For some women, totally sensible fears about childbirth can develop into tokophobia—an anxiety disorder so extreme that it drives them to avoid sex or seek to terminate their pregnancy.
Film still via 'Alien'
Do you remember the first time you saw childbirth? I was twelve and in biology class. As I rested my chin on clasped hands and squinted at the tiny TV screen, nothing could have prepared me for what I was about to see.
Some tried to joke about it, while others (like me) just tried to think about something, anything else. Why couldn't babies really be delivered by giant storks? That seemed less of a crazy idea than trying to push an eight-poud screaming bundle of flesh out of your vagina.
As I get older, I still don't feel the slightest nag of broodiness. While my reoccurring dreams that I'm pregnant with the Alien from a Ridley Scott movie don't help, it's not so much a fear of childbirth that stops me wanting kids, as it is just not feeling ready for such a responsibility. For some, however, the idea of giving birth is so terrifying that it can develop into an extreme mental condition known as tokophobia, which can result in depression, total loss of libido, and anxiety attacks.
Kate* only discovered the term tokophobia in November 2015, after 45 years of suffering from it. "It's an anxiety disorder, a specific phobia and, as with any other specific phobia, it's always present inside me, every hour of my life. It's deep inside, I don't think about it all the time but if I find myself near women having a conversation about their childbirths, it can trigger a massive panic attack in me."
Read More: The Broadly Guide to Pregnancy
An article published in 2015 stated that the fear of giving birth was on the rise, with as many as one in 10 women being affected. It can be triggered by various things, most commonly a traumatic labor, fear of medical procedures, or viewing explicit video footage or images.
A number of events led to Kate becoming fearful of giving birth, including hearing of those that had become very ill during their pregnancies and even died. It all came to a head when she was 10 and saw a documentary on television about childbirth. "My mother watched the TV show with me but not a word was uttered. After a couple of minutes, I experienced my first panic attack. I didn't know what was happening to me but instinctively I went to the bathroom and put a cold wet cloth on my face to avoid passing out."
Tokophobia can be so extreme it has caused those suffering to avoid sex completely, or to even seek an abortion. One particular case in 2012 told of a 24-year-old woman who terminated her pregnancy, having developed the condition after losing her first baby five weeks before he was due.
Mary* was actually six months pregnant when her tokophobia took hold. "I was petrified. I just lay in bed and cried. But as I was pregnant, the good old mommy hormones took over and that was the end of that. I still had flashes of fear but not as bad as the Week Of Fear, which was pretty horrific in the circumstances. I still remember it, 'What have I DONE?! I'VE CHANGED MY MIND! I DONT WANT TO DO THIS!' But I was trapped."
She realised that these weren't just regular pregnancy nerves, with a level of panic that lead her to consider extreme solutions. "A couple of times the coping mechanism [I contemplated] was termination. [After the birth] I even requested a hysterectomy, much to the shock of my doctor as there's nothing wrong with me in that department."
The fear is constant for me. I feel like I'm not a proper wife as I won't bear children for my husband.
Even without choosing to go through life-changing surgery, the difficult reality for many of the women suffering is that they may never be able to have children. Kayleigh is 29 and from the UK. She realized she had tokophobia after Googling "scared of childbirth."
"The fear is constant for me. I feel like I'm not a proper wife as I won't bear children for my husband." Her phobia, as you might imagine, has made her relationship especially difficult. "It's put a strain on my marriage as my husband wanted children, but I can't do it. I want to but won't bear a biological child so we are adopting."
So how do you go about treating this? I spoke to Trevor Turner, honorary consultant psychiatrist with the East London Foundation Trust. "I have been involved in about four or five cases, and treatment is by anxiety management and cognitive behaviour therapy. If the condition is primary (i.e. the woman has had no previous pregnancy) then this is often successful. If the tokophobia is secondary to a traumatic event, such as a very difficult pregnancy, delivery or the loss of a baby then the fear is more entrenched and may be hard to alleviate."
While I wouldn't consider myself a sufferer of tokophobia, I'm truly terrified of childbirth too. I've heard so many horror stories and read far too much about vaginal prolapses. As our generation starts to hold off on having kids for longer, perhaps fears such as this have more time to develop and fester.
Dr Turner says that we might even have no idea how many sufferers are in our midst, even if our closest friends had to run to a bathroom to breathe into a paper bag every time someone mentioned the words "birthing pool."
"It is probably more common than realized because of the natural tendency to cover it up and the sheer embarrassment of having such an 'abnormal or non-maternal' instinct," he explains. "It is not possible to know if it is on the increase for this reason, but like many psychiatric conditions, sufferers now are coming out with their difficulties as understanding improves and stigma is pushed back."
What makes tokophobia such a difficult form of anxiety is that having children is considered by many to be such a part of women's identities. Even if we're sure we don't want kids, we're always aware of those around us that are having them. If there's one positive thing that could be taken from tokophobia, it's the need for us to be more understanding and open about each other's decisions, perceptions, and howling, fear-wracked panic regarding pregnancy.
* Name has been changed