Mithu Kuna 
Nervous about labor? Although birth is a natural part of the human experience, it’s also natural to worry.
Many pregnant people experience anxiety over childbirth. In some cases, the fear is extreme enough to be considered tokophobia—a clinical diagnosis.
In this guide, you’ll learn what labor anxiety is and 10 ways to manage it.
What is Labor Anxiety?
Labor anxiety is the feeling of fear about labor and childbirth. People who have anxiety about labor may be worried about a variety of events going wrong. Concerns fueling labor anxiety might include:
- Fear of going into labor at a bad time (while driving, at work, etc.)
- Fear of not receiving proper care
- Fear of not being able to follow through on birth plan
- Fear of something bad happening to you or your baby
Anxiety about going into labor and giving birth is common. A study on 152 pregnant women revealed that:
- 39% reported low levels of fear
- 41% said they were moderately fearful
- 20% said they were highly fearful
Pregnant women were more likely to have labor fears than non-pregnant women.
Even if you’ve had a smooth pregnancy with no complications, you may still feel fearful about the big day. Labor anxiety can occur:
- Before you’re pregnant
- While you’re pregnant
- Only while you’re in labor
Having some anxiety about labor is normal. But an intense fear of giving birth could point to tokophobia (more on this later).
What Causes Labor Anxiety?
It’s probably easy to understand why pregnant people are anxious about labor. The nature of labor is unpredictable, which makes the outcome difficult to control or predict. For this reason, most people have at least some worry. However, normal anxiety about labor may be increased by a few factors:
- Low self-esteem
- Pre-existing medical conditions that may put you at a higher risk for complications
- Lack of social support
- Fear of pain
- Prior negative birth experiences
- Prior negative medical experiences in general
- Distrust of doctors or the healthcare system
- Prior miscarriage, stillbirth, or loss of a child
- Anticipating lifestyle changes after birth
What is Tokophobia?
Tokophobia is an extreme fear of childbirth that causes severe psychological distress. While tokophobia can cause a person to avoid pregnancy, it can also start while you’re pregnant. It’s more common in people who have never given birth compared to those who’ve been in labor before.
Causes of tokophobia may be similar to the causes of anxiety about labor, like having a belief that labor is dangerous. However, often the causes of tokophobia run deeper. Tokophobia can happen if there’s negative birth stories in your family or if you have a history of anxiety disorder. It may also be caused by sexual abuse and/or post-traumatic stress disorder (PTSD).
Tokophobia can feel isolating because other people may not understand your fear. If you can relate, know that tokophobia is a mental health condition and you deserve support. Although you may feel helpless, know it’s possible to have a positive birth experience.
If you think you have tokophobia, it’s important to seek professional help. A counselor or psychotherapist may use therapies like cognitive behavioral therapy (CBT) or eye movement desensitization and reprocessing (EDMR) to reduce fear.
How to Manage Labor Anxiety & Tokophobia
If you’re struggling with anxiety about giving birth or tokophobia, below are some suggestions to ease your anxiety.
Choose a Healthcare Team You Trust
If you don’t trust your healthcare team, you’re more likely to worry about going into labor.
One study found that women who had a prior negative birth experience (even without complications) were more likely to have a fear of childbirth. This supports the idea that a bad healthcare team leads to a bad birthing experience—even if there’s no medical problems.
To decrease your labor anxiety, ask yourself if you trust your medical team (doctor, obstetrician, midwife, hospital, etc.). If you don’t, consider choosing professionals who you feel more comfortable with.
Improve Communication with Healthcare Team
Research shows that a lack of communication and/or a lack of patient understanding can worsen anxiety about labor. If you feel this may be an issue, you can improve communication by asking questions. Here are a few prompts:
- Can you explain [blank] to me?
- Can you walk me through [blank]?
- What should I expect regarding [blank]?
- Where can I learn more about [blank]?
Understanding pregnancy and labor can make it less scary. When you know what to expect, you may feel more prepared and confident.
Tell Your Doctor You Have Labor Anxiety
Alerting your doctor about your anxiety can help them help you.
If your doctor knows you have anxiety about labor, they may provide better communication. For example, they may explain things more clearly, prompt you to ask questions, or check in about how you feel. They can also provide resources to help you reduce your labor anxiety.
Take a Birthing Class
We often fear the unknown. Demystifying birth can make you feel like you have all the information you need to prepare.
A 2020 study found that pregnant women who participated in an education group had:
- Less birth fear
- Less depression
- Less anxiety and stress
- More vaginal births
- Less birth fear, depression, and anxiety after birth
The women in the study attended two sessions twice a week for four weeks. Each session was two hours long. Finding a similar birth group may help increase your familiarity and comfort with labor.
Consider a Doula or Midwife
While it’s a good idea to tell your doctor or obstetrician about your anxiety, they may have limited time to help you manage your symptoms. A midwife or doula is often better trained to deal with the emotional parts of pregnancy. Since these professionals tend to get closer to their clients, you can build a relationship that may help you trust the labor process.
A midwife or doula can discuss your emotions and educate you on what to expect. They can help you pinpoint your fears and how to manage them.
Choose a Supportive Birthing Partner
If you don’t have a doula or midwife, choose a “birthing partner” who will be calm and supportive throughout the experience. This could be your mother, partner, sister, or friend. This person should be sensitive to your needs and be able to reassure you.
Consume POSITIVE Birth Content
The stories about negative birth experiences are endless and can be difficult to avoid. When you have anxiety, you already know what could go wrong, so you really shouldn’t be filling your mind with more of the same.
Instead, you can slowly shift your perceptions about labor by managing the content you see, read, and listen to. This can give you evidence that positive birth experiences are common. Here’s some suggestions:
- Read positive birth stories– Read: 10 Places to Read Positive Birth Stories that will Change How You Birth
- Listen to positive birth podcasts– For example, The Positive Birth Story Podcast
- Watch birth videos– See 11 Home Birth Videos That Will Convince You You Were Made To Birth
Draw Boundaries
When people find out you’re pregnant, they may share their birth experiences without being asked. Unfortunately, this can cause even more anxiety.
Know that you don’t have to sit through stories and unsolicited advice that make you more anxious. Instead, draw a boundary. You can say something like:
- “I know you’re trying to help, but the advice only makes me more anxious.”
- “I’d love to hear this story, but can we wait until after I’ve given birth?”
- “I’m feeling really anxious about giving birth and I know you don’t mean to, but stories like this make it worse.”
Boundaries might also come in handy when people don’t understand your fear. For example, perhaps your partner doesn’t take your labor anxiety seriously. As a result, maybe they’re unwilling to invest in solutions to reduce your anxiety, like hiring a therapist, taking a prenatal class or buying a pregnancy book.
In this case, you could draw a boundary by saying, “I understand we have a tight budget but I need to make decisions that are best for my body and the baby, which includes going to therapy to lessen my anxiety about labor.”
Read: 7 Boundaries to Reduce Pregnant Anxiety + 31 Phrases To Help
Tour Birthing Facility
Whether you’re giving birth in a hospital or birthing center, see if you can get a tour before the big day. Guided tours walk you through where you’ll be going and allow you to ask questions.
Counseling
Whether you have anxiety about labor or a clinical disorder like tokophobia, you should consider seeking counseling or psychotherapy. A therapist or counselor can help you find ways to manage your anxiety, leading to a better birth experience. They can also help you understand what may be causing your anxiety, whether a specific belief or a prior traumatic experience.
Summary: Labor Anxiety and Tokophobia
Being worried about labor and childbirth is common. If you have labor anxiety, consider trying the tips above, like taking a prenatal class, finding a doula, and consuming positive birth stories. If you have extreme anxiety about labor, you might have Tokophobia. Tokophobia can feel isolating so it’s important to seek help from a mental health professional.
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