Fear of childbirth

New research this month has shown that women who opt for caesareans aren't too posh to push, they're terrified of childbirth

Many mothers-to-be opt for a C-section for non-medical reasons because they are afraid of the unpredictability of a natural delivery, according to a study.

Out of the women interviewed 43 per cent of those having elective caesareans had a fear of childbirth that was so severe that it affected their health.

The latest figures showed that 23 per cent of all babies delivered in Britain's hospitals in 2005/2006 were born by C-section. The figure is more than twice that recorded 15 years ago.

Tokophobia

Very little research has been carried out into the fear of childbirth, but a study published in the British Journal of Psychiatry in 2000 gave it the name "tokophobia".

Helen Mirren revealed in October 2007 that she suffers from tokophobia and that is why she's never had children. She saw a film at school of a woman giving birth and since then has been too terrified to become a mother.

Tokophobia is a distressing psychological condition which may be overlooked. It is associated with anxiety, depression, post-traumatic stress disorder (PTSD) and bonding disorders.

Study

In a study carried out in 2000, the women with primary tokophobia (a fear of Birth before they have had any children) strongly desired a caesarean birth. Four achieved this, bonded well with their baby and enjoyed excellent psychological health. Three women endured vaginal deliveries against their will; all suffered postnatal depression, two suffered symptoms of PTSD and two had delayed bonding with their infants.

Secondary tokophobia occurs after a traumatic or distressing delivery.

A new medical study this week (the first of it's kind) uncovered that almost half the women who choose to have a caesarean delivery are not "too posh to push" - they are simply too scared.

Fears of the unknown

Many mothers-to-be opt for a C-section for non-medical reasons because they are afraid of the unpredictability of a natural delivery, according to a study. Some are terrified that their baby will die or be injured during the birth, while others worry about losing control during labour. 

The scientists involved, from the Karolinska Institute in Stockholm, asked 496 mothers-to-be about their attitude towards childbirth.

The women, all first-time mothers, were divided into three groups - those who had opted for a C-section for medical reasons, those who elected to have the operation for other reasons and those who planned to have a natural delivery.  Almost half of those having elective caesareans had a fear of childbirth which was so severe that it affected their health. In contrast, the figures for women having a natural birth or a caesarean for medical reasons were just 13 per cent and 6 per cent respectively.

Bad experiences

The study, published in the British Journal of Obstetrics and Gynaecology, also found that women who were scared of giving birth were looking forward to motherhood less than the other prospective parents. It is thought that many of the women's fears stemmed from conversations with friends and relatives who had bad experiences of labour themselves.

A second study in the same journal found that one in 14 prospective mothers is afraid of childbirth, with fear more likely in those suffering from depression and anxiety.

Women who choose to have C-sections are carefully counselled on the advantages and disadvantages of the operation. The overall C-section rate in the UK is high but comparable to other Western countries. If we are to lower numbers, we need to understand sympathetically why some women, with no medical reasons, are choosing to have caesareans.

Not 'too posh to push'

Healthy women are sometimes criticised for choosing a C-section over a normal delivery. This study reveals that a psychological reason may be behind elective caesareans. Some women may be too scared, rather than too posh, to push.

GMTV's Dr Hilary thinks that all mothers do feel anxious about giving birth. No-one looks forward to it, however for some women the fear can be overwhelming.

He said: "During pregnancy doctors and midwives should address these fears and often with good counselling these fears can be put to rest and the birth can take place as normal. However if the woman's fears are so great that she will panic and cause distress to herself and the baby a C-section should always be considered.

Natural birth encouragement

An NHS spokeswoman said: "We recommend elective caesarean sections are only performed where there is clinical evidence of expected benefit to the mother or baby and where a consultant is involved in the decision-making. Mums-to-be are encouraged to opt for a natural birth.

"The options for delivery are addressed and a decision made when clinically necessary. Most doctors will only perform a Caesarean when there are medical or psychological indications. Operative deliveries are not without their complications and there are increased risks to mum and baby when a caesarean is performed."