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Tokophobia among First Time Expectant Fathers | OMICS International
ISSN: 2167-1044
Journal of Depression and Anxiety
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Tokophobia among First Time Expectant Fathers

Thilagavathy Ganapathy*
The Oxford College of Nursing, Karnataka, India
Corresponding Author : Thilagavathy Ganapathy
Principal, HOD, Professor- OBG Nursing
The Oxford College Of Nursing
6/9, I Cross, Hongasandra, Begur
Bangalore-560068, Karnataka, India
Tel: 9900759255
Fax: 080-30219829
E-mail: [email protected]
Received September 28, 2015; Accepted October 02, 2015; Published October 05, 2015
Citation: Ganapathy T (2015) Tokophobia among First Time Expectant Fathers. J Depress Anxiety S3:002. doi:10.4172/2167-1044.S3-002
Copyright: © 2015 Ganapathy T. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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Abstract

Commentary
I learned that courage was not the absence of fear, but the triumph over it.
– Nelson Mandela.
Paternal fear of childbirth can impact fathers’ ability to be emotionally and physically supportive of their partner and affect their ability to assume a fatherhood role during a vulnerable time of transition. More than women, men are frightened about birth and what might possibly go wrong due to over medicalization of childbirth [1]. Fear is generally a normal physiological human reaction necessary for the protection and safety of the individual. With regard to childbirth, it is probably healthy to experience concern or anxiety to a certain degree, as it can help first time fathers to make ready for childbirth itself [1,2].
Fathers play a key role in supporting their partner in pregnancy, labor and childbirth and believe their supportive role is an important part of the process of becoming a father and their needs are equally important as the mothers’ needs [3] Whereas men are easily neglected, and if they don’t receive help the chances are that they won’t tell anyone about their fears. Apart from the personal effect this has, it is also possible that this affects their relationship with the mother and child. Expectant fathers genuinely struggle with the need to balance their own transition to fatherhood and that of their partner. Their status and feelings are sometimes overlooked and may cause conflict with their other roles [4]. To provide effective support fathers themselves need to be supported, involved and prepared [3]. Taking time to give relevant information and to engage with the father in all aspects of care can help to foster a greater satisfaction for both the father and his partner.
Paternal developmental processes occurring during pregnancy are as complex as maternal developmental processes. The father may experience mixed feelings, ranging from ambivalence and anxiety to excitement and anticipation [5-7]. Cultural pressure, intrapsychological processes and psycho-sociological adjustment to a new situation can give rise to post-traumatic stress in fathers5 and domestic violence [6]. First-time fathers are particularly vulnerable for negative experiences during childbirth which increases the risk for paternal postpartal depression which may negatively affect his relationship with the mother and child [6,7].
Fear of childbirth- tokophobia is an important men’s health issue. When a man becomes a father, a whole world of feelings is awakened in him through the process of pregnancy and birth. Taking time to give relevant information and to engage with the father in all aspects of care can help to foster a greater engagement with and satisfaction for both the father and his partner [6-8]. Fear of childbirth is a universal human phenomenon but in acute form it can aggravate the course of pregnancy and childbirth [3,9]. While couples share many of the concerns about having children, men have their own distinct worries. To date most studies have focused on maternal childbirth fears and the focus on paternal childbirth fears is relatively new. There is comparatively little research on men’s experience of tokophobia.
It is well known that pregnancy and childbirth may be a time of considerable anxiety with symptoms escalating in the third trimester and first time expectant fathers may express some concerns or fear about the forthcoming delivery of their partners [10]. Over the last decade much research has been focused on the pregnant woman’s fear of childbirth but even the expectant father is vulnerable in experiencing increase in stress and fear due to changing roles and social status. The involvement of prospective new fathers in a child’s life is extremely important for maximizing the life-long wellbeing and outcomes of the child. Pregnancy and birth are the first major opportunities to engage fathers in appropriate care and upbringing of children however there has been much less focus on addressing the roles, their fears and needs.
However, the focus on paternal childbirth related fears among first time expectant fathers is relatively new and most of the research related to childbirth fears has focused on mothers. Therefore it is possible to state that there has not been a particularly significant evolution in research on childbirth related fears (Tokophobia) among first time expectant fathers. Published evidence from India showed that larger proportion (78.4%) of first time expectant fathers suffered from Tokophobia primarily related to the health and life of their partner and child , labor & delivery process, professional competency, behavior, insufficient medical treatment, fear of not being treated with respect and dignity, fear of partners’ & own capabilities, fear of exclusion from decision making, financial matter and fear of responsibilities as fathers in varying intensity from low to severe level [11]. This highlights the fact that fear of childbirth is a universal human phenomenon but in acute form it can aggravate the course of depression or posttraumatic stress disorder (PTSD), either of which can affect both parent–child bonding and the father’s relationship with his partner [12].
Pregnancy and childbirth are unique live events which lead to a major life change and can be perceived as stressful. For the majority of new fathers to be childbirth is appraised as such a threatening or dangerous situation that they experience fear of childbirth (tokophobia). Expectant fathers need to be included in all aspects of maternity care. Positive involvement of fathers has the potential to decrease fear and anxiety and increase trust and respect. It will promote confidence in fathers as valued co-parents. Most expectant fathers now accompany their partners to antenatal consultations and ultrasound scans. All maternity health care providers will encounter opportunities to engage with and support prospective fathers in designing groups or individual psycho health education to strengthen men’s role in the period of transition to fatherhood.
In conclusion, it is time that health professionals recognize that men have tokophobia. The health care personnel should engage fathers in antenatal conversation about their birth expectations, feelings and fear. The treatment of tokophobia—childbirth related fear should aim at reducing anxiety during pregnancy, increasing the self-confidence and relaxation, supporting the transition to fatherhood, and preventing paternal post partal depression by providing sufficient information, psycho education and support. Best practice in preventive obstetrics should involve early identification of fear and feelings of first time expectant fathers to the current pregnancy, childbirth, and future fatherhood. It is essential for the obstetric health care personnel to protect and support every expectant father against these fears or to remove them altogether, to give every one of them the opportunity to deal with his own fears and to obtain the help he needs in his situation.
Healthcare professionals need to acknowledge that first time expectant fathers have needs of their own during pregnancy and childbirth. Fathers also worry and fear about the child and the woman, so they need explanations about normal changes as well as possible complications. Experiencing intense fear related to childbirth constitutes a significant burden for expectant fathers. This calls for preventive obstetric care strategies to identify, involve and support fearful expectant fathers in their own right, in all aspects of maternity care and be offered opportunities to discuss their feelings and any fears that they may have.
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