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Psych Congress  

Tocophobia: Case Report and Review of the Literature

Harita Raja, MD
Catherine Roca, MD
Aimee Danielson, PhD
MedStar Georgetown University Hospital

Introduction: Tocophobia, the fear of childbirth, is a type of specific phobia.  It is thought to affect between 6-11% of women across cultures.  However, it is under-recognized by psychiatrists.  Tocophobia is present in the Ob-Gyn literature in the context of increased Cesarean sections, though has had limited emergence in psychiatry. This case is unique in addressing a case of tocophobia treated by behavioral and pharmacologic interventions.   The hope is to increase awareness of tocophobia.

Case Description:  The patient is a married, female with a previous psychiatric history who initially presented with tocophobia. She had difficulty being around pregnant women, watching childbirth or seeing photos of pregnant women. There were multiple psychosocial stressors, including her parents divorcing and seeing the birth of her sister. She initially underwent behavioral therapies, which provided partial relief.  She then began escitalopram and alprazolam, which together with therapy led to full remission of symptoms.

Discussion:  The literature on this topic is limited.  Psychotherapy and counseling are common treatments.  However, the only pharmacological treatment found was similar with an SSRI and benzodiazepine.  This case study demonstrates the assessment and treatment of a case of tocophobia.  Tocophobia is an under-diagnosed disorder with important implications and consequences.  Psychotherapy is helpful, though medications may be necessary for full remission.  Based on the patient’s preferences, there may be situations where medications can be started simultaneously with therapy. 


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