Tokophobia and Associated Factors in Pregnancy: A Community-Based Cross-sectional Survey

This community-based cross-sectional survey, conducted in Lagos, over a 4-month period, involved 855 pregnant women attending antenatal care at Lagos’ 57 flagship primary health care centers (PHCs). Fifteen eligible pregnant women who were consecutively selected from each PHC's antenatal clinic list, had in-depth interviews using a structured questionnaire consisting of the Wijma Delivery Expectancy Questionnaire (W-DEQ A) for fear of childbirth, the Depression Anxiety Stress Scales (DASS-21), and the Generalized Anxiety Disorder 7-item (GAD-7) scale. Data was analyzed with appropriate descriptive and inferential statistics at <0.05 significance level.
Results: The women’s mean age was 28.37 years and majority were multigravida, in their third trimester with secondary level of education. Fear of childbirth levels revealed 7.7% with low fear, 38.9% with moderate fear, 48.4% with high fear, and 4.9% with severe fear of childbirth (tokophobia). Of those with tokophobia, 35.7% had primary tokophobia, and 64.3% had secondary tokophobia. Comparative analysis showed no significant differences in demographic or obstetric characteristics between women with and without severe fear of child birth. Women with severe tokophobia had significantly higher anxiety and stress levels but multivariate analysis did not find significant associations between severe tokophobia and the psychological variables in the GAD-7 and DASS-21 scales.