Tokophobia, have you told your gp?

[user1483291956]

Is there anyone on here who has, or thinks they may, tokophobia? I would love to have children but I have a deep fear of childbirth. Every time it was on TV, films or featured in books I would feel hot, sick and shaky. I regularly wake up in the middle of the night and spend hours worrying about it. Over time I have become a little more accustomed to pregnancy and birth by forcing myself to look at images, starting off with mild diagrams and can now look at photos without becoming too uncomfortable, however this has taken me 15 years of hard work. 10 years ago I had an unexpected pregnancy and despite desperately wanting to keep my baby I felt I had no other option but to have an abortion due only to my fear. I did mention my reason at the abortion clinic appointments but they were brushed over by the nurses as "everyone gets scared but you'd be fine" and so with no support I went ahead with the abortion. Something which I regret to this day. I'm now 30 and would really like to start a family, but no matter how hard I try I cannot get over this fear alone. As part of my research I have found some nhs guidelines (nice) which state that if a lady really wants a caesarian section she should be offered support and help, but ultimately it would be her choice. I know some of you will probably feel this is the wrong choice as it's a major operation and carries significant risk. I am fully aware of, and understand this. However it is the only way I can ever envisage being able to mentally cope with pregnancy and birth. I have researched people who have opted to have an nhs caesarian on the Internet and seem to be getting quite mixed stories, including those who have been refused whilst heavily preganat. Has anyone on here been in a similar situation? Were you able to get agreement before you became pregnant? Waiting until already pregnant really isn't an option for me as c section is the only way I could allow a pregnancy to progress and I really don't want another of my babies to suffer being aborted. Was your gp understanding? What about family and friends? The few people I've trusted enough to share this with really haven't understood. How did your partner feel about it? I would really appreciate any answers, feeling really alone at the moment.

[Catinthecorner]

Can I recommend the blogger Forever Amber. She's mostly a life and style blogger but is now pregnant and blogging about her experience of pregnancy and tokophobia.

[user1483291956]

Sthitch, I really hope all goes well for you. You are so brave for getting to this point.

[sthitch]

@alnman I am the same - terrified of needles , csection, giving birth in general... I wanted a baby but also felt relieved every month I wasn't because I was so scared.

I'm now 41 weeks pregnant! I've got through every needle, (which weren't many and I also had to have a large one for my blood type- thank god I didn't know about it before I got pregnant.. it wasn't even bad but had I have known!) I've been doing pregnancy yoga to give some positions to help in labour and some breathing techniques to keep me calm... this has all helped to have a calm pregnancy where I have constantly reminded myself that there's no point wasting energy worrying as this HAS to happen.

I'm now at the point where I'll probably be induced which is not what I wanted at all but I'm still trying to keep the calmness and know that I have to go with the flow...I'm also having a larger baby which was not expected as I'm tiny... all of this would have 100% put me off but I'm so glad I'm here at this point and didn't let a fear dictate my life. Hopefully I can come back in a week with a good birthing story but all I will say is you're pregnant for such a long time that you HAVE to keep calm and not panic because it makes for a much better pregnancy and its hopefully one day of your life. I got through every appointment and every needle and I think there's another one out of the way, it's not forever. Good luck!

[AInman]

Hi all, I too feel like I might have a version of this. The thought of childbirth terrifies me and I don't do well with needles either so the idea of an epidural and/or a c-section is just as bad. I'm not pregnant but my husband and I have been talking about trying. We were going to start soon, but the thought of childbirth puts me off even trying, which has upset him. He gets I'm scared and says he'll be there for me, but sometimes I wonder if he gets how terrified I am. I've started to watch one born every minute for the first time, to see if it helps, but I'm not sure it does. Has anyone else had counselling and found it worked, or can suggest anything to make the idea of childbirth less daunting?

[user1483291956]

Well I thought I'd give an update... and ask my next bundle of questions!

Firstly, thankyou. I read back through these messages often, usually whenever I'm having anxious moments, (frequently and generally in the middle of the night!) It's just so reassuring to know there are people who do actually understand. So thankyou again to all of you for your replies 💛.

Well, what's been happening... back in February I had a telephone consultation with a cbt therapist. It wasn't the best phonecall actually, got pretty emotional. She was saying she didnt think i was in the riggt frame of mind to try cbt as I was focused more on a caesarian than curing my phobia. I was devestated that I'd told her some really personal infornation... and she wasn't going to try to help!

She called back the next day to say she had spoken to her manager and wanted to meet me in person. I met her back in March and we did a session of cbt to give me an idea of what it would be like. I still struggled with the the idea of having a vaginal birth as my end goal, but I understand the therapy has no chance of working if I dont.

My local cbt service is so busy that I'm yet to get an appointment, half of me is eagerly awaiting it's start. The other half soooo grateful for the wait!

In May I was watching TV with my lovely partner when an episode of Gavin and Stacey came on. You know, the one where Ness gives birth. I tried my usual casual trick of trying to change the channel, nope, he wanted to watch it.... next trick, I'll keep chatting and try and ignore it, nope, he wants to watch it. I'll do the washing up, nope, come and sit with me. By this point I was pretty horrified and trying desperately not to watch or listen to anything. In the end it turned out to be the best thing to happen. He saw how panicky I had got and wanted to really know why. We spoke for hours about everything and I honestly couldn't have asked for a more caring response. He admits he doesn't really understand, but is trying to and has been googling things on and off and asking me questions. Honestly feel overwhelmed and so grateful for his caring and desire to help, especially as this potentially affects his future so much too.

I took the advice about writing to PALS. Unfortunately after 12 weeks of no response I contacted them again, PALS checked and confirmed they had asked the appropriate department to contact me. After about another month I received a one line email from the head of midwifery, to say my local hospital doesn't have any policies on tokophobia. I replied to her twice, explaining in more detail, however she hasn't replied. Still, I'm looking on the positives- I have her name now and will make sure I never see her!

7 weeks ago I went back to my GP and asked him if I could try his second option- being referred to a gynae. He agreed and said he'd send off the referral. He also tried to convince me to have antidepressants again. I've declined, I honestly don't feel depressed. Anxious yes, extemely. In the middle of the night, perhaps a little out of control. But other aspects of my life are great, I really dont feel down about anything else. Has anyone else been offered these? I'm doubting things now and wondering if it's a normal part of the process!

Well, yesterday after some gentle nagging from the lovely man I called the hospital to see when I was likely to hear about an appointment. The secretary was able to confirm there had been communication between my Gp and the gynae but I could not have an appointment without further confirmation from my GP. He called me today to explain the situation. He said he has picked this particular gynae as he believes she cares about the lady and the whole situation, rather than just a physical need as some consultants do. (Very grateful to him for this). He explained that the delay has been caused by the gynae wanting me to have cbt before or alongside seeing her as she recognises it as an important part of treatment. However the cbt service are not replying to him when he asks about waiting times. My GP has kindly agreed to contact the gynae and ask her to see me before I start cbt. He has also recommended I look into private cbt and hypnotherapy in our local area as he feels this might help. I've been googling prices and they seem to be ranging from £40 to £100 per session, with sessions recommended as weekly. Has anyone tried this before and have any idea of how many weeks I would need to go for? Trying to calculate how much overtime I might need to do to fund this! Also, has anyone tried hypnotherapy?

So really, the wait goes on. But, thanks to all of you wonderful people, after many years I'm actually at the beginning of a journey, all be it slow and anxious. I wasn't going anywhere before and I was still just as anxious. Trying not to get my hopes up, but maybe, just maybe, the gynae will understand.

[Battyaboutbirth]

Tokophobia is very real and it must be absolutely horrible to experience. You've had lots of wonderful advice above but I would also just add that you have to remember labour and birth on tv/films etc is produced for entertainment value. They want people to be on the edge of their seat and gripped to the storyline. Very rarely is labour and birth anything like the crazy scenarios you see on tv.
Definitely try and get some help from your doctor and maybe look in to Hypnobirthing.
It teaches you about the process of birth and how natural and normal it is for our bodies to give birth. It also uses practical relaxation, breathing and massage techniques. It has been known to help with tokophobia. I did not suffer from tokophobia but was very very nervous about the prospect of giving birth when I found out I was pregnant and Hypnobirthing helped me more than I would ever have imagined it would.
I hope this helps x

[Minniemouse1983]

I have the same problem and can only say you are not alone, im 33 and would love to have family but the fear of childbirth accompanies me from a very early age. Fortunately if you attend counselling early in the pregnancy you will be offered a c section, the problem is many women are embarassed to say they are tokophobic and leave it tonthe ladt minute. If you request it in say 8th month the NHS wont manage to fit you in for enough councelling sessions to officially confirm you have a phobia and they may pressurise you to have natural birth. This is why I am planning to request help now, before i am even pregnant. I sometimes wonder if the reason behing my fear of childbirth is the fact that my mum had me via c section and when i used to ask where children come from my mum would point and say from my tummy! when i finally found out that children are born via a womans vagina i was in deepest shock even as a child and I still dont seem to be able to shift it. I can just imagine how ridiculous that sounds. I have only recently at the ago of 33 watched a childbirth on you tube with my husband after he discovered I have never seen live birth, i never wanted to see one the stories were bad enough. Now the time came to start thinking about family i wake up in the middle of the night sweating, I cant remember last time i slept well. It has been constant anxiety for the last 12 months and the pressure is on as my husband would love a baby. I have nearly decided about having a c- section, the only thing that really worries me is the fact that a lot of women complain about migranes for months after c sections. If any of you can advise on the likelyhood of this side effect I would be grateful.

[mimiholls]

That's good he was sympathetic but yes does not sound like he has the experience in this area. I don't think you'll feel differently just because you're pregnant, I certainly didn't. Could you ask to talk to your community midwife? There is likely one at your GP surgery. She may well have experience of other women who have been in your situation and will work closely with the maternity unit at your hospital so may have better knowledge. Writing to your hospital to ask their policy for tokophobia is also a good idea.

[user1483291956]

And no, unfortunately that's about my annual earnings, so wouldn't be something I could afford unless I saved for an extremely long time!

[user1483291956]

I hadn't even considered contacting the hospital directly for policies, that's a great idea, thankyou :-)

[HopelesslydevotedtoGu]

You could write to the hospital and ask to see their policy for tocophobia or maternal request Caesareans. Try writing to PALS (patient advice and liaison service)
I'm not sure if they will share their internal policies publicly, but it is certainly worth investigating
Obstetricians will generally follow the hospital policy

[HopelesslydevotedtoGu]

I do think it is very likely you will be able to have an NHS c section
It is supported by NICE guidance, and generally doctors will follow their guidance
Depending on your hospital policy, you may be offered it straight away, or have to argue your case
I appreciate that may not be reassuring enough for you to get pregnant
We decided that we would go private if we weren't offered an NHS section - around 12-15k in London - is that an option as a back up?

[user1483291956]

Hopelessly devoted to gu- thankyou for the advice, I tried looking on my local hospitals website for some information, unfortunately all I could find about elcs 'was what to do the day' info. Then I tried my county's health care trust website, put tokophobia into the search box, came back with no results :-/

[user1483291956]

Thankyou for all of your replies, it really helps so mucj to hear there are others who feel like me, also that you have been able to receive help.

Well I went to my gp his morning. He was pretty sympathetic and said it's something he had heard about back in medical school 20 years ago, but couldn't remember the name of :-) he has suggested I speak to someone, however it's phone consultations, not sure how that will work, sounds pretty impersonal, but I'm going to try it. Said he can't refer me to an obstetrician unless I was actually pregnant and didn't really seem to grasp that this won't happen! Offered me antidepressants too and said I could continue to take these while pregnant. I've declined, I don't feel they would help. Has anyone else been offered/tried medications? He said pregnancy hormones are designed to make you feel different about giving birth. I just don't feel this can be true, or why would so many of us feel this way! So although he was sympathetic, I don't feel he really had the knowledge to understand how I'm feeling.

[Blueskyrain]

I have this, albeit not quite as severely. I also have a phobia of needles. I mentioned an elective at booking in, and was able to discuss it with the consultant at 12 weeks who agreed it on the spot as she could see how distresed I was. I do have to see a psychologist, but that's helpful with my phobias anyway.

[HopelesslydevotedtoGu]

If you can, do look at your local hospital(s) website. Mine was quite clear that if you requested a c section they considered tokophobia a valid reason. They did want you to see a vbac specialist midwife to discuss your choice. At my first appointment with her she agreed that I could have a c Section.

[SpookyPotato]

I had an elective section for my first and now my second (8months pregnant) due to fear of birth/examinations/instruments and not had any issues getting them, it's a completely valid reason! Good luck OP

[RedToothBrush]

Writing it down is a good start. It helps clarify what you need to tackle one way or another. It means that whoever sees you needs to come up with an answer. Saying they can't help isn't good enough. They need to do something.

You might well get some bumps along the way on this, and things might not go the way you imagine right now so don't take a potential set back as the end of the road.

[mimiholls]

Great good luck! Let us know how it goes.

[user1483291956]

Thanks red tooth brush, for your reply, all of this is really helping, I keep thinking through all of my reasons and I'm going to write them down to take with me, as suggested by yourselves. We'll ago appointment is booked for Friday 13th, not sure that's actually the best omen!!!

[RedToothBrush]

Is there anyone on here who has, or thinks they may, tokophobia?

Yes I had. There are a number of women on MN who consider themselves to have primary or secondary tokophobia even if they have not had a formal diagnosis.

As a rule this section of MN is very supportive of women who find themselves in this situation. You are definitely NOT alone. There are a number of posters who regularly post on the subject and try and offer a degree of support by just making the point that it is more common than you think.

The subject is generally still taboo in many places which is part of the problem. MN is NOT one of them.

As part of my research I have found some nhs guidelines (nice) which state that if a lady really wants a caesarian section she should be offered support and help, but ultimately it would be her choice.

The guidelines are a big help but they are still problematic as not all hospitals follow the guidelines. You do not have a 'RIGHT' to an ELCS. It is however, worth pointing out that you do however have a right to healthcare treatment most appropriate to your medical needs. This means if you are diagnosed as having tokophobia you can argue the case that an ELCS is the more appropriate course of action for your medical needs - therefore you have a right to it.

There are a lot of politics to get your head around with the subject if you are determined and really want to have a baby.

I know some of you will probably feel this is the wrong choice as it's a major operation and carries significant risk. I am fully aware of, and understand this. However it is the only way I can ever envisage being able to mentally cope with pregnancy and birth.

STOP RIGHT THERE. You do not have to justify yourself to anyone. Mental health IS health. Would you justify having your leg put in plaster if you broke it? If you wouldn't then don't do it for this. Change your attitude, as you have a genuine issue and a genuine reason to seek medical help and attention. As I said before, there are lots of people in this section of MN who understand this and are supportive (This is not necessarily the case elsewhere on MN, but here there is a good understanding of the issues).

I have researched people who have opted to have an nhs caesarian on the Internet and seem to be getting quite mixed stories, including those who have been refused whilst heavily preganat. Has anyone on here been in a similar situation?

I have been lurking on these threads for at least 8 years now. (Yikes!) NHS policy on ELCS for mental health is extremely patchy and inconsistent. It is a complete postcode lottery really. Some places have very little (or no) mental health support for this, others are much better. One hospital can effectively have a 'blanket ban' in place whilst the next will let you have an ELCS without any problem what so ever. It is not always easy to identify which is which, but it is possible. This can be half the battle.

Were you able to get agreement before you became pregnant?

YES! I did. I went to my GP before becoming pregnancy and was able to be referred to someone who could help (My GP didn't know what to do with me, but I had been able to identity a specialist and she was happy to refer me after I gave her the details).

I was told I could have self referred, direct to a specialist or I could go through the GP (which is what I did). It CAN be difficult to get a referral simply because services are limited, and too far and few between and heavily oversubscribed as a result with priority given (naturally and rightfully) to women who are already pregnant. But you DO still have a genuine reason to get access to these services. Anyone who tells you, you have to be pregnant is NOT right.

Access to appropriate mental health services should be available to all women of childbearing age. Keep this in mind at all times.

Was your gp understanding?

Yes very. Not all are, but awareness of the subject is much better than it was. If they aren't, you may still be able to go through the self-referral route or approach another GP.

What about family and friends? The few people I've trusted enough to share this with really haven't understood.

I think its hard to talk about, especially if you have friends who don't know much about the subject. For me, it took some years, and learning how to talk about it in a way which explained it as a mental health issue rather than being 'too posh to push' or something that you just somehow get over as part of being pregnant. How you frame your situation helps how others respond to you.

There is also no obligation to tell anyone. Its not their business. If you are worried about how others will react you can always say that you have discussed your medical problems with your doctor and you both agree that under the circumstances which are complex, that having an ELCS might be the best option for you and the baby. It makes it difficult for others to stick their oar in then.

However in the end, the majority of my friends all know now, and have been extremely supportive and understanding, especially since a couple have subsequently had difficult births themselves and have struggled with the prospect of having a second baby.

How did your partner feel about it?

With him I'd have been lost. He was brilliant. Having a supportive partner is important and a good ally to have if you do face obstacles to getting the support you need. A supportive partner, who 'gets' it, is your best asset.

Final Thought:

In posting this, you may have just taken your first steps forward on a long journey. Please keep in mind this can be a bumping road at times and it takes time to go through the process and find the right way for you. There is no one right way to do this - only the right way for you.

What other people take for granted, is not as straightforward for others. This is NORMAL. Anxiety over childbirth is a spectrum, with normal being both ends of the spectrum for fear and no fear and everything in between. You just happen to be at the more extreme end which means you need more support than the average woman.

Fear of Childbirth is something that has existed, probably as long as women have given birth. There are historical references to it, which are not about the physical risks of giving birth of the past but about the mental aspects of it. Don't let anyone tell you different or give your the crap of 'women having been giving birth for thousands of years' shit. It misses the point that this is 2017 and how health care has progressed and recognises how important mental health is in addition to physical health.

Things have changed a lot since the NICE guidelines were last updated in 2011, and there is a lot less ignorance on the subject but it is still not treated and as well understood as it should be.

There are a number of hospitals that have conducted research into the subject in recent years which had never been done in this country prior to 2011. I know of one that is currently on going at present. So despite the problems the situation is a lot more positive than it has been in the past.

Just keep thinking that this is about your mental health and your need - and right - to have support with that. How you actually give birth in the end is actually secondary to that need. Indeed, with the right support it is not inevitable that you will want an ELCS afterall, as inconceivable as that might sound now. There are women that do change their mind, as they have managed to build a trust with their HCPs to a level where they feel they can have a VB afterall. Having an ELCS agreed in principle ahead of getting pregnant was a safety net and a stepping stone to building that trust.This did not happen to me; but I do recognise that the support my hospital gave me was so good that other women might feel confident enough to change their minds.

As I say, there is no 'right way' to do this. Only your way.

Good luck. I hope it works out for you.

[user1483291956]

Or a blubbering mess of course!

[user1483291956]

Thankyou to each of you for your replies, it's wonderful to hear some positive 'stories' and I'm truly pleased that all of yours ended in a way that was right for you. Well I've decided that once my doctors surgery reopens-Wednesday I believe-I'm going to brave it and make an appointment. Hopefully if it's on my records then if and when the time does come it'll make things quicker and easier. And if my gp is not understanding then I'll be a blubbering message, but in now worse a situation than I am now. Thankyou and happy need year to all of you x

[TwentySomething]

You are not alone. I posted about this recently and got some brilliant advice. Good luck!

[Puppymouse]

Hi - another elective section due in part to tokophobia and also historic sexual abuse. I started worrying about giving birth from about 9 when my mum properly talked to me about it. I was petrified. I can't even use tampons.

When I fell pregnant I was referred and sadly consultant didn't listen despite midwife being supportive. She gave me some leaflets about vaginal birth and sent me packing. I couldn't hold myself together anymore and had a panic attack in the hospital. Needless to say I had a home visit from the head midwife a week later and the consultant agreed straight away based on her recommendation. I just wish I could have got my message across factually and with dignity. I very nearly pissed myself with fear when the consultant brushed me off. I had always told DH I'd have to have an abortion if they wouldn't let me have a section.

DD's birth was as good as it could have been having major surgery.