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Understanding Tokophobia and Social Care Expectations among First-Time Mothers in a Tertiary Care Setting

Author(s) Ms. Dhanalakshmi Poongavanam, Dr. Sumathi Chandran, Dr. Shankar Shanmugam Rajendran, Dr. Vanitha Narayanasamy Naidu, Ms. Kavitha Manimohan, Ms. Latha Krishnan, Ms. Revathy Vinayagam
Country India
Abstract Background: Fear of childbirth, known as tokophobia, has emerged as a significant psychological issue among pregnant women, particularly those experiencing pregnancy for the first time. This fear can affect emotional stability, confidence, and readiness for labour. In addition to fear, expectations related to social care and support play an important role in shaping maternal experiences during pregnancy. Examining both aspects together provides a broader understanding of primigravida mothers’ needs within institutional maternity care.
Objectives: The study aimed to determine the level of tokophobia among primigravida mothers, explore their social care expectations, examine the association between fear of childbirth and selected demographic variables, and integrate quantitative and qualitative findings for a comprehensive interpretation.
Materials and Methods: An explanatory sequential mixed-methods design was employed. In the quantitative phase, 60 primigravida mothers were selected using non-probability convenience sampling. The qualitative phase included 6 participants chosen through purposive sampling. Data were collected using a socio-demographic proforma, the Fear of Childbirth Questionnaire, and a semi-structured interview guide. Quantitative data were analysed using descriptive and inferential statistics, while qualitative data were analysed through thematic analysis.
Results: Most participants were aged 26–30 years (53%), had graduate-level education (51.6%), and were homemakers (81.6%). Over half of the mothers resided in urban areas (55%), and the majority identified as Hindu (88%). Moderate tokophobia was observed in 68.33% of mothers, while 25% reported low fear and 6.67% reported high fear. Concerns about being left alone during labour without a chosen birth companion received the highest score (67.33%), whereas confidence in staff availability during labour scored the lowest (15.33%). Increased fear levels were noted among younger mothers, those with lower educational status, and those living in rural areas. Qualitative findings revealed three central themes: emotional vulnerability related to childbirth, expectations and experiences of social support, and sources of information with coping strategies.
Conclusion: Tokophobia is commonly experienced by primigravida mothers and is closely linked to emotional insecurity and perceived inadequacy of support. Enhancing supportive maternity care, strengthening childbirth education, and addressing social care expectations may reduce fear and improve childbirth preparedness.
Keywords Tokophobia, primigravida mothers, fear of childbirth, social care expectations, mixed-methods study, maternal support
Field Medical / Pharmacy
Published In Volume 17, Issue 2, April-June 2026
Published On 2026-05-21
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