.

I was 25 or something when some of my friends began to start their families. It was very strange and new to me as I had not witnessed any of that before. Simply, no pregnant people had been around me. Therefore until then I hadn't even thought about pregnancy and having children for real. I had only had a vague idea that I might some day have them, but that moment in the future had always seemed too far away for me. Then suddenly it became very real and I realized that if I wanted to have a family, I had to go all through that too.

It was quite useful for me because it gave me a chance to think about what I really want in life and what is only the society's idea what my life as woman should be like. I didn't feel ready to have children at all by then. Seeing my friends and how it changed their lives, I knew that I didn't want that at all. It was a very alien concept for me and only my parents and people around me and the society forced this idea on me, but it wasn't really my own wish and plan. However, I decided to be open and I explored all the things that were related to parenthood. One can say that I was in fact a little obsessed with thinking about it and some people might think it was unhealthy obsession, but for me it was only a part of my development. I guess I needed that phase to get to know myself better and avoid making rash decisions in my life.

I even visited friends with kids just to see if I am able to interact with them and to see how they have to be cared for etc. I still didn't feel motherhood was for me, although I found out I had no problem dealing with little children.
So I continued to feel ambiguous about having a family. However, one thing was for sure and I think I'm never going to change my mind about it. And that is that I'm simply not willing to undergo vaginal birth. I can't. There are many different reasons, but to name a few:

PAIN - I am not into pain at all, I avoid it at all costs (I would always take pills when in pain, don't do any painful sports or activities etc.) because I react very badly to it (get hysterical and even aggressive or suicidal). I have known I'm not very tough since I was a child and I also suffer from occasional migraines and I swear I would even swallow any kind of poison to kill that pain even if it killed me. So I can very well picture myself begging for a mercy shot and hating my husband for doing nothing about it, if I get into hands of the "natural brigade" by chance.

SEX AFTER VB - I had great problems with sex in the beginning, it was something like vaginism, but not so serious. It took me a looooong time to be able to have sex without any obstacles despite me being a very sexual person. So you can imagine how it had been bugging me. I'm not willing to risk reverting this situation or even making it worse. I simply need sex, without it I get highly frustrated and then slide into depression. I'm sorry if anyone finds this laughable, but I know myself enough to say this. By risking VB, I would risk destroying my sexual life in some cases forever. Because no one can guarantee you the opposite, it is one of the greatest reasons of my definite NO.

POSSIBLE INJURIES - There is a great chance (about 60%) of perineal injury (some can be really nasty and life changing), incontinence and prolaps and other not-so-nice consequences after VB. Judging by life expectancy in my country, I still have some 40 years to go and I don't want to spend them in nappies.

MENTAL PROBLEMS - I don't want to risk PTSD after being treated badly by staff, feeling helpless or suffering unbearable pain. I want my hypothetical child to have a functioning loving mother not a wreck.

So for me the only way is CS. The only possible way. Someone might call me a wimp, someone a tocophobic, others just too posh to push. I know I cannot be "cured" out of my opinion because all the funny arguments the natural brigade comes up with are mostly fabricated, non-science based and rather wishful thinking. VB vs. CS is equally risky, so I simply choose risks of CS.

And anyway, why should I care what anyone else thinks? Are they going to live my life for me? No. So let them have their own decisions and me have mine.

I feel like you, Wants, worry about childbirth so much because just like me a couple of years ago, you feel it is inevitable for you if you want to have children. But do you really want to have children or is it only the expectations of other that were pressed on you? And if you really do at your young age, you still have plenty of time to decide how you are going to have them. And you have plenty of time to save up for private care if by then the rules will not have changed more in favour of CS on maternal request.

Sorry for lenghty writing, but I needed to explain all.

wheresmespecs Sat 22-Sep-12 10:15:34

I agree with Hmm about there being other issues complicating the tokophobia. if you get an answer to one question that reassures you, you find another set of questions or potential problems, and that makes you continually anxious.

If this is an overwhelming issue in your life, you have to sort it out somehow.

A girl I was at university with had overwhelming problems with bulimia - after hiding the problem for years, she had to deal with it as it was making her life unliveable - she dropped out of university for two years, got help and came back to resume her degree. Someone in the year below did something similar because of depression. It's not unheard of. If your problems are too much to put on the 'back burner', what other options are there?

The problem is that even if someone were able to guarantee you a caesarian right now, before you are pregnant, it wouldn't assuage your worries. You've been advised to save up for a private op (you are young enough to do this), but this doesn't reassure you - you worry about being granted a CS and then going into labour early -

All of these things do preoccupy tokophobics (I should know, I am one) - but do think there is some other problem going on, in that your worries are endless and your anxiety is self fuelling.

You seem to hAve not been having counselling for very long, but seem to having 4 sessions a week. This is an awful lot - I would go back to your HCP and get reassessed. Therapy and counselling is not a magic wand, but seeing as you are not pregnant or aiming to be pregnant soon, and are young, then I would try it for at least a year to give it a chance to help you.

I had well over a year of twice weekly counselling for severe depression in my twenties and ultimately it was very helpful (though not always steady progress, it rarely is!).

It doesn't matter if you think you will not be 'cured' of tokophobia - you need urgent help managing your anxiety.

Ushy Fri 21-Sep-12 19:52:05

Have you considered doing something practical like saving for a private c/s if you can't get one on the NHS?

Hopefully, with tokophobia as bad as you have it, getting a caesarean should not be a problem providing you pick the right hospital.

Just to feel you have a 'fall back' may be all you need and if you can get the c/s on the NHS - which you should be able to because you have a medical need - you'll have a nice little lump sum saved up.

I don't know if your financial circumstances would allow this, but at least it would put your mind at rest.

Good luck

HmmThinkingAboutIt Fri 21-Sep-12 17:40:06

Tokophobia is more common in women who have anxiety / depression issues to begin with. The two go hand in hand. My gut feeling is you are focussing on the tokophobia when the reality is there is more going on than one simple issue here.

If you've failed your degree because of it, then I would suggest its not just tokophobia which is ruining your life; its definitely providing a focus for your anxieties but I'm not convinced its your only problem and if you keep thinking it is then I don't think you'll find the solutions to your problems.

Honestly, I think you need to get a second opinion. I strongly suspect that actually there is a lot more going on here than just tokophobia.

1944girl Thu 20-Sep-12 18:41:53

Take one thing at a time.If you are studying for a degree try and put tokophobia on the ''back burner''.
I know it is hard but if you really want or need your degree that comes first, provided you dont get yourself pregnant during that time of course!.

RalucaV Thu 20-Sep-12 09:49:28

Wants,
I'm bumping it up because others might have some wise words for you.

I really feel for you, but consider that you haven't had good conditions to be able to work on your degree. Having to deal with mental problems is the same as any kind of disease. Would you feel bad for failing because you have been dealing with pneumonia? Not really, right.
I'm sure you will be able to overcome this and get your degree, but you need to be less demanding on yourself at least for a while.

WantsToBeFree Wed 19-Sep-12 15:14:24

I failed my degree. I failed it...

And it's all my fault because I couldn't deal with my tokophobia and anxiety.

I used to be so focused, so bright. I had a bright, bright future ahead of me and everyone said so. Now it's ruined.

I'll never be able to explain this to an employer....I'll never get over this...

thunksheadontable Thu 13-Sep-12 05:02:59

Are you on any meds? I found I couldn't really engage with therapy until I was on the medication. I did nearly three months of two sessions of CBT and Mindfulness while pregnant and I would have said the same as you - it did almost nothing for me, if anything, all the talk just made it worse! Once I started medication, things began to improve...

I think for therapy to work you have to totally engage with it, heart and mind. I paid lip service to it for ages. I was going in there spinning tales but in reality I was just sitting there critiquing the therapist thinking "you don't get this" and doubting every word that she said. Then I went on the medication and got a new CBT therapist and although again for the first few weeks I only half did the work, eventually I thought ... sod this, I can't and don't want to live like this so I am going to give it everything I have. I diverted ALL time I had been using to look up horror stories/seek reassurance about my fears to learning about OCD, Acceptance and Commitment Therapy (my favourite) and Mindfulness (this helps with thought/action fusion where you believe that your thoughts about a problem are as worthy of attention as a real life problem or are trying to problem solve hypotheticals). It took a few weeks and there are times the compulsion to seek reassurance is still high but I don't do it now because I know it maintains my fear and there will never be a positive outcome to it. At the stage I'm at, I am beginning not to have as much anxiety but it is not a quick fix, it is good days and bad days and my meds have had to be increased again. It is a slog, I have to say... but the days the anxiety is less make me realise it is worth it.

4 sessions a week is a lot! It doesn't really give you any chance to do the work, does it?

WantsToBeFree Tue 11-Sep-12 16:33:39

thunksheadontable

Firstly, I'd like to clarify that I have been officially diagnosed with tokophobia and extreme anxiety. I haven't self diagnosedsmile

That aside, I think you've really understood my problem! I couldn't have put it better myself if I tried. That's exactly what is happening with me- I seem to fixate on negative stories and spend my time worrying that it will happen to me.

I am petrified of the idea of a vaginal birth and I desperately seek reassurance that I won't ever have to do it. Obviously, nobody can provide that kind of reassurance and therein lies the problem. You are absolutely correct in saying that I am attempting to solve a hypothetical problem which is admittedly a fruitless exercise. The trouble is, I can't seem to break out of this cycle even though I fully realise how pointless and damaging it is.

I have been undergoing therapy for over two months now. I have 4 sessions a week and I am undergoing CBT.
It hasn't helped. At all.

thunksheadontable Sun 09-Sep-12 07:30:09

PS imaginal exposure (which is writing the story out) is also used for anxiety, it is not just for phobia. CBT for anxiety involves confronting your fears just as much as it would for a phobia. My fears revolve around my baby dying and I have just had to do this, writing in excruciating detail what it would be like to find his lifeless body. Like you say, it made me want to jump off a cliff when it was first suggested and really, I couldn't approach it until I was on anti-anxiety meds. Even then I needed my dose to be increased when this therapy started...

the thing is, even if you end up getting a cs, you need to deal with these fears so they stop you avoiding real life situations that are only tentatively connected to childbirth and pregnancy e.g. all children, married couples.

Imaginal exposure may never cure your fears around childbirth but you will need to address this hyperextension of your fears anyway if they are affecting your everyday life to the extent they are.

thunksheadontable Sun 09-Sep-12 07:24:03

Hey there

I think you need to see a psychiatrist if you are self-diagnosing tokophobia. From what you say, you are avoiding a lot of situations and it is disabling your life. I don't know enough about tokophobia to say that's not tokophobia, but it certainly also sounds a lot like it could be OCD (avoidance is a compulsion). There are a lot of "what if's" and also that fear that you can't be certain, the need for reassurance etc which can be OCD. It also seems to be snowballing so that more and more situations need to be avoided to stop the panic.

I am not saying this is OCD and not tokophobia. At all. I am just saying that it would be valuable to have this looked at professionally, ideally by a specialist perinatal mental health team.

Counselling won't really help with these sorts of fears unless it is cognitive and/or behaviourally based.

The main issue as I see it is that as you are not pregnant now there is absolutely no way of dealing with your fear productively e.g. you can't arrange for an elcs. So all your thinking about it is going nowhere. None of your thoughts will solve your problem; you are spinning yourself into a frenzy trying to apply problem solving strategies to a hypothetical problem. The issue with this is that you can never, ever solve a hypothetical problem the same way you can solve a real one. Seeking reassurance that you will get an elcs won't work, because no one can GUARANTEE it in your current situation as you are not pregnant etc and so at the back of your mind, you will always doubt: what if, what if. This will drive you to seek out stories of people who did get an elcs but even if you read 1000 stories where a woman did get one and 1 where they didn't, your mind will fixate on that.

The thing that is disabling you now is not actually your fear of childbirth per se. It's your worry about your fear of childbirth not being taken seriously and being forced/coerced into having a natural vb. If you were pregnant, you could take steps to ensure that you didn't have a vb if you didn't want it (arranging a cs, going through the process to get one, moving area if you needed to, getting it privately) and close the loop.. but your life now revolves around something you just can't solve or cure right now. That is your core issue from my reading of it. I think your issue right now is what the desire for certainty is doing to your life in the here and now.

WantsToBeFree Fri 07-Sep-12 08:11:32

I've realised that the NHS system is too much of a "lottery". Even if they agree to give me a c section, there is too much uncertainty associated with what will happen if I go into labour prematurely. If the consultant on call is opposed to c sections for non medical reasons I may well have to give birth vaginally.

Could someone with experience of private care chime in? Under private care will I be guaranteed a c section even if my waters break early?

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