Does childbirth fill you with fear? A midwife's tips for managing tokophobia

Anxiety around pregnancy and labour can be overwhelming – but there are things that can help, writes Liz Connor

Pregnancy and the thoughts of labour can be overwhelming for many women

GIVING birth can be a daunting prospect for many women, but for some, the fear of labour can be severe and debilitating.

Known as 'tokophobia', an acute fear of childbirth can be triggered by a range of factors, such as a previous traumatic birthing experience or an underlying mental health issue, and in some cases it can develop out of the blue.

Parent support charity the NCT says up to 78 per cent of women have fears associated with pregnancy and childbirth, with 13 per cent saying their fear is strong enough to make them consider postponing pregnancy – or avoid having a child altogether.

It's important to remember that changing hormones during pregnancy can have an impact too – so feelings of anxiety and worry that might start out mild could become worse for this reason. There's no need to struggle on alone, though, and getting the right support and advice can make a world of difference.

Here, midwife Layla Rumble shares her top tips for managing fear and anxiety around childbirth...

1. Therapy

Tokophobia can be a lot less debilitating with some practical therapies, like cognitive behavioural therapy (CBT), which focuses on changing negative patterns of thinking. "A specialist will encourage you to talk about your fears or try to investigate what the root cause might be," says Rumble, a midwife at The Portland Hospital in London. Typically, CBT will help you to notice problematic thinking styles, and devise steps and techniques you can employ in order to help change them.

2. Breathing techniques

"Breathing techniques are a well-known method to reduce feelings of panic and worry," says Rumble. Generally, these are easy to learn and involve inhaling and exhaling rhythmically, to calm the mind and body.

"Breathing physiologically reduces anxiety by supplying sufficient oxygen around the body, thus reducing heart rate," explains Rumble. "Concentrating solely on breathing will divert the focus from what is causing the anxiety.

"During both pregnancy and childbirth, this can calm a mother's nerves and reduce their chances of panic attacks."

3. Antenatal classes

Antenatal classes are a really simple way of learning more about pregnancy and childbirth, and they're free on the NHS. "Classes can help in a variety of ways, such as prepare you for birth, provide insightful information, and ultimately help boost confidence," says Rumble.

They're also a great way to meet other pregnant women, so you can share stories, any concerns and, most of all, feel excited for impending motherhood.

"The well-known phrase, 'A problem shared is a problem halved', comes into play, because everyone in the class is in the same boat, so you're able to support each other as you approach your due date," says Rumble.

Classes are run by knowledgeable professionals, who are well placed to provide emotional support and help create a birthing plan that suits each individual. Rumble adds: "Antenatal classes provide tips on how to cope with labour, including the birthing techniques and methods that are out there, as well as the pain relief options available."

4. Hypnobirthing

The meditative practice involves breathing and visualisation techniques to help manage the process of childbirth.

"Also known as 'The Mongan Method', hypnobirthing is a method that teaches expectant mothers how to use self-hypnosis techniques," explains Rumble.

"It's all about deep relaxation during childbirth – the techniques have been shown to positively impact hormones, which can increase pain tolerance and calm nerves significantly. In turn, this can make for a quicker and more relaxed labour.

"Women who decide to use hypnosis to help them cope in labour usually start practising during their pregnancy, as it takes some time to perfect. It's a method that's becoming increasingly popular, with more and more women taking up classes."

5. Birthing plan

"Control is a very important factor with managing tokophobia," says Rumble, who believes creating a birthing plan can help put your mind at ease.

"It gives her an opportunity to express any worries she might have and also have influence over her birth," she says. "This includes choosing a birthing partner and discussing the different birth options which best suit your needs."

6. Knowledge is power

"My final tip is something I would impart to all mums-to-be, and especially those feeling anxious: collect as much information as possible about childbirth," says Rumble. "There are many classes, reading materials and informative videos about labour, which can help women understand what happens during childbirth and what options are available to them.

"If you're worried, don't hesitate to speak to your midwife or GP and ask for their advice and support during pregnancy."

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