Causes and frequency of tocophobia — own experiences
Abstract
Objectives: The phenomenon of tocophobia (pathological fear of labor) has not been fully explored. Currently, there are no diagnostic criteria that would enable its detection or make it recognizable as a disease entity. The aim of study was to determine the degree of anxiety/tocophobia as well as to learn about and analyze the causes of this phenomenon in Polish pregnant women.
Material and methods: The prospective study included 120 pregnant women in the third trimester of gestation from February to May 2016. The study was performed with the use of a standardized and revised version of the Labor Anxiety Questionnaire (KLP II) designed by Putyński and Paciorek (1997) as well as a proprietary interview questionnaire and structured data documentation form.
Results: In 6.7% of the subjects, the level of labor anxiety was very high (> 18 in KLP II). It was the highest in women over 30 years of age (Pearson’s chi squared test = 0.00422; p < 0.05). It has been shown that successive childbirths have an impact on the degree of anxiety (p = 0.04217).The highest level of anxiety was noted in primiparous women. In 85% of the subjects, anxiety was caused by fear of labor pain. 56.7% of the tested women did not use any professional help in the preparation for childbirth and motherhood.
Conclusions: Primiparas and women over 30 years of age experience very high levels of fear significantly more frequently. The lack of proper preparation for childbirth determines the occurrence of tocophobia. Ante-natal classes and prenatal education based on standards of obstetric care should be promoted in order to reduce or eliminate fear of natural labor.
Keywords: laboranxietytocophobiacausesfrequency
References
- Huizink AC, Mulder EJH, Robles de Medina PG, et al. Is pregnancy anxiety a distinctive syndrome? Early Hum Dev. 2004; 79(2): 81–91.
- Eriksson C, Jansson L, Hamberg K. Women's experiences of intense fear related to childbirth investigated in a Swedish qualitative study. Midwifery. 2006; 22(3): 240–248.
- Bewley S, Cockburn J. Responding to fear of childbirth. Lancet. 2002; 359(9324): 2128–2129.
- Hofberg KM, Brockington IF. Tokophobia – a morbid dread of childbirth. Its presence in Great Britain and Grand Cayman, British West Indes. J Psychosom Obstet Gynaecol. 2001; 22: 96.
- Hofberg K, Ward MR. Fear of pregnancy and childbirth. Postgrad Med J. 2003; 79(935): 505–510.
- Cekański A. Tokofobia — lęk przed porodem naturalnym, prośba o cięcie cesarskie. Przegląd Ginekologiczno-Położniczy. 2009; 9: 31–33.
- Billert H. Tokophobia — a multidisciplinary problem. Ginekol Pol. 2007; 78(10): 807–811.
- Andersson L, Sundström-Poromaa I, Wulff M, et al. Implications of antenatal depression and anxiety for obstetric outcome. Obstet Gynecol. 2004; 104(3): 467–476.
- Martini J, Knappe S, Beesdo-Baum K, et al. Anxiety disorders before birth and self-perceived distress during pregnancy: associations with maternal depression and obstetric, neonatal and early childhood outcomes. Early Hum Dev. 2010; 86(5): 305–310.
- Suchocki S. Jak ograniczyć epidemię cięć cesarskich (How to reduce the cesarean sections epidemic)? GinPolMedProject. 2012; 2(24): 9–16.
- Chestnut DH. Cesarean delivery on maternal request: implications for anesthesia providers. Int J Obstet Anesth. 2006; 15(4): 269–272.
- Nerum H, Halvorsen L, Sørlie T, et al. Maternal request for cesarean section due to fear of birth: can it be changed through crisis-oriented counseling? Birth. 2006; 33(3): 221–228.
- Hanley J. Zaburzenia psychiczne w ciąży i połogu. Sidorowicz S. Red. Elsevier Urban & Partner. ; 2012: 13–25.
- Reid H, Power M, Cheshire K. Factors influencing antenatal depression, anxiety and stress. British Journal of Midwifery. 2009; 17(8): 501–508.
- Di Renzo GC. Tocophobia: a new indication for cesarean delivery? J Matern Fetal Neonatal Med. 2003; 13(4): 217.
- Putyński L, Paciorek M. Kwestionariusz Lęku porodowego (KLP II) Wersja Zrewidowana - konstrukcja i właściwości psychometryczne. (Labor anxiety questionnaire (KLP II) – revised – the construction and psychological validation). Acta Universitatis Lodziensis. Folia Psychologica. 2008; 12: 129–133.
- O'Connell M, Leahy-Warren P, Khashan A, et al. Tocophobia — the new hysteria? Obstet Gynaecol Reprod Med. 2015; 25(6): 175–177.
- Saisto T, Halmesmäki E. Fear of childbirth: a neglected dilemma. Acta Obstet Gynecol Scand. 2003; 82(3): 201–208.
- Melender HL. Experiences of fears associated with pregnancy and childbirth: a study of 329 pregnant women. Birth. 2002; 29(2): 101–111.
- Dziennik Urzędowy Rzeczypospolitej Polskiej z dnia 4 października 2012r. poz. 1100. Rozporządzenie Ministra Zdrowia z dnia 20 września 2012r. w sprawie standardów postępowania medycznego przy udzielaniu świadczeń zdrowotnych z zakresu opieki okołoporodowej sprawowanej nad kobietą w okresie fizjologicznej ciąży, fizjologicznego porodu, połogu i opieki nad noworodkiem.
- Sioma-Markowska U, Poręba R, Skrzypulec-Plinta V. The model of active participation of the father in childbirth, based on the preferences of the parturient women. Neuro Endocrinol Lett. 2015; 36(4): 374–379.
- Sioma-Markowska U, Poręba R, Machura M, et al. Paternal engagement during childbirth depending on the manner of their preparation. Ginekol Pol. 2016; 87(9): 639–643.
- Gebuza G, Kaźmierczak M, Gierszewska M, et al. Lęk przed porodem w III trymestrze ciąży i jego powiązania ze stanem noworodka. (Fear of childbirth in the third trimester of pregnancy and its relationship with the state of newborn). Medycyna Ogólna i Nauki o Zdrowiu. 2015; 21(1): 39–44.
- Müldner-Nieckowski Ł, Cyranka K, Smiatek-Mazgaj B, et al. Psychotherapy for pregnant women with psychiatric disorders. Psychiatria Polska. 2015; 49: 49–56.