Fear of pregnancy and childbirth

Ms. Xuan, 30 years old, and Mr. Truong, 33 years old, have been in love for nearly 7 years. She once declared that she would live "without children", spending time taking care of her parents and family. Mr. Truong thought that he would change his girlfriend's mind after marriage, so he was determined to marry her. After two years, she continuously avoided him, not wanting to have children, causing tension in the family atmosphere. Every time her husband bought health supplements, she blamed it for wasting money and refused to use them.

The woman confided that she was afraid of giving birth because of the trauma of an unhappy family situation, with her parents often arguing due to the burden of raising 5 children. Xuan's two older sisters both suffered from postpartum depression, one of them attempted suicide and had to be hospitalized in a psychiatric hospital, which made her even more panicked when she mentioned pregnancy.

Researching online, she found that the rate of miscarriage and birth defects was increasing. The thought of "what if the risk happens to me" kept haunting Xuan, making her more worried and restless. She went to see a doctor and was warned of signs of anxiety disorder.

Also putting her plans to have a baby on hold, Ms. Lan, 36 years old, said she was always haunted by her first labor. She had abdominal pain from 2am to 10pm but could not give birth naturally, so she had to have spinal anesthesia for a cesarean section.

"With the pain of labor and the back pain from anesthesia, I thought I wouldn't be able to give birth," she said.

Not only that, the postnatal diagnosis showed that the baby had congenital adrenal hyperplasia, requiring treatment, causing the woman to panic, fall into postpartum depression, often have insomnia, be bored, and be angry. Now the first child is 10 years old, in normal health, but Ms. Lan is still afraid when thinking about getting pregnant, even though both families urge her to have a son to continue the family line.

Tokophobia (also known as Tokophobia) is a term used to describe the fear of pregnancy and childbirth in women. According to Very Well Family, this is not a disease but a psychological disorder caused by excessive fear of pregnancy and childbirth, including fears such as fear of pregnancy defects, fear of stillbirth, fear of pain, fear of injury to the baby, fear of the mother's genitals tearing, and danger to life. A report on Tokophobia published in the American Journal of Psychiatry estimates that up to 13% of women feel obsessive and fearful of childbirth.

"In fact, most women experience fear related to childbirth, this is a very normal psychology, because childbirth is a complicated process with many risks," said Dr. Phan Chi Thanh, Department of Examination, Central Obstetrics Hospital.

This syndrome can occur in people who have not given birth but have been victims of a medical risk or are aware of the risks and complications of childbirth... Another group has given birth but the pregnancy and childbirth process was painful, difficult or complicated. Women who have had a miscarriage, stillbirth or abortion can also experience this fear. Some women with a history of anxiety and depression can also have the syndrome.

There are currently no specific figures on this situation in Vietnam, however, the trend of not having children is becoming more and more popular. In 2022, the General Statistics Office said that Vietnamese people are increasingly reluctant to have children, especially in Ho Chi Minh City, where the birth rate is only 1.39 children per woman, while the necessary replacement level is 2.1 children. Vietnam's birth rate in 2022 is 2.01 children, the lowest since 2018.

When experiencing the above situation, women's psychology is often seriously affected. Many people show signs of depression and anxiety disorders, affecting sleep, diet, family and social relationships... Some other symptoms include decreased libido, delaying or avoiding pregnancy despite wanting to have children.

According to Dr. Thanh, pregnancy is a sacred mission for women, but both father and mother need to be most carefully prepared. First, the wife needs to stay calm and frankly discuss her feelings and thoughts with her husband. This helps both understand the problem and find a solution together. Both can change the space to relax and reduce stress. At this time, the husband's care and understanding are very important.

"As long as both husband and wife listen and share, they can overcome these difficulties," the doctor said.

Sharing the same opinion, Dr. Nguyen Viet Chung, Head of the Department of Mental Health, E Hospital, said that this syndrome is not too dangerous, but needs psychological treatment combined with medication to stabilize before deciding to get pregnant. During pregnancy, women also need support from doctors or psychologists to avoid anxiety, fear, and panic attacks.

In addition to medication, people with the condition can be treated with cognitive behavioral therapy (CBT). This is one of the most effective treatments for phobias, helping people recognize and change negative beliefs about pregnancy and childbirth.

In addition, before planning to get pregnant, men need to improve their health, maintain their weight, take vitamins, quit smoking, and eat healthily. Women need to take vitamins, eat well, maintain their weight, and limit stress. Couples can travel to improve their mood, relax together, and solve problems.

*Character names have been changed