There are plenty of women who wake up after an intimately-risky evening panicked that that they may be pregnant. For most, this initial anxiety passes but for a small group of women this fear does not go away – they live with tokophobia, the fear of being pregnant or of giving birth.

They will suffer deep anxiety, and some will practice celibacy out of paranoia of becoming pregnant.  

Shelby, from Arizona, has known that she doesn’t want to become pregnant since she was four years old, she recalls having a sick feeling in her stomach at the thought, even while she was playing with a pregnancy-type Barbie doll.  

“I honestly didn’t even realize it was an actual thing until I saw it mentioned on Facebook. After that it all just clicked. I’ve felt sick and anxious my whole life when thinking about becoming pregnant,” Shelby says.

“Many people believe that it is a woman’s duty to bring children into the world, and it is typically seen as ‘in a woman’s nature’ to want children, so it makes sense that people just sweep it (tokophobia) under the rug.”  

For women with tokophobia, there is a point where prevention of pregnancy becomes an obsession. This demands a lot of attention to detail, often at the expense of other areas of their life. But there is not a lot known about this phobia, it is not well covered in the mental health field and there are not a lot of resources available to sufferers. Yet research by Acta Obstertricia et Gynecologica Scandinavica suggests that between 2.5 per cent and 14 percent of women are affected by tokophobia, and some even argue that the rate of impact could be as high as 22 percent.

There are two recognised types of tokophobia. In primary tokophobia, which occurs in women who have not given birth before, the dread may begin in adolescence and, while it may not affect sexual relations, anxiety is prevalent over the perceived risk of getting pregnant. Secondary tokophobia occurs in women who have experienced childbirth prior and may have developed it as a result of trauma from that experience. The presence of secondary tokophobia could be a symptom in post-natal depression.  

It is important to note that most of the medical research into tokophobia focusses on secondary tokophobia and its impact on women who are already pregnant by the time the phobia develops, which leaves a noticeable gap in knowledge and, in turn, support for those with primary tokophobia. This leaves women who experience anxiety over the possibility of becoming pregnant in the dark about what they could be experiencing, and how they could get help for it if it becomes too much to handle alone, especially in a society that emphasises motherhood as something joyful and selfless. 

There are groups on social media sites such as Facebook or Reddit that act as safe places for women to talk about feeling pressure from their family to have children, or can discuss things such as tokophobia without being met with confusion.

Often women who experience primary tokophobia avoid getting pregnant (through contraception or celibacy) and find themselves in a place mentally where having sex becomes a trigger. Other triggers involve irregular period cycles and general panicked anxiety. Tokophobia goes beyond just not wanting to have children – it means having to deal with dread and unjustified paranoia over the idea of becoming pregnant.  

For Amber, in Ohio, this means a sick feeling and dread. She has found herself unsure of whether her fears will alter her family planning status in the future but, for now, the idea of becoming pregnant makes her stomach ache.

Like many other women, Amber found out about tokophobia through a Facebook group for child-free women. Currently, she is undiagnosed, but is convinced that she is afflicted.
“I do know it affects a lot more woman than people know. Being educated about things others experience is always good, especially when they can affect someone’s life so greatly,” she said.

No one is sure about what causes tokophobia, some factors that may contribute to its development is a fear of loss of control or privacy that comes with starting a family, as well as past sexual abuse. Whereas in the case of secondary tokophobia, there is suspected causation in the developed fear of going through the pain of childbirth again, or a lack of trust in medical professionals.  

Whether the fear passes or not, the fact remains that there are women who experience genuine fear at the idea of becoming pregnant or delivering a child, and the realm of it has barely been explored. This is all despite maternity being such a prominent experience in the lives of almost every woman, and in many cultures. 

The current advice to women who feel that they could be struggling with more than just an adversary to motherhood, is that they should reach out to their GP and mention the word tokophobia.