Fear of childbirth, or fear of medicalisation?

22385000206_701b885dceA pregnant women just asked me a really good question, to which I didn’t know the answer. “What’s it called when you’re fearful of medicalisation?”

I paused for a moment. The first word that came to mind was iatrophobia, but it didn’t feel right in that context and ten seconds on a search engine confirmed that iatrophobia is a fear of doctors. Which is interesting in itself, because the word iatro-, which is Greek for healer, is also the root of the word iatrogenesis, which describes the unwanted effects of health care that can stem from medicalisation. The iatrogenic effects of health care, according to Ivan Illich, come in a variety of forms from clinical iatrogenesis, where medical intervention causes side effects which are worse than the original problem, to social and structural iatrogenesis, which describe states where people become docile and reliant on the medical profession and/or give up their autonomy, especially in relation to their capacity for self-care. None of which, by the way, are necessarily the fault of individual doctors or other healthcare providers; these are socio-cultural processes whose root systems are complex and deep.

We’re not talking about fear of doctors, though. The woman and I both agreed that it was entirely possible to like individual doctors very much while still being fearful of iatrogenesis and/or medicalisation on a wider scale, which would seem to suggest that they are different things, but this didn’t take us any closer to finding the answer. But it’s a great question, because I am seeing more research and articles being published which include the word tocophobia – or fear of childbirth – and yet in at least some of the women I meet who are said (generally by others rather than by themselves) to be experiencing tocophobia, the women’s fear is not really of childbirth itself but either partly or wholly of the possibility that they will end up subject to unwanted medical intervention or iatrogenic consequences as a result of engaging with the maternity services.

Does anyone else know what this is called, or do we need to come up with a name in order to get the issue on the table for discussion?

4 comments for “Fear of childbirth, or fear of medicalisation?

  1. Rebecca King
    January 14, 2016 at 1:12 pm

    Hi Sarah, This is a really interesting questioning, I work a lot with women who have a ‘fear of birth’ which may or may not stem from a previous experience. When we unpick what’s going on for her, it is often the fear of loss of control rather than the fear of the process.

  2. January 16, 2016 at 5:27 pm

    My take is that we need to look deeper. There is fear of childbirth, fear of doctors, fear of medicalisation…..and then there’s something else which I feel is really at the root: fear of having one’s rights taken away. I recently heard a story where a woman was told by a nurse: “interventions trump birth plans, every time.”

    We may not have control over the birthing process but when the right to make the decisions is taken away, the result is a violation of human rights.

    No new language needed, just an acknowledgment that these are issues of basic human rights.

    • Geographer Jo
      January 28, 2016 at 10:15 am

      What an interesting and thought-provoking thread. I also think it’s important to include as a third heading women’s fear of being treated again how they were treated in their previous childbirth experiences, which is sort of but not quite a fear of medicalization; in some cases, of course, increased medicalization is a strategy women might choose to use to protect themselves from this hazard in future births. re having one’s rights taken away more specifically, I would like to share an Ivan Illich inspired line of thought. I wonder whether what we are also observing on the part of birthing women is deep unease that as a society we have constructed – and continue to reproduce in everyday birth practice – a social practice of birth in which we have chosen to give up our power to external agents (including experts), in return for the benefit of also handing over responsibility for outcomes. This practice, whilst perhaps ‘efficient’, produces an everyday level of violation (to women, to babies, to the physiological process, as well as to wider families and staff) which is taken-for granted, accepted as the price we have to pay for this trade. Most women are able to move on from it quickly; it is a temporary assault that is just not politically important enough to address. But at the same time, these outcomes reveal that birth is just too embodied a process to outsource. Hope this makes a bit of sense …

  3. Heather McCosker-Howard
    January 16, 2016 at 7:30 pm

    Hi Sara
    Great question, and I agree in part with Rebecca. The fear often stems from the outcome associated with the medicalisation, but often there is a fear of birth and I am not sure we can sort them out without some qualitative research.

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