Behind the desire for motherhood that many women hold, others live a lesser-known reality: an intense fear of pregnancy or childbirth. Rama, Astou, and Lala share their experiences of a psychological condition affecting between 10% and 15% of women according to the WHO, yet one that remains largely taboo.
DAKAR — While many women take extensive steps to conceive, others struggle against an irrational fear that prevents them from considering motherhood at all. This condition, known as tocophobia, can be so intense that it leads some women to avoid pregnancy altogether, or even to forgo marriage or sexual relationships.
Between the Desire for a Child and Paralyzing Fear
After nearly four years of marriage, Rama still has no children — a situation that fuels speculation among those around her about her fertility or her husband’s virility. The reality is different: both spouses are in good health, but Rama suffers from an irrational fear of pregnancy, rooted in her mother’s death during childbirth.
“My mother died giving birth to a child, and this tragedy has haunted me since childhood,” she confides. Every pregnancy she sees in another woman revives her anxiety. “I have never had intercourse with my husband without contraception. My husband is patient, but I know this situation hurts him,” she says with regret.
According to her, some women wrongly considered infertile may actually be suffering from this phobia without daring to speak about it.
The Terror of Childbirth in a Pregnant Woman
Tocophobia also affects women who are already pregnant. Four months into her pregnancy, Astou lives with daily anxiety, focused more on childbirth than on the pregnancy itself. “I’m afraid of dying while giving birth. As the months go by, I’m overwhelmed with anxiety,” she explains.
This constant fear affects her sleep and psychological balance. Like other women in her situation, she is considering a cesarean section in hopes of reducing her anxiety, although she had initially wanted a vaginal delivery.
A Condition Recognized by the WHO
According to data published by the World Health Organization (WHO) and cited in The Lancet Global Health in December 2023, tocophobia affects between 10% and 15% of women. It is officially classified as a perinatal condition.
This condition can cause intense anxiety, sleep disturbances, chronic fatigue, and difficulty managing pain during labor. In some cases, it is associated with an increased risk of difficult deliveries, the use of obstetric instruments, or emergency cesarean sections.
An Experience Marked by Pregnancy Loss
For Lala, the fear of childbirth has taken a dramatic turn. She links two successive miscarriages to the stress and anxiety she experiences with each pregnancy. “I can’t sleep anymore, I eat poorly, and I live in constant anxiety,” she recounts.
She regrets being unable to openly share this suffering with her husband, who hopes to become a father. “My fear prevents me from fulfilling this dream we share,” she confides.
Several Forms of Tocophobia Identified
Gynecologists distinguish several forms of this condition. Primary tocophobia affects women who have never given birth, often after exposure to frightening accounts or anxiety-inducing information about childbirth.
Secondary tocophobia occurs after a traumatic experience during a previous delivery — intense pain, hemorrhage, or obstetric complications. Other women develop this fear following postpartum depression, or in connection with a history of rape or sexual assault during childhood, according to specialists.
In the most severe cases, some women refuse any pregnancy, sexual relationship, or even marriage. Others may be tempted to seek an unsafe abortion out of fear of childbirth.
The Need for Multidisciplinary Care
Faced with this suffering, specialists recommend a care approach combining gynecologists, midwives, and psychologists. Prenatal preparation classes play an important role by helping women better understand the stages of pregnancy and childbirth, thereby reducing their anxiety. Medication may also be considered in some cases to help manage stress.
Dr. Abdoukhadre Sanoko, a certified sociologist specializing in psychology, notes that alarming accounts from those around a woman and false beliefs often reinforce this phobia. “Pregnancy requires significant psychological balance. Constant fear can weaken a woman and complicate certain stages of childbirth,” he explains.
He recommends relaxation, breathing, and sophrology sessions starting in the final months of pregnancy, and encourages affected women to voice their fears rather than keep them to themselves.
A Subject That Remains Largely Taboo
Tocophobia remains poorly recognized in many societies where motherhood is often taken for granted. Yet thousands of women experience silent distress that affects their mental health, their marriages, and their plans for motherhood.
For specialists, the first step is acknowledging that this fear exists and encouraging affected women to consult a healthcare professional. Tocophobia is neither a whim nor a lack of willpower, but a genuine psychological condition that can be treated with appropriate care.
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