Tokophobia Therapy: When the Fear of Childbirth Feels Unbearable
Specialist CBT therapy for women whose traumatic birth has left them terrified to do it again – plus support for primary tokophobia. Based in Leicestershire, available online across the UK and EU.
What Is Tokophobia? (And Why It's Not "Just" Pregnancy Anxiety)
You desperately want a baby. But every time you think about actually giving birth, your chest tightens, your mind races, and the panic sets in. Maybe you're not pregnant yet - but the thought of pregnancy and childbirth terrifies you so much that you're avoiding trying, even though you desperately want to be a mum. Or maybe you're pregnant right now - and instead of excitement, you feel dread.
Tokophobia is an intense, overwhelming fear of pregnancy and childbirth that goes far beyond typical nervousness. While most pregnant women feel some anxiety about labour, tokophobia is different. It's a phobic-level fear that can dominate your thoughts, interfere with your daily life, and make the idea of giving birth feel absolutely unbearable.
Research shows that up to 14% of women experience tokophobia – though many suffer in silence, not realising there's a name for what they're experiencing or that help is available.
There are two types of tokophobia:
PRIMARY TOKOPHOBIA (Also Supported)
You've never been pregnant or given birth, but you've always been terrified of childbirth. Maybe the fear started in your teenage years, is linked to past medical trauma, sexual abuse, or frightening stories you've heard. The thought of pregnancy fills you with dread – even though part of you desperately wants a baby. While my main clinical experience is with secondary tokophobia, I also work with women experiencing primary tokophobia using the same evidence-based CBT approaches.
SECONDARY TOKOPHOBIA (My Primary Expertise)
You've given birth before, and that experience was so traumatic that you're now terrified to do it again. This is the most common form of tokophobia and is often a form of Post-Traumatic Stress Disorder (PTSD). Your last birth left you feeling helpless, out of control, or genuinely unsafe.
Maybe:
• You had an emergency C-section you weren't prepared for
• The pain was unbearable and medical staff didn't listen
• You thought you or your baby might die
• You experienced severe tearing, hemorrhage, or other complications • Medical interventions felt forced upon you
• You felt dismissed, ignored, or traumatized by staff
Now you're pregnant again (or thinking about getting pregnant), and instead of excitement, you feel absolute dread. The thought of going through labour again triggers panic attacks. You lie awake at night replaying your last birth. Every kick from your baby reminds you that labour is getting closer. You can't shake the feeling: "I can't do this again. I won't survive it."
This is my specialist area. I've spent over a decade in NHS mental health services working specifically with women whose previous traumatic births have left them terrified of giving birth again. I understand the unique challenge of processing past birth trauma WHILE managing overwhelming fear about your current or future pregnancy.
Here’s what tokophobia:
IS
✓ A recognised anxiety disorder
✓ Treatable with specialist support
✓ A real, valid mental health condition
✓ Something that affects how your brain processes threat
IS NOT
❌ Being "dramatic" or "overreacting"
❌ Something you can "just relax" your way out of
❌ A sign you don't want children
❌ Something that will go away on its own
When Birth Leaves You Shaken - or Too Afraid to Try Again
You desperately want a baby. But every time you think about actually giving birth, your chest tightens, your mind races, and the panic sets in.
Maybe you're not pregnant yet – but the thought of pregnancy and childbirth terrifies you so much that you're avoiding trying, even though you long to be a mum.
Or maybe you're pregnant right now – and instead of feeling excited, you're counting down the weeks with absolute dread. Every kick reminds you that labour is getting closer. You can't sleep. You can't think about anything else. The fear is taking over.
This isn't "normal" pregnancy anxiety. This is tokophobia – and you don't have to face it alone.
I'm Aleksandra Balazy-Knas, an Accredited CBT Therapist and Mental Health Nurse with over a decade of NHS experience. I help women work through their terror of childbirth using evidence-based CBT – so they can either move toward pregnancy with confidence, or get through their current pregnancy without living in constant panic.
What Changes When You Get the Right Support
Right now, the thought of giving birth might feel absolutely unbearable. You can't imagine going through labour. You can't imagine coping with the pain. You can't imagine surviving it.
Here's what shifts when tokophobia is treated with specialist support:
In Your Body:
𑁍 The catastrophic thoughts ("I'm going to die," "I can't survive this," "Something terrible will happen") lose their grip.
𑁍 You can think about birth without spiraling into panic.
𑁍 You still feel nervous (that's normal), but it's not consuming terror anymore.
𑁍 You can imagine different scenarios for birth - not just the worst-case catastrophe.
𑁍 You can start to believe: "I might actually get through this."
In Your Mind:
𑁍 The physical panic when someone mentions birth or pregnancy eases.
𑁍 Your chest doesn't tighten. You don't feel like you're going to be sick.
𑁍 You can have conversations about birth without your body going into fight-or-flight mode.
𑁍 You start to feel like your body is yours again - not a ticking time bomb waiting to betray you.
In Your Daily Life:
𑁍 You can attend prenatal appointments without spending the entire week beforehand in dread.
𑁍 You can be around pregnant friends without feeling triggered.
𑁍 You can watch TV shows with birth scenes without changing the channel.
𑁍 If you're already pregnant, you can start to bond with your baby instead of just surviving until the due date.
𑁍 If you're not pregnant yet, you can actually consider trying for a baby without the thought of birth stopping you completely.
This doesn't mean the fear disappears completely.
But it becomes manageable. It doesn't control your life. You're not living in constant terror.
Most clients notice shifts within 6-12 sessions:
- The catastrophic thoughts decrease dramatically
- They can imagine giving birth without full-body panic
- They feel more in control of their choices
- If pregnant, they can actually enjoy moments of their pregnancy
- They feel empowered to advocate for the birth they want (whether that's vaginal, C-section, or anything in between)
This isn't about forcing yourself through a vaginal birth if that's not right for you.
It's about processing the fear so you can make decisions from a place of calm, not terror. So you can actually choose what's best for you - not what panic is dictating.
The Signs You're Dealing with Tokophobia (Not "Normal" Anxiety)
Tokophobia affects both your mind and your body. You might be experiencing:
In your thoughts:
• Constant, intrusive thoughts about childbirth that you can't shake
• Catastrophic thinking: "I'm going to die," "Something terrible will happen," "I won't survive this"
• Obsessing over every possible thing that could go wrong during pregnancy or birth
• Feeling trapped in your own body if you're already pregnant
• Ruminating about pain: "I won't be able to cope," "It will be unbearable"
• Researching pain relief options compulsively, or avoiding all information about birth entirely
In your emotions:
• Panic attacks when you think about labour or childbirth
• Overwhelming dread as your due date approaches (if pregnant)
• Feeling terrified instead of excited about your pregnancy
• Intense fear of losing control during labour
• Fear of dying during childbirth
• Guilt or shame for feeling this way when "everyone else" seems fine
• Feeling misunderstood or dismissed when you try to explain your fear
In your behaviour:
• Avoiding trying to get pregnant, even though you want a baby
• Using multiple forms of contraception simultaneously to prevent pregnancy
• Avoiding sex or intimacy because of pregnancy fears
• If pregnant: avoiding antenatal appointments or feeling sick before each one
• Avoiding anything that reminds you of pregnancy (TV shows, pregnant friends, baby shops)
• Requesting an elective C-section to avoid vaginal birth
• Considering termination solely because of fear of labour (not because you don't want the baby)
Physical Symptoms:
• Heart racing, sweating, trembling when thinking about birth
• Difficulty sleeping (even when pregnancy insomnia isn't a factor yet)
• Nausea or stomach problems when confronted with pregnancy/birth topics
• Feeling constantly on edge or hyper-alert
If you're nodding along to several of these, you're likely dealing with tokophobia – not just typical pregnancy nerves.
The good news? With the right support, you can work through this fear.
Where Does Tokophobia Come From?
Tokophobia doesn't happen in a vacuum. There are usually specific reasons why your brain has learned to see childbirth as a catastrophic threat.
Common causes of tokophobia:
𑁍 Previous Traumatic Birth (Secondary Tokophobia) 𑁍
You've given birth before, and that experience was so traumatic that you're now terrified to do it again. This is the most common form of tokophobia I see. Maybe you had an emergency C-section you weren't prepared for, or the pain was unbearable and medical staff didn't listen, or you thought you or your baby might die. Now you're pregnant again (or thinking about it), and instead of excitement, you feel absolute dread.
𑁍 Past Medical Trauma 𑁍
Maybe you've never given birth, but you've experienced traumatic medical procedures, sexual abuse, or past trauma where you felt out of control of your body. The thought of pregnancy fills you with dread - even though you desperately want to be a mum.
𑁍 Fear of Pain 𑁍
You've heard the stories, watched the videos, listened to friends describe birth as "the worst pain imaginable." Your brain has decided: "I can't cope with that level of pain. I won't survive it."
𑁍 Fear of Death 𑁍
You're convinced you or your baby will die during childbirth. Every story you hear about complications confirms this fear. You can't imagine going through birth without something catastrophic happening.
𑁍 Fear of Loss of Control 𑁍
The idea of your body doing something you can't stop, of medical staff making decisions about your body, of being vulnerable and exposed - this terrifies you at a deep level.
𑁍 Stories and Media 𑁍
You've heard traumatic birth stories from friends, family, or online. You've watched birth scenes in TV shows that looked horrifying. Your brain has absorbed these as threats, not just information.
𑁍 Pre-Existing Anxiety or OCD 𑁍
If you already struggle with anxiety disorders or OCD, tokophobia can be an extension of that - your brain latching onto pregnancy and childbirth as the "worst thing that could happen."
Here's the important part: whatever the cause, your tokophobia is VALID.
You don't need to have had "the worst" experience to deserve help. If childbirth feels unbearable to you, that's enough.
How CBT Helps You Work Through Tokophobia (Step by Step)
I know what you're thinking: "How will talking about my fear make it better?"
Here's the truth: CBT for tokophobia isn't just talking – it's about retraining your brain to see childbirth as something you CAN cope with, rather than a catastrophic threat. Right now, your anxiety is running the show. CBT helps you take back control.
✿ Here's how tokophobia therapy works:
-
We map out exactly what you're afraid of. Is it pain? Death? Loss of control? Medical interventions? Something specific that happened last time? Tokophobia isn't one-size-fits-all. Your fear is unique. We need to understand YOUR brain's specific catastrophic narrative before we can challenge it.
What this means for you: You'll finally understand WHY you're so terrified, and that understanding alone often reduces some of the panic.
-
Before we challenge the fears, we build your capacity to manage anxiety. You'll learn grounding techniques, breathing exercises, and ways to calm your nervous system that actually work (not just "try to relax").
What this means for you: You'll have tools you can use during scans, appointments, or when panic hits at 2am. You won't feel completely helpless anymore.
-
This is where we gently challenge the catastrophic thoughts. Not by dismissing them ("birth isn't that bad!"), but by examining the evidence, looking at realistic outcomes, and helping your brain see that childbirth - while challenging - is something you CAN survive. We might also use gradual exposure: watching birth videos, visiting the hospital, reading positive birth stories. But we go at YOUR pace. No forcing.
What this means for you: The thoughts like "I'm going to die" or "I can't survive this" start to lose their power. You can think about birth without immediate panic.
-
For many women with tokophobia, planning the birth they feel safest having is part of therapy. Whether that's a planned C-section, a highly medicated vaginal birth, or a home birth - we explore what feels most manageable for you. I'll never push you toward a vaginal birth if that feels unbearable. If a C-section is what you need to feel safe, I'll help you advocate for that with your medical team.
What this means for you: You feel empowered to make choices about YOUR birth, not what panic is dictating or what others think you "should" do.
-
If your tokophobia comes from a previous traumatic birth, we'll process that trauma using TF-CBT or EMDR (completing certification May 2026). Because until we address what happened last time, your brain will keep seeing this birth as a repeat of that trauma.
What this means for you: You can approach this pregnancy/birth differently because you've processed what happened before. You're not just reliving the past.
Tokophobia therapy typically takes 8-12 sessions, though some women need fewer and some need more depending on severity and whether there's underlying trauma.
The goal isn't to make you "excited" about birth.
The goal is to make birth feel survivable - so you can make empowered choices instead of choices driven by terror.
Why You Need a Therapist Who Understands BOTH Anxiety AND Childbirth
Tokophobia isn't like other phobias. You can't just "avoid" childbirth the way you might avoid spiders or flying. If you want biological children, you HAVE to go through pregnancy and birth. That makes tokophobia uniquely challenging – and it's why you need someone who understands both the psychology of phobias AND the realities of perinatal care.
I'm Aleksandra Balazy-Knas, and here's why I'm qualified to help:
✿ Specialist Perinatal Mental Health Training:
- Accredited CBT Therapist with specialist perinatal expertise
- Mental Health Nurse (NMC Registered) with over 10 years in NHS
- Currently completing EMDR training (for trauma-linked tokophobia)
- CBT Clinical Supervisor
✿ I Understand the NHS Maternity System:
I've worked in NHS mental health services for over a decade. I understand how maternity care works, what your options are, and how to advocate for your mental health needs within the system. I know the NHS tokophobia guidelines inside and out.
✿ My Specialist Experience with Secondary Tokophobia:
The majority of my NHS perinatal work has been with women experiencing secondary tokophobia – those who've had a previous traumatic birth and are now pregnant again and terrified. I've worked extensively with the dual challenge of processing past birth trauma WHILE managing overwhelming anxiety about current or future pregnancy. This combination – trauma processing + anxiety management – is my area of specialist expertise. I understand that secondary tokophobia isn't just fear – it's fear layered on top of trauma, and both need addressing.
✿ I Know CBT Works for Tokophobia:
CBT is the evidence-based, NHS-recommended treatment for tokophobia. I don't use unproven techniques or promise "quick fixes." I use methods that are backed by research and proven to help.
✿ I Won't Dismiss Your Fear:
You won't hear "just think positive" or "millions of women do this every day" from me. Your fear is valid. My job is to help you work through it – not minimise it.
✿ I Support ALL Choices:
Whether you want a vaginal birth, an elective C-section, or you're still figuring it out – I'm here to support YOUR choice, not push an agenda. If you decide a C-section is right for your mental health, I'll help you advocate for that.
✿ I Work Throughout Pregnancy (and Beyond):
Tokophobia doesn't magically disappear after you give birth. If you need postpartum support to process the birth or work through residual anxiety, I'm here for that too.
✿ This isn't generic anxiety therapy. This is specialised tokophobia treatment from someone who gets it.
Exactly What Happens in Tokophobia Therapy (Step by Step)
I know uncertainty makes anxiety worse. So here's exactly what happens when you work with me:
-
We start by understanding YOUR tokophobia:
- When did the fear start?
- What exactly are you most afraid of?
- How is it affecting your life right now?
- Are you pregnant? Planning pregnancy? Unsure?
- Have you had previous trauma (birth or otherwise)?
- What are your goals for therapy? By the end, you'll have:
- A clear understanding of your specific type of tokophobia
- A personalised treatment plan
- One anxiety management technique to try before our next session
No pressure, no judgment. Just clarity. -
If you're not pregnant yet:
We focus on processing the origins of your fear, challenging catastrophic thoughts, and building confidence so pregnancy feels less terrifying when/if it happens.If you're pregnant:
We work more intensively because we have a deadline. We focus on: - Managing daily anxiety and panic - Challenging specific fears about labour - Birth planning that feels empowering - Practicing coping strategies for labour - Working with your medical team to communicate your needsIf you have secondary tokophobia:
We often spend time processing your previous traumatic birth first (similar to birth trauma therapy), then move into managing your current pregnancy fear. -
After 4-6 sessions, we review:
"How are you feeling? Do we need to continue, or are you ready to finish?" Most women find 8-12 sessions helpful, but it varies. If you're in late pregnancy, we might work more intensively over fewer weeks.What Each Session Looks Like (50-60 minutes)
- Check-in: How have you been? Any panic attacks? New fears coming up?
- Main work: CBT techniques, exposure work (if appropriate), birth planning, trauma processing
- Practice: What will you try this week to manage anxiety?
- Reflection: What helped? What didn't? -
Online therapy only – via secure video call. You can be anywhere in the UK (I'm based in Leicestershire) or worldwide.
Sessions are £130 per session.
Q&AYour Questions About Tokophobia Therapy, Answered
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Answer: Absolutely not. Tokophobia therapy is about helping you make an INFORMED choice – not pushing you toward vaginal birth. If, after working through your fears, you still feel an elective C-section is right for you, I'll support that. If you decide you want to try vaginal birth with lots of support and pain relief, I'll help you prepare for that. If you're unsure, we'll explore both options without pressure. According to NHS guidelines, if your tokophobia is severe and unlikely to respond to treatment in the time available during pregnancy, requesting an elective C-section is a valid option – and I can help you advocate for that with your medical team.
-
Answer: It's NEVER too early. In fact, getting help BEFORE you're pregnant is often the best time because:
1. There's no time pressure (no approaching due date making you feel rushed)
2. We can work through the fear thoroughly without pregnancy adding extra anxiety
3. When you DO get pregnant, you're starting from a more confident place Many women with primary tokophobia put off getting help until they're already pregnant and panicking. Don't wait. Start now. -
Answer: It's not too late. Even in late pregnancy, therapy can help. We'll work more intensively and focus on: - Immediate anxiety management tools - Fast-track birth planning - Working with your medical team on your options - In crisis situations, advocating for an elective C-section if needed Even a few sessions can make a significant difference in how you approach labour. Many women in late pregnancy say, "I wish I'd started sooner, but I'm so glad I got help now rather than trying to white-knuckle through it alone."
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Answer: If you want this baby but the fear of labour is making you consider termination, please reach out URGENTLY. This is a mental health crisis, and you deserve immediate support. Tokophobia is treatable – and there are options (including elective C-section) that might make continuing your pregnancy feel possible. If you're in this situation, contact me immediately for a discovery call. We can discuss intensive support and work with your medical team quickly.
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Answer: Yes. If you're already working with a psychiatrist, taking medication for anxiety/depression, or receiving other mental health support, tokophobia therapy can work alongside that. In fact, it's often helpful. Let me know what other support you're receiving, and we'll coordinate.
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let's get startedYou Don't Have to Live in Terror of Giving Birth
Tokophobia doesn't just go away on its own. Avoiding thinking about it won't make it better. And you can't "positive think" your way out of it. But here's what DOES work: specialist CBT therapy with someone who understands both anxiety and perinatal care.
Whether you're:
- Too terrified to try for a baby
- Pregnant and panicking every single day
- Facing your due date with absolute dread
- Considering options you never thought you'd consider
You deserve support that actually helps.
I've spent over a decade in NHS mental health services. I've seen how tokophobia traps women in fear – and I've seen how the right therapy can set them free.
Book your free 20-minute discovery call and let's talk about what's keeping you stuck – and how CBT can help you move through it.
Ready to Start?
I'm Aleksandra Balazy-Knas, an Accredited CBT Therapist, Registered Mental Health Nurse, and CBT Clinical Supervisor.
I specialise in tokophobia and perinatal mental health, with over 10 years of NHS experience. I'm currently completing EMDR training (May 2026) and work with women across the UK and worldwide via online therapy.
Location & Availability
Online therapy across the UK and worldwide. Based in Leicestershire, but available to anyone with an internet connection.
Related Services
If you're also dealing with birth trauma (not just fear of future birth), you might find my Birth Trauma Therapy page helpful. Many women need support for both.
Read more about me and my approach HERE.