Some worry about giving birth is very common. But for some people, the fear is much bigger than that. It might keep you awake at night, make you avoid talking about the birth or even make you dread the idea of pregnancy at all. Maybe a past birth was hard and the thought of going through it again feels unbearable. If this sounds like you, you're not alone, and your feelings make sense. This post explains fear of childbirth, the signs to watch for and how prenatal therapy can help you feel steadier.
This post is general information, not a diagnosis or medical advice. It covers the emotional side of fear of childbirth only, not medical or birth planning advice.
What is fear of childbirth?
Fear of childbirth means feeling worried, anxious or afraid about giving birth. A Cochrane review explains that many people feel some fear about birth during pregnancy, and that this can be normal. For some, though, the fear is high or severe.
People often ask what fear of childbirth is called when it becomes extreme. The answer is tokophobia, also spelled tocophobia. The Cochrane review describes tocophobia as the extreme end of the fear spectrum. It notes that it can cause distress, affect well-being in pregnancy and make the move into parenthood harder.
Is it a phobia? Many people search for "fear of childbirth phobia" because the fear feels out of proportion and hard to control. Like other phobias, a strong fear of birth can lead to avoidance. You might skip reading about birth, change the subject or put off thinking about it at all. Avoidance brings short-term relief, but it can make the fear grow over time.
Tokophobia isn't a sign of weakness or of not wanting your baby. It's an intense fear, and like other fears, it can be understood and eased with support.
Fear before a first birth and fear after a previous birth
Fear of childbirth can show up at different times:
Before any birth. Some people feel intense fear about birth before they've ever given birth. It may start long before pregnancy and can even affect whether they want to become pregnant.
After a previous birth. Others develop fear after an earlier birth felt hard, frightening or out of their control.
A 2019 systematic review found that people giving birth for the first time and people who had given birth before had similar levels of fear, but for different reasons. For those who had given birth before, the strongest predictor of fear was a previous negative birth experience or an operative birth. The authors suggest it's important to tell apart fear of childbirth and fear after birth.
Birth trauma is a related but separate topic.
Tokophobia symptoms
Tokophobia symptoms can look different for everyone. You may:
Feel dread or panic when you think about labour and birth
Have nightmares about giving birth
Avoid pregnancy, prenatal reminders or birth stories
Feel panicky or tearful when others talk about birth
Have frightening images of birth pop into your mind
Feel tense, on edge or unable to enjoy your pregnancy
Have trouble sleeping or focusing because of the worry
This isn't a test, and only a qualified professional can assess what you're feeling. But if the fear is taking over your thoughts, it's worth talking about.
What can cause fear of childbirth?
There's usually no single cause. The 2019 review found that stress, anxiety, depression and a lack of social support were linked with fear during pregnancy. Other factors that may play a part include:
Past trauma, including trauma not related to birth
A previous hard or frightening birth
Hearing scary birth stories from others or online
Fear of pain, loss of control or something going wrong
General anxiety or a tendency to worry
A 2018 review describes fear of childbirth as a common problem that affects health and well-being. It also notes that it's a common reason people ask for a caesarean birth. Birth choices are personal, and this post doesn't give advice on them. Our focus is the fear itself and how to ease it.
Fear of childbirth and pregnancy
Fear of childbirth and pregnancy can feed each other. Body changes, check-ups and planning for the baby can all bring the birth to mind. Partners may feel helpless or unsure how to help. It's okay to feel excited about your baby and afraid of the birth at the same time.
If you're a partner, you can help by listening without trying to fix or dismiss the fear. Phrases like "That sounds really scary" or "What would help right now?" go a long way. Try not to share frightening stories, and ask before offering advice.
Coping with fear of childbirth
If you're thinking about suicide, call or text 9-8-8 now. If you or someone else is in immediate danger, call 911.
Small steps can help you feel more in control of the fear:
Name the fear. Try saying, "I'm feeling very scared about the birth." Naming it can make it feel more manageable.
Get specific. Ask yourself what you fear most. Is it pain, losing control, something going wrong or being alone? Knowing the details helps you and your supports respond.
Ground yourself. When fear rises, breathe slowly and notice what you can see, hear and feel around you.
Take gradual steps. Avoiding every reminder can make fear grow. With support, you might slowly face small pieces, such as reading calm, factual information.
Limit scary stories. It's okay to tell people you'd rather not hear frightening birth stories right now.
Tell your partner what helps. Let them know whether you need comfort, distraction or a listening ear.
The Cochrane review found that talking-based and educational supports, such as psychoeducation and cognitive behavioural therapy, may reduce fear of childbirth. But the evidence is still limited, and the authors say it's uncertain how big the benefit is. More research is needed.
How prenatal therapy can help
You don't have to face this fear alone. Talking with a therapist can help you understand where it comes from and build ways to cope. Our support for fear of childbirth can include:
Cognitive behavioural therapy (CBT). CBT can help you notice frightening thoughts and find more balanced ways to see things. Learn more about CBT counselling.
Gradual exposure. With a therapist, you face feared thoughts or reminders slowly and safely, so they lose some of their power. Our post on exposure therapy for phobias explains how this works. It is one form of tokophobia treatment.
Trauma counselling. If your fear started after a hard birth or another trauma, trauma-focused therapy can help you process what happened.
Couples sessions. Partners are often affected too. Couples sessions happen in person together or online together, and partners can join one online session from separate locations. Both partners need to be in Ontario during the session.
Support is open to all birthing people and their partners.
You can see us in Kitchener, Waterloo, Cambridge or Ottawa, or by secure video from anywhere in Ontario.
Cost, billing and your first step
Sessions with our therapists range from $130 to $200, depending on the clinician.
We accept Health Spending Accounts (HSAs).
We can direct bill many insurers. Coverage depends on your plan, so check with your insurer before you start.
Book a free 15-minute consultation with our admin team. Let them know you're struggling with fear about pregnancy or birth, and they'll help you find a good fit.
If you're in crisis: if you or someone you love is in immediate danger, call 911. If you're thinking about suicide, call or text 9-8-8 any time, day or night.
Last reviewed: October 2026
Sources
Interventions for fear of childbirth including tocophobia, O'Connell and colleagues, Cochrane Database of Systematic Reviews, 2021
Causes and outcomes in studies of fear of childbirth: a systematic review, Dencker and colleagues, Women and Birth, 2019
Definitions, measurements and prevalence of fear of childbirth: a systematic review, Nilsson and colleagues, BMC Pregnancy and Childbirth, 2018