Hull and the East Riding has become the first area outside London to offer specialist support to pregnant women frightened of giving birth.
Hull University Teaching Hospitals NHS Trust is introducing the new pathway to help women with tokophobia, a debilitating and overwhelming fear of giving birth.
Women who request elective caesareans when they first book into maternity services or women who are demonstrating possible signs of tokophobia will be seen by midwives who can refer them to specialist midwives, mental health services or to specialist support in the community.
They could be helped through birth education classes or one-to-one support to prepare them for birth with continued input from maternity and mental health services.
A consultant obstetrician will review the case around 28 weeks into the pregnancy to begin planning and a decision will be made jointly with the woman and the health teams looking after her over the best way for her to give birth.
Lesley Robson, Specialist Midwife for Vulnerable Women at Hull Women and Children’s Hospital, said: “We want to show women that we know this condition exists and that we take it very seriously.
“We are only the second place in the country to have this pathway in place for women with a deep-seated and very real fear of giving birth.
“Women with tokophobia should be assured that Hull and the East Riding has the skill, understanding and expertise to support them throughout their pregnancies.”
While it is common for women to feel anxious or afraid of giving birth, tokophobia is a rare but recognised mental health condition. It can make women so frightened of giving birth, they don’t want to go through with the pregnancy, even ‘though they long for a baby.
Tokophobia can happen if a woman already has an anxiety order, had gynaecological problems, experienced sexual abuse, assault or rape or has heard frightening birth stories from people in their own family.
Current research suggests that around seven per cent of women may experience this condition.
Although some women have a severe fear of childbirth after a previous traumatic birth experience, it is more likely they have post-traumatic stress disorder rather than tokophobia and will be supported and referred for different treatment.
Midwives will be given additional training to follow a consistent approach which ensures the women get the help they need at the earliest opportunity.
Staff at Hull Women and Children’s Hospital, Humber Teaching NHS Foundation Trust, the University of Hull, City Health Care Partnership, Hull Clinical Commissioning Group and East Riding of Yorkshire Clinical Commissioning Group will host an event in September to help their staff understand more about tokophobia.
Held at the Medical Education Centre in Hull, health professionals will be invited to attend the event to find out more so they can help women.
Women and their partners will also be able to find out more about the treatment pathway and how the trust can help and support women with the condition at the monthly HEY Baby Carousel events, which take place on the last Wednesday of every month at the Clinical Skills Building.
Lesley Robson said: “Sometimes, women come to us asking for an elective caesarean because they are so frightened not realising that we can offer psychological support which could help the woman through her pregnancy and the choices for birth.
“Despite recent advances, there is still stigma surrounding mental health support and women are often too frightened to tell us about the extent of their feelings and fears.
“However, by working together with our colleagues in perinatal mental health, we can help the woman explore the reasons why she feels she needs a section.
“Working with both the perinatal mental health and primary mental health teams can be of great help to a woman with tokophobia which could hopefully lead to a more positive experience in pregnancy and post-natal period.”
