Case report of tokophobia

Abstract

Introduction: Tokophobia is a pathological fear of pregnancy that can lead to avoidance of childbirth. It is classified as primary or secondary. Approximately 20% to 78% of pregnant women report fears associated with pregnancy and childbirth. This report describes a patient with tokophobia: presentation, risk factors, comorbidities, and treatment. Case presentation: A 43-year-old Saudi woman experienced tokophobia upon becoming pregnant for the fifth time. She was assessed in 2 clinical interviews by a consultant psychiatrist specializing in women’s mental health. In addition, she completed several questionnaires that aimed to assess different aspects of her mental health: overall depression, perinatal depression, generalized anxiety, maternal functioning, and fear of childbirth. Several risk factors and comorbidities that may have contributed to the development of tokophobia in this patient were discussed, including traumatic experiences in previous deliveries, the unplanned nature of the pregnancy, perinatal depression, and pronounced symptoms of anxiety. A collaborative decision to perform a C-section was made, in line with obstetric guidelines and good mental health practices. Full symptomatic recovery was achieved immediately after delivery. Conclusion: We hope to increase clinical awareness of the assessment and management of tokophobia, which is a relatively new concept and, as yet, understudied.