Perceived labour-pain and parity are not determinants of tokophobia amongst birthing mothers: A cross-sectional study.

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From: Port Harcourt Medical Journal(Vol. 14, Issue 3)
Publisher: Medknow Publications and Media Pvt. Ltd.
Document Type: Report
Length: 2,686 words
Lexile Measure: 1570L

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Byline: Chinemerem. Eleke, Ogochukwu-Mbonu. Steve-Tamuno, Ifeyinwa. Agu, Esther. Bempong-Eleke

Background: Maternal health experts opine that poor control of labour-pain could result in traumatic childbirth experience which could lead to tokophobia. Aim: This study examined the association between perceived labour-pain and tokophobia amongst mothers who had normal vaginal birth in University of Port Harcourt Teaching Hospital Nigeria. Methods: A cross-sectional design was used. A sample size of 218 randomly selected birthing mothers was examined for the study. Fear of childbirth and numeric analogue scale for labour-pain interview questionnaires designed by the research team were used for data collection. Data were collected through face-to-face interview of consenting postnatal mothers at 24-36 h after labour. Collected data were analysed using descriptive and inferential statistics at P 0.05). Conclusion: Severe perceived labour-pain is widespread, whereas tokophobia is not very common in South-Southern part of Nigeria. Tokophobia was predicted by unemployment but not perceived labour-pain, parity and age. Midwives and other obstetric care givers should incorporate mental health services into prenatal care of unemployed women and advocate for adequate analgesia during labour to further reduce perceived labour-pain.


Labour-pain is an experience which many birthing women usually undergo in the course of childbirth. It stems from physiological changes that occur in women during childbirth. Nonetheless, not all women experience labour-pain in the same way, manner and intensity.[1] At the peak of labour some birthing women may express pain by crying, screaming and stoic-related poise.[2] In certain cultures in Africa, the inability to tolerate labour-pain would signify emotional incompetence.[3] Some mental health experts opine that the stigma that could arise from such societal beliefs could have some impact on a woman's postnatal wellbeing.[4] In addition, some maternal health experts hint that poor control of labour-pain could result in negative and traumatic childbirth experience which could lead to tokophobia.[5]

Tokophobia is a morbid apprehension specific to childbirth. Even when it is considered normal for women to have some reservations regarding the uncertainties of childbirth, morbid fears could prove to be problematic.[6] Some women experience high levels of tokophobia which may be related to prior expectations formed about childbirth.[7] It is envisaged to be responsible for some women wanting to avoid pregnancy and labour regardless of wanting a baby.[8] Some evidence has it that tokophobia could negatively affect maternal wellbeing.[9] It has been documented that unresolved tokophobia is strongly linked to future adverse maternal birth outcome.[10] The remediation of tokophobia may rely on a clear understanding of its aetiology and determinants.

Within the past decade, there has been a growing argument on the aetiology and empirical determinants of tokophobia. Some researchers argue that severe tokophobia results from anticipated intensity of labour-pain for nulliparous women and prior experience of labour-pain for parous ones.[11] Some other researchers refute any link between labour-pain and tokophobia, but suggest an association between previous complicated birth and tokophobia.[6],[12],[13] In addition, some researchers suggest that parity status is strongly linked to tokophobia.[8],[9] Conversely, a few researchers do not support any link between parity status and...

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Gale Document Number: GALE|A656645789