Tocophobia

Abstract

ABSTRACT Introduction Fear of childbirth is common during pregnancy and is believed to be the most common underlying reason for requesting a caesarean section without medical indication. Despite the fact that 17%-20% of all pregnant women report extreme fear of birth, named tocophobia, in ICD -10 International Classification for Disease-10 revision – ICD-10,) there is not established diagnose Tocophobia, which can also occurs in non-pregnant women and in men. Primary tocophobia may have its onset in adolescence, affecting nulliparous women to such degree that some women never bear a child. They also describe sexual dysfunction as vaginismus and non-consummation. Secondary tocophobia may be associated with a previous traumatic birth experience such as stillbirth. Tocophobia is not just associated with antenatal psychological morbidity, but also raised rates of postnatal depression, impact on the mental well-being of the baby for life, increased length of labour, lower birth weights and increased prevalence (8%) of admission to neonatal intensive care. They can have feelings of isolation, guilt and shame, difficulties to prepare for birth. They may have sleeplessness, nightmares, stomachaches and depression with anxiety that can leads to panic attacks. Women may also be concerned with pain, their own incapability, possible obstetric injuries, lack of control, lack of partner or family support, and loss of their baby. The interventions included psychosexual education, cognitive behavioural sex therapy. Therapeutic interventions reduce the number of women who go on to have caesarean birth. Tocophobia is a common condition with both acute and chronic implications for the welfare of mothers and babies. It can cause not only mental but also physical morbidity and needs a clear both plan for the care of women and her specific fears. Objective Couple has started with couple sex therapy for his problems with erection before they have children. They are married; they have already two children (5y, 3y). She has recently discovered that she is pregnant for the third time and she is in gestational week 8. As nulliparous woman, she has developed sever tocophobia. She has intensive therapy with clinical psychologist through all first pregnancy time, but she still developed minor postpartum depression but without any need for antidepressants. Methods We present a case of a 40-years old woman with sever tocophobia and the results of the treatment interventions. Results Treatments include sensitive psychosexual education about the birth process, development of problem-solving skills, teaching coping strategies for labour. Conclusions Tocophobia is a common condition with both acute and chronic implications for the welfare of mothers and babies. It can cause not only mental but also physical morbidity and needs a clear both plan for the care of women and her specific fears. Disclosure Work supported by industry: no.