Investigating the psychological factors underlying tokophobia in women following birth trauma, and the need for psychological counselling of women who fear and avoid childbirth

The aims of the study were to uncover the major psychological factors underlying tokophobia, their impacts, and whether there is likely to be a role for psychological counselling to help women and their families. Nine women who indicated that they fear and avoid childbirth despite wanting a baby, volunteered and participated in a semi-structured interview. Six of these interviews were transcribed and analysed using the guidelines provided by Smith, Jarman & Osbourn (1999), from which tables of individual themes were created. For the participants, violation of expectations led to enduring distress, which manifests as symptoms of post-traumatic stress. ‘Loss of control’ and ‘loss of self’ are powerful themes that support existing literature. The theme ‘need of acknowledgment’ adds to the existing literature. As difficulties adapting to changes in lifestyle were expressed, a seven-phase transition model was suggested as a way of explaining and understanding difficulties faced by women with regard to changes in identity and lifestyle. It was concluded that the presentation of ‘secondary tokophobia’ does not fit with the term ‘phobia’. A reclassification of tokophobia was suggested for women who experience fear and avoidance of childbirth following a traumatic birth.