I need your help and advice regarding tokophobia(66 Posts)
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 terrified 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 children I used to love them to bits
Wantstobefree, its late but I wanted to reply tonight. There are a bunch of women on here who can relate to you and are fairly regular posters. Some have secondary tocophobia. Some have primary tocophobia but have managed to have kids. Some are like me and you and don't. So no you don't sound crazy or messed up. And there is lots of research that also that backs this up - you are more normal than you think. I'm sure one or two of them will pop in and say Hi when they see this thread. There aren't many places that seem to offer much support for tocophobia, but MN does have a few people willing to talk about it and try and help.
I'll reply again in the morning, when I'm less tired and can think a little better.
I think for your own sake you need to take a bit of control. Getting pregnant is not inevitable, obviously you move around a lot, but if the fear is affecting your life so much you need very good contraception until you are in a position to have the birth you need.
For you it sounds like you would need to be in a liberal country to be able to cope with pg and birth, I don't know what job you have, but you need to arrange this as a precursor to actually getting pg.
I may be wrong, but in this country if you had a phobia, you would be allowed a cs, if you could afford to go private this would be even more certain.
I remember reading a ladies account of a fourth degree tear on the internet when heavily overdue with my first, this scared the life out of me. I did end up an emcs, I honestly had never imagined a small person emerging from my vag, it just seemed impossible to me.
I had no idea of the after effects of birth when pg with my first, at that time nobody seemed to talk about it.
Hi OP, I've just read your post and I couldn't not reply. Everything you have written sounds exactly like me, I have felt every single thing you describe. I have tocophobia and am currently 29 weeks pregnant with my first baby. I don't know how I've been able to get to this point but I have, and I have been very lucky and had a great experience with the NHS so far. I had a brilliant midwife who understood straight away and referred me to a consultant, who on my first app with him when I was 15 weeks pregnant agreed to an ELCS when I'm 39 weeks. I still struggle every day with my phobia and have constant worries about the baby coming early etc but I am trying to get through it. For what it's worth I really couldn't fault the care I have had from the NHS but then I have been lucky as not everyone receives the sympathy that I have. I've also been lucky to have a supportive husband and mum and if it wasn't for them I don't know where I'd be.
Tocophobia really is awful to try and live with, I know exactly how you feel. It leaves you feeling petrified, anxious and depressed. Even though I have been granted the ELCS, I still feel awful and haven't been able to enjoy pregnancy one bit. Sorry if any of what I have written is depressing, I'm just trying to give my experience of it all. Have to say as well, Mumsnet has been great as I've met women with tocophobia who I would never have met in real life, it helps to talk about it here.
You really aren't alone in feeling the way you do, you are not crazy or messed up!
I'm so glad to know I'm not alone! Thanks so much to everyone for being so honest and forthcoming.
I think I should mention here that I don't have much support from my family. My mum is great-she's a fabulous mum, but I think she just doesn't get how serious my phobia is. She thinks I'm crazy to worry about something that hasn't even happened yet. She also seems to think its basically quite easy to get a c section if you want it but I disagree strongly. Sometimes when I say my own fears out loud, they sound bizarre to me as well, but I can't help how I feel
In my culture, not having children is almost unheard of so I'm working with the assumption that I'll likely end up with a man who wants children. My last boyfriend wasn't understanding at all about my phobia. He just told me to be practical and 'get a grip'. Needless to add, that wasn't helpful at all.
I'm single at the moment and terrified of being in a relationship. I'm convinced that he won't understand my phobia and put pressure on me to have children before I'm ready.
I know that private doctors usually agree to requests for c sections (at least in the UK) but I have no way of knowing if I'll have the requisite funds when they are needed.
Well, the requisite funds are something that you could work on? You're only 24 let's not forget. If having a c-section fund makes you feel more relaxed then start saving for one.
Since you're not TTC I would think about going to the doctor for anti-depressants as well to help you cope day to day.
And remember what you certainly can control - including the country you have your baby in. If you are in a country which doesn't do c-sections under those circumstances you can always (assuming you're British?) move back to the UK to have the baby. That could be challenging, but it's possible and so just decide no matter what the obstacles - that's what you're going to do.
Right, got a bit of time to sit down and answer this properly.
I just went through to find a couple of good old threads from the past that are interesting reading.
Please help a crazy woman
Petrified of Birth
I'm sorry to ask this, but I couldn't help but notice but two of these threads were started by a person called "WantsToBeAMan" and I couldn't help but notice the similarity in your username and the fact you'd be the same age. Are you the same person? The reason I ask is not to 'out you' in anyway, but more because it might help others to be able to try and advise you and help you better. Rather than going round and round in circles or just repeating what you've or others have said before. If you are not the same person, then they provide a really good comparison for you to look at and see that you are not alone in the way you are feeling and how it is controlling your life.
I really advise you to write all your fears down, point by point - no matter how trivial - to work out just what your phobia is about and to try and work out where its coming from. Not on here, but privately.
If you are falling exams over this or its affecting your relationships, you have a problem now - not one in the future if you get pregnant. Which again puts a slightly different angle on things.
I think the big thing for you is, if you haven't got this flagged up now with a doctor, is to do so - and to carefully explain the huge extent to which this is controlling you and your life. It sounds very much, like you need some sort of professional support now, not just when you are ready/desparate to have a baby. Its the very best thing you can do to ensure that wherever you happen to be, that your fears will be taken seriously.
In terms of getting an ELCS in this country or abroad on mental health grounds, you might face a battle but equally if you are already displaying such strong anxiety over this and have a documented history of it, then you'd have a strong case for one. Culturally, I think you'd probably actually be ok in most of Europe, the US and ironically a lot of Islamic countries where the preference is for a CS anyway.
I was rather alarmed by a story about Turkey were there is talk of changing the law to reduce the number of ELCS taking place - but was very pleased to read on www.cesareandebate.blogspot.co.uk/ that actually they were intending to put a clause into the law about tocophobia. It surprised me. I find it good to know that tocophobia is gradually starting to be properly recognised as a very real mental health condition that needs medical support in a variety of countries.
WantsToBeFree I'm sorry to hear you haven't got much support right now. My mum kind of knew my feelings about natural birth but nowhere near to the extent of how serious my phobia is. I told her about it properly when I was 4 months pregnant and she was great. It's a very hard conversation to have with anyone, and comments from partner's like 'get a grip' are very unhelpful. Tocophobia is a mental health disorder and unfortunately not a well known one at that. It's very difficult because I don't think any mental health issues are dealt with by society in general and even within the medical profession very well at times (my pov is also based on experiences I have of being treated for depression as a teenager, not just my tocophobia).
I'm really not sure what to suggest for you to do to help right now, as you say you move around a lot and haven't mentioned what the healthcare and dr's are like where you are right now. I can only tell you my experience of healthcare and the NHS in the UK. When I was in the same position as you (i.e. before I became pregnant) I went to see my previous GP in the area I used to live, as the anxiety and upset I was going through was becoming unbearable. He wasn't very helpful or understanding at all, and it was a very upsetting experience. I have been lucky that since becoming pregnant, the dr's, midwife and consultant I have seen where I am now have all been great. Do you feel that going to your dr now would be of help to you? One of the things recommended to me was CBT, not to cure my phobia but to help with my anxiety, so this may be an option for you at the moment?
You also mention about paying privately for a c/s, which I'm sure would not be a problem at all in the UK. It can be very expensive though and I wasn't aware of any hospitals outside of London or Watford where you could pay privately, but if anyone can correct me on this please do! This may not be an issue for you anyway, but although we arent too far from London, it's not close enough for my liking. Are you aware of the NICE guidelines that were updated last year regarding c/s? In theory they mean that women with tocophobia shouldn't be refused a c/s by an NHS consultant, but I don't think it's a guarantee, just a guideline. I don't know if this info is helpful at all to you but I hope it is.
HmmthinkingaboutIt, thanks for posting those links! Despite the similarity in usernames and the similar problem, I'm not the same personIt did however help me to know that there have been similar posts on here before.
I will take your advice and write down my fears and hopefully discuss them with a mental health professional sometime soon. I have been to a psychiatrist but I find most of them rather unhelpful. I think they don't quite get why I'd fear a normal, natural process so much.
I don't know if this makes sense but I feel like counselling would help me more if I could be given an assurance that a c section will be performed if I still want it. I know this sounds pessimistic, but I'm just not going to change my mind about the fact that I prefer a c section.
Where I am at the moment, the couple of doctors (obstetricians) I've spoken to so far have been most dismissive about the mere suggestion of a c section on request.
I'd like nothing more than to deliver in London when the time comes, but I'm not sure if that will be possible because my future plans are completely up in the air at this point. I don't know where I'll be in the next 5days let alone 5years. Perhaps I'll feel more centred and settled when the rest of my life is more sorted.
Ariel24, It is very heartening to know that your phobia was taken seriously and that you've been granted a c section. To take what you are saying forward, unfortunately there are no fixed guidelines about CDMR in most countries and even where they do exist they aren't always followed.
OP I think that's great that you are thinking of seeing a mental health prof soon, that's a brave step to take and ultimately I think it's the right decision, as if it's affecting your life so much then you do need some support. I'm sure they would at least be able to help advise you on dealing with your anxiety now, which may not cure your phobia but it hopefully will stop it controlling your life. I also think longtalljosie's suggestion of perhaps starting to save some money will be good as it gives you the financial back up to pay for a c/s, I think that would give you more of a feeling of being in control of things too.
Good luck and hope you get some good support soon.
Wants good luck and be determined in your choice - you feel instinctively it is right so don't be deterred.
On the point of addressing mental health issues around wanting a c-section, I personally have quite strong feelings about this.
I had a vaginal birth that left me in agony, unable to walk, with ongoing health (bowel) problems and PTSD. A subsequent birth was by caesarean section( no-one would have talked me out of it and this was before the NICE guidelines changed). I was given a list of the risks as long as your arm. I pointed out that no-one had told me anything about the risks of perineal trauma before my vaginal birth.
Actually, wants I don't think you have a mental health problem - I just think you are very aware of the potential risks of perineal trauma in a way I was not. Personally I think you are right. You will however, have to play the mental health card because the disgraceful system we have does not willingly support women's informed choice.
However, if you want a c/s wants you go for it. Don't be afraid to kick up a fuss, ring the press, call your MP - stir stir stir. Blog on the Care quality Commisison site about how awful the hospital is in not abiding by NICE guidance - keep on and on and on. Been there, done it, it works.
Actually, with the change in the NICE guidelines you will probably find you are pushing on an open door.
Good luck and remember everyone who makes a stand on this makes it better for other women in the future.
Wants sorry not at all implying that the affects of tokophobia are not real but that it is the system not you that is the problem
Sorry didn't explain myself Good luck
I live in the UK, I was granted c/sections with both DC for tokophobia. My reasons are very similar to yours. I also have a RL friend who would love a baby but she suffers from it too.
Unfortunately it seems that lots of people (both on here and RL) judge negatively when it comes to elcs and don't seem to take tokophobia seriously. too posh to push and other such judgemental bollocks.
But please be assured you are not on your own at all, and please feel free to PM me if you want to chat more as I am not comfortable talking about it in detail on the main boards.
Ushy, You don't have to explain yourself I understood how you meant it
In fact I think you may have hit the nail on the head. The issue here is that I prefer the risks of a c section because the potential after effects of a normal birth terrify me. Now if c sections were a readily available and accepted option, there wouldn't really be a cause for concern. What fuels my anxiety is more the possibility of being denied my choice than anything else.
The judgement from random strangers is something I'd just tune out because it doesn't bother me.
I'm so terribly sorry to hear about your first childbirth experience I've seen women very close to me suffer from similar conditions and I know how devastating and shattering they can be. It's a right shame that you had to kick up a fuss to get a c section even with a prior traumatic birth that left you with ongoing issues. I can't believe how backward our society can be when it comes to childbirth. We welcome technology in every other sphere of life, but try hard to keep childbirth as primitive as possible.
WoodlandHills, I agree with you! I've been called 'too posh to push' so many times! My gosh it's such an awful phrase isn't it? So insensitive and quite vulgar to be honest.
I will definitely PM you soon. Thanks
I have been granted an ELC but not neccasrily on mental health grounds. I had a text book fist labour - very short for a first time and had no physical after effects to speak of compared to others. HOwever I found the general pain levels and worry etc and not knowing how long labour will last - how it will end all too much for me. I had homeotherapy massage and all the rest of it - MW amazing as was DH, so really it couldnt have gone better, this is what worried me for the next time round!
My consultant is part of birth trauma association and basically has let me choose what I want with no stress or worries, she told me this at about 20 weeks.
I am keeping an open mind about other modes of delivery but now I have been told I can have an ELc the weight of worry lifted off me has been incredible. Whilst I still worry about going into labour before my date - as all us elc ladies do - I have been able to relax a whole lot more.
I even had a dream about being in the operating theatre last night which has helped me mentally prepare for surgery!
There are consultants out there who will grant you one without a fight, just make sure you take the reigns of your life - when/if you fall pregnant do your research and get yourself into a country that will give you what you want.
For warned is for armed - research and prepare yourself.
If you are living abroad then you may have to return to UK to deliver your child. But this is possible - no one else is in control of your life! You are.
I just wanted to post a quick update. I went for my first counselling session yesterday.
The lady seemed nice enough and was understanding.
But I have a confession to make. I am convinced that I cannot ever agree to the idea of a vaginal birth. I'm not seeking therapy to get over the phobia (because I know I can't) I am seeking it to learn how to cope with it and live a normal life. I don't want it taking over my thoughts.
But I sensed that she is trying to get me to get over the fear and get used to the idea of a normal birth. How do I tell her that it's not going to work?
I've even spoken to my obstretician gynecologist about my concerns and she was most dismissive. She told me that childbirth was normal and so were it's risks and lectured me on how I'd get through it just like all other women.
Right, you aren't pregnant now, so you can start saving. If you could afford a private c section then you would have the choice 100% and it wouldn't matter if your NHS obstretician thought. I think you strike me as needing that safety net of 'control'. Would it help you if you knew you had the option of buying what you want?
If you could save towards it, you could always tell others it's your retirement fund or your house fund (which it could be if you are able to get an NHS ECS), but then would that help you relax that you have the choice if at that point (20 weeks normally) they said no?
(I think it's about £10k you'd need to save for a private birth in London, not that unrealistic if you said, save £170 a month for the next 5 years)
Many health professionals are dismissive of fears of birth, but then it's 'normal' for them - they 'experience' hundreds of births a year, yet this is a 'one off' for you - it is normal for the human race, but so are many things that I'm scared of.
I think you have to be honest with her and tell her right away that you have no intention to ever have vaginal birth and that you are seeking counselling because you want to feel better now in your life. Tell her that if she tries to talk to you out of ELCS, she should rather suggest a different counsellor because there is no chance you could ever change your mind about it.
Just save up to have a private c section just in case you can't get one on the nhs, but tvh with a history of sexual abuse I can't see you being refused. When talking to professionals I'd focus in this as the reason rather than the risk of fistulas etc.
The idea of a savings fund is really helping me to be positive and feel more in control. It's worth it to shop less and save up for the future
RalucaV, I did try to subtly point it out to her that I'm not going to change my mind but since we were out of time I don't think it registered. I'll make it clear at the next appointment. I'm currently not in the UK by the way so this isn't an NHS counsellor.
sgb - with you all the way. I am coming to my own realisation that I really don't want to control another person's desires, actions, feelings. Why should anyone be expected to stay with me forever? That is working on the assumption that they shouldn't change, and what they want from life shouldn't change, imo.
Change is inevitable; all relationships end one way or another. I would prefer to enjoy them and value them for what they are, however long they last.
oh, crap - sorry!
Hi I had similar feelings to you and as the NHS trust that I live in was very anti CS I paid privately to have it done. I needed that control and couldn't bare having to beg unsympathetic HCPs and even then not have a guarantee (eg what if I went into labour early - would they then still give me a CS).
I had heard private CSs in the UK were 10k minimum so looked into having it done abroad but in the end the hospital where my parents live (in West Kent) does private CSs for 6k. I know this is a lot of money but I'm quite minimalist in other ways (for example I rarely drink, buy clothes, £50 wedding dress, don't drive) and had been saving half my salary for a while.
I had a lovely birth - it was really amazing and I loved getting to meet my baby girl. I couldn't belive how easy it all was and pain free also (most painful thing about having a baby for me was the cracked nipples). Not that fear of pain was my reason for having an ELCS - I'm actually really good with pain but like you was terrified of potentially being left very badly torn or incontinent or forceps delivery. I was worried that a vaginal birth might leave me with issues bonding with the baby.
As suggested I think you should save up a CS fund so that you don't have to worry about this. It would be such a shame for this to put you off having children if that is what you want. And then if you didn't have to pay privately to have it there is no harm in having savings.
Also IME male doctors were much less judgemental about my decision - pretty much every female doctor, nurse or midwife made horrible sarcastic comments about my choice whereas the male doctors were really sympathetic and nice.
I'm actually a medical statistician and the likelihood of something bad happening is a lot higher then they would have you believe. The RCOG website itself states that around 8% of women have severe (3rd or 4th degree) tearing:
I'm happy to answer any questions you might have.
I'm actually a medical statistician and the likelihood of something bad happening is a lot higher then they would have you believe.
Oooh is this for elc or VB? Thanks for your reassuring post as well!
I've never heard if this phobia so thank you for sharing and feeling as if you could
I'm sorry that you feel this way and im sorry that I can't give you any advice. However, at least you've now heard that there are other ladies in your position and your not alone.
I hope in time you will feel comfortable enough to have a baby and be granted the elcs that you would like.
I'd also like to add a positive story....
I had my first baby in may this year and had a normal vaginal delivery with just gas and air and no intervention e.g forceps. However I did suffer a 3rd degree tear which lead to me being taken to theatre afterwards to be repaired. If I didn't have the surgery I would have been left faecelly incontinent. I have healed very well and was prescribed strong pain killers and anti biotics which helped a great deal.
3 months down the line I am back to having sex again, using tampons and mobilising freely. I feel no pain at all now
My experience has not put me off having another baby vaginally in the future as it felt wonderful (sounds strange I know) There is no evidence to show that I'm more than likely to suffer another 3rd degree tear again it's just pot luck.
I just wanted to say that yes it's not a great thing to happen but I feel the strongest I've ever felt and by far the bravest
Whoops just realised I didn't phrase that very well. I meant with regards to VB - not that is is super risky but it is often presented as bad things being so unlikely as not worth worrying about.
Of course ELCS has risks too.
No your right love pigeon, its always elc probs that are pushed.
most people with a brain realise that there is a risk to any form of surgery! many thanks
OP - I'm sure it is very upsetting to be called 'too posh to push' but as you're only 24 and not pregnant I don't really see why the issue needs to come up in conversation. I wouldn't have thought it's helpful for you to keep going over the same ground with your friends and be insulted. Just stop discussing it with them.
I just need to vent a bit and share a quick update. I've been going for counselling regularly and it hasn't helped in the slightest.
My counsellor is trying to tell me that women with tokophobia can deliver vaginally. I don't deny they can and I'm sure many have. But I know that I can't and I find it annoying and patronising when people think they know what I can and can't do better than me.
How do I tell her that for me it's a c section or nothing? I'm not looking at changing my mind, I just want to get over the constant anxiety and random panic attacks. That's why I went in for counselling.
I'm feeling so frustrated and disheartened right now. This phobia has literally ruined my life.
The question I would ask, is what is it you are trying to get out of the counselling and what is the actual goal of the counselling in the first place?
If you are in the mind set that a c-section is the only thing you will consider and the counselling is designed to only explore the idea of giving birth by VB rather than address the issues around your anxiety I think you have a fairly big sticking point.
From what you have said it does suggest the counsellor isn't making a connection with you and really doesn't understand what you hope to achieve - you have different goals effectively. Its certainly something you should discuss with the counsellor purely from the point of view of establishing what you are both actually trying to achieve from it.
You should be discussing exactly how you feel and how you don't feel the counselling is doing a thing for you, and how you are finding it patronising, not listening to how you feel and it is frustrating you. Precisely because if they don't know that they really can't progress from where you are now in a positive way, and because to be blunt about it, there is a hell of a lot of counsellors out there who have no experience whatsoever of tocophobia and are trying to treat patients. Unless you tell them, what they are doing is crap, they'll keep doing it like that!
As I described in my OP, anything related to childbirth can make me anxious and panicky. The preoccupation with this fear is so bad that I find it hard to concentrate on my studies since the smallest of things can trigger a panic attack. I want the counselling to help me deal with this anxiety and block out these triggers or at the very least deal with them better. My aim isn't to get used to the idea of a VB because I will NOT consider a VB. It has to be a c section and of that I am certain.
I've said this to her numerous times but she keeps harming on about the possibility of me not getting a c section. I don't want to even think about that possibility because it makes me want to jump off a cliff.
Have you considered trying a different counsellor. If shes not 'getting' it, then I don't know if you are ever going to get anything out of it.
I'm feeling a bit hopeless to be honest. It's hard for me to explain this, but I live in mortal fear of being forced to endure a vaginal delivery.
The thing is, I'm not sure if anybody can even understand what I go through.
The truth is that there is some very poor counselling for tocophobia out there. Even NICE admit they don't know what works and what doesn't. Their recommendations as part of their updated guidance on c-section was that research in this area was urgently needed to assess what DID work.
So I think you need to take that on board and if this is taking over your life this much be prepared to try a couple of alternatives.
Perhaps breaking down into dealing with panic attacks and how to cope with that, rather than the actual problem of your fear of childbirth is the way to go. Deal with the symptoms first then the cause.
I don't know. I don't think anyone has the answer you are looking for at the moment.
I keep having thoughts that I know are ridiculous but I don't know how to avoid them.
I keep thinking "What if no doctor agrees to perform a c section?" or "What if my I go into premature labour and they fob me off?" or "What if I am placed too far from London to be able to access private care?" or "What if there are no private hospitals available?" or "What if the guidelines change and c sections by request are outlawed?" .... the list is endless. I want to avoid these thoughts but I find myself frustrated.
How many counselling sessions have you had OP? What is your counsellor actually called? (I don't mean name, I mean are they a CBT counsellor, etc).
Are they private or NHS? If NHS, you have done very well to get one so quickly. Is this counsellor someone who specialises in tokophobia? They are very rare. Presumably this is not a 'midwife counsellor' as you are not pregnant and are not in the ante-natal care system.
It seems very odd that this councillor is making you focus on having a VB rather than dealing with your anxiety in a more general way. Especially given that they are very unlikely to be directly connected to ObGyn HCPs. I think some more specific details about this counsellor would be helpful OP.
I had an elective caesarian for my 1st DC on the NHS for primary tokophobia so I have a fair bit of experience in this area.
Wants, is this CBT you're having? If so, what the counsellor is possibly trying to do is to encourage you to theoretically confront the object of your greatest fear. It's a standard approach with phobias. It may be, for the counsellor, more about getting you to have that theoretical confrontation here and now than about any future pregnancy and birth you may or may not have.
You may need to tell her very directly that you would like her to treat your anxiety rather than your phobia. Phobias are usually treated with the goal of being able to perform the feared activity (go on the tube, on a plane, cope with cleaning up vomit, etc.) If she is treating you for a phobia, this is likely to be her aim. Perhaps say 'I would like you to see me as an anxiety patient needing techniques to get it under control rather than a phobia patient'.
That said, if you could have that confrontation it might be very beneficial to you - whether or not you go for a CS or VB later on.
Have you spoken about your abuse?
Yes, she said we are starting CBT. And you're right she asked me to come up with a hypothetical situation related to childbirth that terrifies me the most and to write about it in detail. That should be easy- my worst nightmare is a forceps/ventouse assisted birth.
I have spoken to her about my abuse and my absolute aversion to intimate medical exams. The sight of stirrups makes me sick to my stomach and gives me panic attacks. I cannot bear to be touched or examined intimately by a HCP.
She is a clinical psychologist who specialises in phobia management. And this isn't in the UK- I am temporarily out of the country and I am under the care of a private clinical psychologist.
I have sent you a PM as well with some questions!
Here is the link to the previous thread OP - www.mumsnet.com/Talk/childbirth/954334-Anyone-asked-for-ELCS-for-first-baby
It has good and bad stories on it - mine was a good one, but the original poster Pixiecake had an awful experience, to warn you.
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?
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.
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.
Firstly, I'd like to clarify that I have been officially diagnosed with tokophobia and extreme anxiety. I haven't self diagnosed
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.
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?
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...
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.
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!.
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.
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.
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.
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.
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.
You've all been so patient and helpful 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?
you are welcome
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.
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.
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?
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?
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.
I think you need help with your problem.Professional help.Please for your own sake get some.You cannot live your life like this.
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.
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.
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.
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.
PS - ariel24, lovely to hear your good news! That's so encouraging to read - huge congratulations.
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.
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
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