Tokophobia - before getting pregnant

[Shortie987]

Hi everyone,

Without going into too much detail, I suffer from tokophobia. The whole idea of giving birth scares me so much that I am seriously considering not having children, but the idea of a vaginal birth scares me the most. I'm still probably years away from being ready to potentially have a baby, however I've already done some research and I feel that the only way I might be able to do it is if I were able to have an elective/planned c-section.

My question is: has anyone ever approached a healthcare professional about their tokophobia prior to getting pregnant?

I've read articles about some hospitals not always allowing (or being keen on) planned c-sections for tokophobia because they don't see it as "medically neccessary". I feel like if I were ever to go through with having a baby, I would need some assurance that, as long as there was no medical reason that meant a c-section would be too dangerous, I would be able to have one scheduled if that was the only birth option which felt acceptable for me given my phobia.

I worry that if I approached my GP about this prior to getting pregnant they might just laugh and tell me to come back when I'm actually pregnant to discuss birth options. I feel like it would be most helpful for me to be able to speak to a midwife who has experience of helping women with tokophobia beforehand, but I'm not sure this would be possible. Personally I don't think I could get pregnant without being able to talk things through with someone first.

I do understand that pregnancy and birth are very unpredictable, so even with a planned c-section there is no guarentee that it will 100% happen. What I'm worried about is getting pregnant at some point in the future and then having to wait until my 20 week scan to be told that tokophobia isn't a valid reason for them to offer me a c-section in my local area, and having no option but to have a vaginal delivery (unless emergency c-section was needed).

I'd really appreciate it if anyone is willing to share their experience about this! Please understand that this isn't just me feeling a bit nervous about childbirth, it's a genuine phobia I have had for a long time!

I chose a c-section for MH reasons and had one and it was definitely the best option for me, and entirely my choice.

Apologies that I can't relate directly to your fears but I have booked appointments with a GP just to talk about fears or anxieties that are similar.

The key is finding an empathetic and compassionate GP. Hopefully you are in an area where you have several to choose from, but perhaps you could ask around or look on Facebook groups etc for recommendations. A good GP should be able to talk you through all the facets of your phobia including whether you may want to consider counselling, and they could also comment on the elective CS thing.

It is possible to manage phobias to the point where you no longer fear the thing, with proper therapy. Maybe that's something you can look into before it's time to get pregnant.

Worth googling if there’s a perinatal midwife in your NHS area. They may be able to have a chat at this stage, before you even become pregnant. They look after the mental health needs of mums to be.

Stupid question perhaps but if someone has tokophobia are the thoughts of CS not considered scary by some as well? Or can sufferers have a CS under general a?

@OnceUponAFairyTime

Thank you for your replies! It's good to hear that you were able to have one and you feel it was the right choice for you. I will definitely have a look into your suggestion of seeing if we have a perinatal midwife I could talk to.

You can in theory more or less pay for a c section.

@theamplifier

Thanks for your reply. It's reassuring to hear that you managed to speak to a GP about fears and anxieties. Hopefully my GP might be empathetic and understanding!

@womnat

Any type of birth is a terrifying prospect for me, which is why I am not sure at this point whether I will ever actually be able to do it! I'm sure it's probably different for everyone who has this phobia. For me personally, a planned CS sounds slightly less scary (although I would still struggle) mostly because people seem to have fairly similar experiences so I can sort of know a little what to expect. It's also the fact that I (hopefully) wouldn't have to experience any labour pain, which I really don't think I could handle!

What I mean by paying for it is if you go for private ante natal care and ask for a c section it's unlikely they'll refuse or ask many questions.

I, like you OP, could never give birth naturally. I couldn't mentally prepare for it and I simply couldn't have done it. I've a very high pain threshold and I'm not scared of much but the fear of giving birth was a whole different thing.

I didn't think I'd be taken seriously, assumed I'd have to go through many appointments begging and the thought of being pregnant without that guarantee of a c-section was just too much.

@Shortie987 just wanted to say that whilst I didn’t speak to a midwife before becoming pregnant I have Tokophobia and have just had my little boy 2 weeks ago.

I experienced amazing care from my local hospital, my community midwife didn’t know much about it but did refer to me to the consultant psychiatrist as I requested a c section - it was absolutely possible for me to have a section based on my phobia and mental health grounds.

I went into labour a few weeks earlier and the hospital respected my decision for a cesarian and honoured it and I ended up having an emergency section (only due to me already being in labour when I came in) but it was still very controlled ans relaxed.

I was also looked after by a specialist midwife who was so lovely and helped me through the pregnancy.
Hope this gives you some reassurance.

I don’t experience tokophobia but I had a planned c section for mental health reasons. It really wasn’t difficult at all, I had one consultant who sort of tried to talk me out of it but other than that I came up against no resistance. If I were you I really wouldn’t be worrying about it now, years before you want to have children. It will all fall into place. Good luck x

I also had primary tokophobia. Because I knew that the rules had changed to allow this (though patchy in places - see Birthrights charity for a map of Trusts that do or don't easily comply!), I went ahead and planned a pregnancy, then brought it up at my first midwife appointment.

This isn't what you asked, and I support your wish, but it might interest you to know that after I'd finally got them to agree to it, I went into labour a few days before the planned C-section date, and went through with a vaginal birth! They actually offered me a C-section there and then, but since labour had started, something just clicked and made me want to continue with it. I had an early epidural. This was already in my back-up birth plan, suggested by my consultant when discussing my fears. This made the whole thing a different story altogether to what I had feared - I was in control and felt no pain. I am glad I did it. I had been starting to question the C-section decision basically as soon as it was agreed (despite having been dead set on it for years and crying uncontrollably through antenatal classes), and I feel really proud to have faced my fear and come through it.

No judgement from me whatever you choose, but I wanted to share my story in case it helps you now or later. Best of luck.

Yes.

Gp refered me to a specialist.

Specialist saw me and agreed i had sufficient anxiety to merit the request. Told me to now go away and get pregnant and they would book me in asap.

Got pregnant. Was booked in for cs at 16 weeks pregnant.

HOWEVER i had asked the gp to be referred to this particular specialist after researching them and knowing where to get help.

This wasnt at my local hospital - i had to travel (was still nhs though).

This isn't necessarily something you can do everywhere - some trusts are still difficult about this.

One of the reasons i wanted to be referred to this specialist is because of their reputation for birth fear in general - their research had found that lots of women once their request has been granted have found that this was a foundation of trust upon which they could build a relationship with midwives and as such they went on to change their minds and not have a cs.

A cs isnt the solution to everyone, and you should still see about addressing the underlying anxiety(s) around this fear because it tends to be part of a bigger picture which is relevant to becoming a parent.

So yes it is possible, though not everywhere and it's still not the right thing for everyone.

I spent a number of years researching this and things have moved on somewhat since i did, so id say the single most important thing is to know your stuff inside out...

@Shortie987 I hear you. I have been petrified aswell, and now time is really ticking. I eventually reached out to my GP again and have been referred to talking therapies CBT. I don't actually have that much confidence that it is going to be the deep dive I want, as CBT tends to be more superficial but I will wait and see. Did you manage to get help?