tokophobiaA leading consultant midwife has urged maternity service providers to consider tokophobia when devising training for healthcare professionals.

"Women who are afraid don't labour well", explained Astrid Osbourne when delivering her talk on tokophobia, the technical term for a fear of childbirth, at JFHC Live 2013 [12 Mar].

"The panic and anxiety may be so intense, it takes over their whole life and occupies every waking moment of their day," she added. 

Women can be fearful for a whole host of reasons, but if a mother's previous delivery was truamatic, or they received poor perineal care, this can often be at the root cause of their fears.

The consultant midwife runs small training groups in University College London Hospitals helping around 17 tokophobic women at a time. She said that most of the women she sees are in a high state of anxiety and distress and can be "difficult" people to deal with.

However most just want to be "ordinary" and so typically make up lots of excuses to explain and 'justify' their fears. She reminded the room that birth is a psychological as well as a physical experience, so advised midwives to "engage emotionally" and "be kind" to their clients.

In her own group she advises the women to have two birth plans and automatically books them into theatre for an elective ceasarian at 41+1 weeks. They are free to change their minds up until the last minute (she fully acknowledges the support of flexible theatre staff in this!), and an indicator of how successful this project's birth outcomes are is the fact that around 60% of these women go on to have a vaginal delivery. 

Tokophobia can be caused by various different factors including a fear of pain, past experience of a difficult childbirth, depression and even sexual trauma.

Women whose phobias occur after a traumatic delivery are likely to have experienced severe pain or tearing during the birth or witnessed their baby in serious distress. As a result, when they become pregnant again, they often cannot face the prospect of a vaginal birth and want to have their baby by Caesarean section instead.

The problem is estimated to affect about 10% of women in the UK. For more information on tokophobia visit www.birthtraumaassociation.org.uk/default.asp

For video and audio highlights of all the talks at JFHC Live visit our dedicated mini-site at www.jfhc.co.uk/jfhc_live_2013_33265.aspx

Posted 19/03/2013 by penny.hosie@pavpub.com