My Pathological Fear Of Getting Pregnant

Sun Herald

Sunday March 2, 2008

Meredith O'Donnell

An acute phobia about childbirth is deterring some women from becoming mothers, writes Meredith O'Donnell.

Around me in the cinema people laughed, as I sat, body twisted away from the screen and my face shielded by my coat, wondering how quickly I could toss the shopping out of my bag if I had to throw up.

Even writing this now, a scene from the film flashes into my mind and I feel light-headed; my insides start to twitch, and a sour taste fills my mouth.

I shouldn't have gone to see Knocked Up, last year's hit film. But when you're trying to accommodate someone else's viewing preferences five minutes before a film begins, you hope you can get through a romantic comedy without having to reveal your psychological disability - a disability that is usually greeted with "What? Oh don't be so ridiculous!"

For those who haven't seen it, Knocked Up is about an unplanned pregnancy and features a graphic delivery-room birth scene. I suffer from tokophobic tendencies, which means that references - let alone big-screen close-ups - to pregnancy, or, even worse, giving birth, make me feel instantly nauseous and tearful.

What I saw during that film was, with cruel inevitability, added to the mental library of distressing birth-related images already embedded in my brain. They jump out unbidden at odd times, leaving me feeling faint and hardly able to stay on my feet.

Tokophobia - a profound dread and avoidance of childbirth - was identified as a medical condition in 2000 in a survey by Dr Kristina Hofberg in the British Journal Of Psychiatry. According to her research, one in six women is tokophobic. Previously, the syndrome had received little or no attention, and even today few people know about it, although there must be tens of thousands of sufferers.

Helen Mirren recently revealed that seeing a graphic film about giving birth during her school days had been a factor in her decision not to have children. "I swear it traumatised me," she said. "I haven't had children and now I can't look at anything to do with childbirth. It absolutely disgusts me."

A study published in the British Journal Of Obstetrics And Gynaecology last month found that almost half of all pregnant women who request a caesarean section do so not because they are "too posh to push", but because they are scared.

Sufferers can be split into two groups - primary and secondary. I am a primary tokophobic because I have never been through the process of giving birth.

Secondary tokophobics are those mothers who had a terrible experience first time around, know what they're up against and are desperate to avoid repetition at all costs (which doesn't help those in the primary division at all, confirming as it does everything we suspected). I consider myself to be pretty tough in terms of what I can handle emotionally, but I can't credit myself with the physical strength or stamina required to endure giving birth, and that depresses and enrages me. I feel inadequate next to those women who have been through it.

How have I ended up like this: paralysed, stuck on the window ledge, unable to go back or forward in my life, while everyone else seems to skip through to the next "natural" stage?

I used to think it was a "given" that I would be a mother. As an only child I had envisaged a large family. Two is boring, three's a crowd; it had to be four or more. But I had never been in close proximity to pregnancy. I never saw my mother go through it, or any other close relative.

In my early 20s a series of rough cervical examinations and a gruesome procedure, which, dear God, I gave permission for students to observe, instilled in me a horror of gynaecological procedures - so much so that I refused to have another examination for years, despite a risk of cancer. (These days I can cope only if I take a tranquiliser beforehand).

After all of that, I used to joke that I would need a general anaesthetic to give birth. Then a younger friend got pregnant with twins. What she told me after the birth had a devastating effect. It was like listening to a soldier returning traumatised from war, "It's a conspiracy," she said. "Nobody tells you, nobody prepares you, for what you go through. If they did, the human race would die out."

Suddenly, a low pain threshold and an ability to over-empathise became my curse. I told myself that thousands of women give birth every day and yes, some do so alone at the side of a paddyfield or out in the Serengeti. In a strange way, this almost seemed preferable to being observed by strangers in an operating theatre, which I associated with feeling vulnerable and humiliated.

I know there are some tokophobic women who face losing their partner if he is determined to be a father, or who must lie endlessly about their reasons for failing to conceive.

I've often wondered how many parents would admit (if it was guaranteed that their answer would never be revealed) that they'd rather not have had children. I've seen a girlfriend beg to be committed when a lack of bonding with her newborn was not taken seriously.

As for me, I've never hankered for children so much for their own sake that I would consider adopting. I know I want my own biological issue. I'm enthralled by the vanity of reproduction, and the extraordinary all-consuming love that a mother has for her child fascinates and appals me in equal measure.

While I feel disabled by my phobia, I have never sought "professional help". I can't be talked into putting my hand into a pan of boiling water by someone telling me that it will heal. I could be hypnotised, but why would I want to be duped into getting scalded? It's irrational, and yet at the same time totally sane.

I am still deeply conflicted about whether or not I want to have a child. If I could be spared the pain and just be handed a baby, would I sign up? Now I am in my early 40s, when the dangers and complications for mother and baby multiply and it would be so much easier just to close the door on the matter. But as long as I think there is a prize worth walking through the fire for, then there is torment. Part of me looks forward to the day it is out of my hands - but part still longs for a family life. Which adds up to a whole lot of misery.

Recently my mother announced she intended to give away my crib - "seeing as you won't be having any now". This casual comment, my "fait non-accompli", caused a stab of pain.

I want to make that decision, not be told by someone else, or be dictated by fear.