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Causes and frequency of tocophobia — own experiences
Affiliations- School of Health Sciences in Katowice, Medical University of Silesia, Katowice, Chair of Woman’s Health, Department of Nursing in Gynecology and Obstetrics, Katowice, Poland
- Department of Gynecology and Obstetrics, Provincial Hospital in Bielsko-Biała, Poland, Poland
- School of Health Sciences in Katowice, Medical University of Silesia, Chair of Woman’s Health, Department of Sexology, Katowice, Poland
- School of Health Sciences in Katowice, Medical University of Silesia, Chair of Woman’s Health, Department of Obstetric Propaedeutic, Katowice, Poland, Poland
open access
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.
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
labor, anxiety, tocophobia, causes, frequency
About this articleTitle
Causes and frequency of tocophobia — own experiences
Journal
Issue
Article type
Research paper
Pages
239-243
Published online
2017-05-31
Page views
3415
Article views/downloads
3784
DOI
Pubmed
Bibliographic record
Ginekol Pol 2017;88(5):239-243.
Keywords
labor
anxiety
tocophobia
causes
frequency
Authors
Urszula Sioma-Markowska
Agnieszka Żur
Violetta Skrzypulec-Plinta
Mariola Machura
Mariola Czajkowska
References (24)- 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.
