- Jemma Smith suffered anxiety attacks throughout her pregnancy, obsessing about the risks of labor.
- Her fear of death became so intense she wrote goodbye letters to her partner and unborn child.
- Mental health experts stepped in after her diagnosis of tokophobia — a pathological fear of birth.
This as-told-to essay is based on a conversation with Jemma Smith. It has been edited for length and clarity.
In January, when I was around four months pregnant with my first child, I tearfully wrote two letters — one to my partner and the other to our unborn baby.
My letter to his father said, "By the time you read this, I won't be here anymore." I put the envelopes inside some newborn clothes we'd already bought for our son.
I imagined my partner opening the letter on the day that I died during childbirth. At the time, I was 100% convinced that something would go wrong and, though the baby would survive, I'd lose my life.
We decided to start a family shortly before I turned 32. I run a tuition franchise for children and loved the idea of finally having my own kids.
Luckily, I got pregnant within a matter of months. We were delighted, but almost as soon as I found out, I started worrying about the physical process of giving birth.
At first, I thought it was natural and everyone has the same fear. But it went far beyond that for me.
I'd wake up at 3 a.m., crying. My breathing would get faster. I'd feel it in my chest. It was the same type of feeling you get from extreme stage fright.
Then, unable to get back to sleep, I'd open my laptop and Google the likelihood of dying during childbirth. The statistics were relatively low in my native UK, but, in my mind, at least, the worst would happen to me.
I confided in a friend who suggested professional help
It never got to the point that I considered a termination. I wanted to have a baby so much. But the dread was affecting my mental health and the pregnancy as a whole.
I confided in a friend who was trained in cognitive behavioral therapy. They suggested that I needed professional help because I kept playing out nightmare scenarios like massive hemorrhaging.
So, at around five months pregnant, I was assessed by a perinatal mental health team from the National Health Service (NHS.) They diagnosed me with tokophobia — a pathological fear of giving birth.
I'd never heard of it before, but knowing it was a recognized condition was a relief. Recent research has shown it can affect as many as 14 % of women, so I wasn't alone.
Fortunately, it can be treated with therapy. I began a six-week course of one-hour sessions before my due date at the end of April.
I told the mental health counselor that I saw childbirth as a giant mountain. It was such a big obstacle I couldn't see past it. I couldn't imagine coming out the other side with a newborn.
We discussed how my mom had experienced a traumatic labor with me. The details had stuck with me since I was a little girl. She'd needed an emergency C-section and blood transfusions.
However, the biggest part was the lack of control. I was terrified of not being in charge of events. I was fixated by the thought that I'd need a C-section, like Mom.
I verbalized my concerns and tried meditation, relaxation and visualization techniques. The counselor encouraged me not to fall into the habit of black-and-white, catastrophic thinking.
Next, they helped me set small, achievable goals. We made a flow chart listing the possible sequence of events and how best I wanted to deal with them.
I cried when I finally held my healthy son in my arms
In the end, I decided to have an elective C-section. I researched the risks. There's a definite split between emergency C-sections and those that are planned. It made me feel a lot more confident as I talked through the decision with my consultant.
A few days before the planned delivery in late April, I had a pre-op appointment, during which I met every member of the medical team. They explained the procedure, and they were an incredibly supportive group of professionals.
Still, I was incredibly nervous when I lay on the operating table. But I had a spinal block and used the relaxation techniques I'd been practicing. My partner was there to support me.
I felt no pain, just a bit of pressure. My son was born safe and sound. He weighed a healthy eight pounds and seven ounces. I cried with joy and relief when I held him for the first time.
That said, I won't be going through the process again. Raising our boy as an only child is fine by us.
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