Surviving Pregnancy When You Have Tokophobia and/or Anxiety
When I opened up about my struggles with tokophobia and anxiety during my pregnancy last year, a wonderful thing happened: readers started confiding in me about their own pregnancy fears, and telling me my posts on anxiety had helped them feel a little bit less alone when they found themselves dealing with the same thing.
So, first of all, I just want to encourage you all to keep doing that: seriously, I might take a little longer than usual to respond right now (Then reason for that is currently napping in his swing next to me, and is the living proof that anxiety and tokophobia CAN be overcome – I mean, if I can do it, anyone can, right?), but it makes me so happy to know those posts have helped some of you, and if there’s anything else I can do in that respect – even if it’s just lending a sympathetic ear from time to time – I’m more than happy to hear from you. I think early pregnancy especially can be such a lonely time: you’re basically stuck in this weird limbo where the pregnancy is so all-consuming that it’s literally ALL you can think about, but hey, guess what’s the ONE THING you absolutely CAN’T talk about? Yeah, it’s that same thing you can’t stop thinking about! Lucky you! Welcome to your new life!
As I’ve had so much interest in this topic, though, I thought it might be helpful, now that I’ve come out the other side of the process, so to speak, to talk a bit about some of the things that helped me through it: obviously everyone is different, and there’s no “quick fix” for ANY kind of anxiety, unfortunately, but here are some of the things that helped me survive pregnancy while dealing with tokophobia and anxiety…
Dealing With Pregnancy Fears / Tokophobia
The knowledge that I wasn’t alone
As I said above, early pregnancy can be a lonely time for anyone, I think (I wrote a bit here about how I struggled with the constant, low-level deception involved in the first trimester, and even when you’re just trying to conceive: I honestly wish our culture was a bit more open about this stuff, because, for me at least, while I understand the reason for it, the secrecy really added to the stress I was already under), but for those of us struggling with anxiety, it can be even more so – not just because there’s no one you can really turn to for reassurance, but also because it makes you feel like such a FREAK.
EVERYONE has babies, after all – or, at least, it can feel that way when you’re trying to start a family of your own. And everyone just seems to… well, HAVE THEM, without any fuss or drama: so when you find yourself feeling so scared you can barely even function, it’s hard not to wonder why you’re so different from everyone else, and why you can’t just get on with it, like every other woman in the world seems to.
Well, I’m here to tell you that everyone else DOESN’T “just get on with it” – it just LOOKS like that, because pregnancy anxiety isn’t something that’s really talked about: in fact, a lot of the time, women are actively discouraged from saying anything that might be perceived as “negative” about their pregnancies, and to just pretend that everything is wonderful, out of respect to those who aren’t so fortunate.
I, of course, DIDN’T pretend everything was wonderful, and although I had my fair share of scoldings from people who felt I shouldn’t be complaining, and should just “enjoy” the experience (My favourite comment is still the one from the woman who wanted me to “enjoy” the morning sickness – sister, NO ONE actively ENJOYS throwing up, and anyone who says otherwise is a liar…) (Actually, I say this like it’s funny, but it’s actually pretty serious, as comments like that one really help illustrate the level of pressure pregnant women are given to remain “positive” NO MATTER WHAT. I mean, if we’re not even allowed to throw up without being told to enjoy it, no wonder women dealing with anxiety are made to feel like freaks, right?)… er, let’s just start that sentence again, shall we?
I DIDN’T pretend everything was wonderful with my pregnancy, and although my honesty made me feel pretty vulnerable, and occasionally a little silly, I’m still glad I was open about my experience, because what I learned from it was that I WAS NOT ALONE.
The truth is that most women – even those who don’t normally suffer from anxiety – find pregnancy a little bit scary. Some of them find it a BIG bit scary, of course, and, again, I’m not just speaking here about people like me, who were already dealing with severe health anxiety and generalised anxiety even before getting pregnant: I’m talking about perfectly “normal”, sane women, who suddenly find themselves going through this totally INSANE process – because, let’s face it, growing a human being inside your body is next-level crazy, right? – and realise that, hey! This is TERRIFYING. Because it IS terrifying: and, since I started writing about it, I’ve had tons and tons of women confide that, yes, they had exactly the same pregnancy fears I did – many of them qualifying that statement with something like, “And I’m not normally an anxious person, either!”
Hell, even my own doctor, who is, by her own admission, one of the most pragmatic, no-nonsense types you’re ever likely to meet, told me that, when she was pregnant, she ended up listening for the baby’s heartbeat every single day, just to reassure herself that it was still there. The lesson?
You are not the only one who feels like this. And that’s why the next thing I did was so important…
Asking for support
I was open about my anxiety right from the very start. At my first meeting with my midwife, when I was 8 weeks pregnant, I told her I was terrified, and would likely need a lot of support – and I got it.
I’m not sure if my experience was unusual in any way – I really hope it wasn’t – but I got a huge amount of support from the health service while I was pregnant. Extra midwife appointments. Counselling. Regular meetings with my doctor. A tour of the labour and delivery ward. A meeting with an anaesthetist, once I’d decided on an elective c-section. None of this would have happened if I’d done what I normally do in medical situations, which is to downplay my anxiety about it all and try to pretend I’m fine. No, totally FINE! REALLY! *forced grin*
As I said, I don’t know how typical my experience was, here, and I know some people who’ve unfortunately had very little support from health professionals during their pregnancies, which makes me really sad. What I do know, however, is that you won’t know what kind of help is available until you ask – and until you start being honest about your pregnancy fears and anxieties.
Early and regular “reassurance” scans
I had scans every two weeks in my first trimester, and while the first one was deemed medically necessary in order to make sure the pregnancy wasn’t another ectopic, the rest were done purely for reassurance, and to help me manage my pregnancy fears, which, at that stage revolved mostly around the possibility of another miscarriage.
While I genuinely don’t think I’d have made it through the first trimester without the reassurance these scans gave me, I have to admit that they’re something of a double-edged sword. For one thing, after my two previous loses, I’d developed a fear of scans which bordered on a phobia: I would be literally shaking with fear as I sat in the waiting room, and I was so convinced that I’d be given more bad news that I found the whole experience traumatic, to say the least.
The other issue with early scans, of course, is that they only provide reassurance at the time of the scan itself. So, I’d come out of each one feeling absolutely elated from the sheer relief of having been able to see my baby and know everything was OK… but by the time I went to bed that night, I’d be back to worrying that something might have happened in the hours that had elapsed since the scan. GAH.
At the end of the day, this one is a very personal decision, and only you can know for sure whether an early scan(s) will help with your pregnancy fears, or simply exacerbate them. Ultimately, I feel it was the right decision for me, because, as I say, I really don’t think I’d have coped with them, but it would be remis of me not to acknowledge that I did find the scans incredibly stressful, and I was glad when I moved into my second trimester, and onto a schedule where I was given only those scans deemed to be medically necessary.
(I’ll just quickly add here that I didn’t actually ASK to be given so many scans – it was something that was offered to me by the Early Pregnancy Unit, whose care I was under following my earlier ectopic pregnancy – so I’m not sure exactly how you would go about requesting this on the NHS. I would imagine your midwife or Early Pregnancy Unit would be able to help with this, though, if it is something you think would help.)
Not Googling anything
No, seriously: step away from Doctor Google, because that way madness lies.
This is a principle I’ve used to manage my health anxiety for years now, and it became even more important during my pregnancy, when everyone I encountered seemed to have some kind of horror story to share. I couldn’t stop people telling me about their traumatic experiences, unfortunately (I did end up asking some people to stop scaring me, though, or just walking away from conversations that seemed particularly insensitive to me.
I wouldn’t normally do something like that, for fear of being seen as rude or “difficult”, but I got to a point where I knew I had to put my mental health first, and it was the only way to do it.), but I did my best to avoid anything I knew might be triggering: so, TV shows like ‘Call the Midwife’ and ‘One Born Every Minute’ were out, and rather than Googling symptoms that were worrying me, I either contacted my midwife – or got Terry to do the Googling for me.
To help me deal with my pregnancy related fears, I was referred – first of all by my midwife, and then by my consultant – to the psychology department at the local hospital. I saw a psychologist every few weeks from about the middle of the second trimester, and I found it really helpful: not just in the sense that the psychologist was able to help me find coping mechanisms to manage my anxiety, but also in that she was able to help me access some of the practical help I needed: for instance, arranging a private room in the hospital, and making sure I’d be allowed to have my husband with me at all times during the birth.
This counselling continued for a few weeks after Max was born (In fact, the psychologist even made a point of popping in to visit me on the day he arrived, to make sure I was OK), and is something I would really recommend to anyone dealing with excessive/uncontrollable pregnancy fears or tokophobia.
Having an elective c-section
Of course, I can’t write a post about surviving tokophobobia without mentioning the biggest issue of all – the birth itself. In my case, I dealt with my extreme fear of childbirth by requesting an elective c-section, which I believe is pretty common for people who have tokophobia. I wrote at length about my decision, and the reasons behind it here, but, in short, while childbirth is never really going to be something you can plan right down to the last detail, I just felt much more in control of the experience knowing I was definitely going to be having a c-section.
My situation is perhaps a little unusual in that my biggest fear revolves around having to have a general anaesthetic, which I knew is sometimes necessary if a c-section has to be done in a hurry. My age meant that a c-section was always pretty likely for me anyway, so, in a way, I opted for a planned one mainly in order to avoid an emergency one (Or to try to, at least – it was made clear to me throughout the process that there was never going to be a guarantee that I wouldn’t need a general anyway – this was re-iterated to me right before I went into surgery, which was… scary, to say the least…): that might sound crazy but, well, phobias are rarely logical, and mine is so intense that it all made perfect sense to me!
Having an elective c-section also meant I avoided being induced, which was my other big fear, and I also didn’t have to go through labour, or be in pain. I know a lot of people will judge me for that, or feel that I missed out on an essential part of the childbirth experience, but I honestly don’t care about any of that: as one of my commenters put it, I wanted to be a mother, not a martyr, and I had absolutely no desire to experience contractions etc: all that mattered to me was that the baby got out safely, and in the least traumatic way possible, and that’s exactly what happened, leaving me with absolutely zero regrets.
Having said that, I will just add that, although I believe my c-section was less frightening for me than letting things happen naturally would have been, it definitely wasn’t the “easy” option some people believe it to be. I’ve already written about both the birth itself and my recovery, so I won’t repeat myself, other than to say that it was the hardest thing I’ve ever done and I was absolutely terrified – but I still believe it was the right decision for me.
I had no issues at all in getting my c-section: I just mentioned at my first midwife appointment that I thought I might like one, and I was immediately referred to a consultant, who agreed that it could be a good way to control my extreme anxiety about childbirth.
I was, of course, told about the various risks of the procedure, and was asked to go away and give it some thought before going forward with it, but my doctor made it very clear to me that, while the NHS will always recommend a vaginal birth as the best option in cases where there’s no medical reason not to have one, she would be happy to refer me for a c-section if that’s what I decided I wanted. I was never given any pressure, or made to feel judged in any way – again, I’m not sure if I just got lucky in that respect, or if it’s the norm, but, either way, I’m very grateful that my decision was supported, and that I didn’t have to fight for it the way I know some women do.
Visiting the birthing suite in advance
One of the things my doctor arranged in order to help manage some of my pregnancy fears – and particularly the ones revolving around childbirth – was a visit to the hospital’s birthing suite, which includes the theatre where c-sections are carried out. I was really quite nervous about this, because, well, hospitals terrify me, basically, but it actually turned out to be one of the most helpful things I did.
I was met at the entrance to the ward by a wonderful midwife, who walked me through exactly what would happen when I came in for my c-section, from arriving at the ward, right through to showing me the room I’d wait in before the surgery itself. The plan here was for me to also be taken into the operating theatre itself, but that didn’t happen, as there was a c-section taking place when we were there. The nurse did, however, open the door to the room next to it, where the baby is taken immediately after birth to be cleaned and weighed… just in time for us to see a tiny, newborn baby being carried in.
I found it really moving to see this brand new bundle of life, moments after he or she entered the world, and it really helped remind me that, terrifying though it was to me, this experience would also be the moment I met my baby for the first time, which was exciting, as well as scary. I also found it incredibly helpful to know EXACTLY what was going to happen on the day Max was born, and the midwife who talked me through it all was so reassuring I wanted to bring her home with me. She really helped me understand that, although this was going to be a HUGE deal for me, it was just a normal day at work for the staff in the birthing suite, who were all going about their business and chatting about their weekend plans. It really helped calm me down a little, as well as reassuring me that I was making the right decision, and would be in excellent hands, so, if some of your pregnancy fears revolve around not knowing what will happen, or wanting to have some degree of control over the situation, this is something I’d really recommend doing, if at all possible.
A private room, which my husband could stay in overnight
I’m very aware that this admission makes me sound like an absolute child, but I knew long before I got pregnant that I would NOT be able to do it alone: in fact, being left on my own in hospital was one of my biggest fears, and therefore something I knew I’d have to address before the birth.
In Scotland, partners are not allowed to stay overnight on maternity wards (Or, at least, not at the time I had Max: I know there are some moves afoot to change this policy…), and you’re also not able to pay for a private hospital room. This was a huge issue for me, because at least part of my hospital phobia revolves around the lack of privacy you encounter on communal wards, and the fear of being left to try and cope on my own – either during the early stages of labour itself (For instance, if I’d had to be induced, Terry wouldn’t have been allowed to be present until labour was established, so I could have had to have spent many hours/days in hospital on my own, while going through something that would’ve been absolutely terrifying to me…) or with a newborn.
This was such an issue to me that I seriously looked into going private, purely so I could have privacy and support from my husband. Unfortunately, though, it turns out that there are no private maternity hospitals in Scotland (Yes, really…), so my only option was to try to explain my fears to my doctor, and hope she was willing to help. Luckily for me, she was, and not only did she arrange for me to have a private room in hospital, she also arranged for Terry to be allowed to stay overnight in it with me. This was totally against the hospital’s policy at the time, and I was really, really lucky that they were willing to make this concession for me, because I honestly don’t think I’d have coped on my own – especially not right after the operation, when I still couldn’t move properly, and needed Terry to help with the baby.
As I say, though, while I was lucky to have a doctor who understood my concerns, and was able to help address them, if I had been able to pay for a private room, I’d have been more than willing to do that, because I spent a huge amount of time during my pregnancy worried that I’d be facing early labour alone, and just knowing that wasn’t going to be the case was really helpful to me.
One final point here: my doctor also arranged for Terry to be allowed to accompany me into the operating theatre while the spinal block was administered. Under normal circumstances, partners aren’t allowed into the theatre until this has been done (I have no idea why), but my doctor knew without me even having to ask that being separated from the person I was relying on to support me at the most crucial time of all REALLY wouldn’t be helpful for me, so he was allowed to be with me every step of the way. Again, I’m not sure how willing other doctors would be to make this concession, but it’s definitely worth asking about if you think it’ll help – and assuming, of course, that your partner is willing!
Packing my hospital bags well in advance
This will sound absolutely crazy, I know, but I had a hospital bag packed long, long before I needed one – before I was even pregnant, in fact. Why? Because a large part of my anxiety revolved around feeling like I’m not in control of the situation, and being prepared for a possible hospital stay was one of the ways I dealt with that, by trying to regain just a little bit of that control.
Because I’d already had a miscarriage and an ectopic pregnancy, most of my early pregnancy fears revolved around the conviction that something would go wrong with this latest pregnancy, too, which is why I packed a bag before I was even pregnant: I knew I had an increased chance of having another ectopic pregnancy, so even just making the decision to try again was terrifying to me., and something I wanted to be prepared for. If the pregnancy HAD turned out to be ectopic, it could’ve resulted in me needing surgery, and I might not necessarily have had a lot of notice about it, so I packed a bag just in case. I just want to add here that I’m well aware of how crazy that sounds, but I think that, when it comes to anxiety and pregnancy fears, you do whatever you have to to get through it – even when you know it’s something that non-anxious people probably won’t understand.
With all of that said, though…
…. I can’t deny that, although I did manage to get through my pregnancy despite my fears, it was the hardest thing I’ve ever done, and I found that, as soon as I got past one set of pregnancy fears, something else would turn up to take its place. By the end of the pregnancy, I was so obsessed with monitoring the baby’s movements at all times, that I was almost unable to function: I’d actually started to resent anything that required me to leave the house (because how could I make sure the baby was moving if I was walking around all the time, which just made him go to sleep?), and, when I did, the second I got home I’d go and lie on my side, just waiting to feel him kick. Almost every single day I’d become convinced the movements had stopped, and would have a complete meltdown – occasionally this would happen when we were visiting my parents or Terry’s mum, which was pretty embarrassing, but I just couldn’t seem to stop myself worrying – and I never really did, despite everyone’s best efforts.
And that, I think, is the crux of the whole thing: if you have tokophobia, or pregnancy related fears, there will be times – maybe even a lot of them – when you just can’t stop yourself worrying. “Honestly,” my midwife said at one point, “I think you’re going to feel like this until the baby’s here safely, and that’s all there is to it.” It might sound strange, but, in some ways, accepting that that was the case, and acknowledging that I was probably never going to be able to relax enough to “enjoy” the pregnancy – no matter how often people told me I SHOULD be – actually helped me get through it, with realistic expectations.
Of course, in retrospect, I had a pretty textbook pregnancy: I was extremely lucky not to have any serious problems or complications, and I’d be lying if I said I wasn’t able to enjoy ANY of it at all. Even I had my moments, and in fact, the last time I was at the hospital, for a counselling appointment, I got a little pang of nostalgia when I saw a young couple coming out of the scan unit clutching one of the blue folders which hold all of your pregnancy-related notes. Was it enough to make me want to do it again? HAHA, NOPE. Not a chance. I’m very glad I was able to keep my anxiety at bay for long enough to do it once, though: and, as I said, if I can do it, ANYONE can…