Improving trauma-informed support during pregnancy to women and birthing people from Black, Asian and other minority ethnic backgrounds with moderate to severe fear of birth (tokophobia)

By Dr Amanda Spong (Principle Clinical Psychologist), Zareen Kazim (Assistant Psychologist), and Linnea Miklaucich (Improvement Advisor)

Tokophobia represents a profound fear of childbirth. Women and birthing people who experience adverse events during childbirth have an increased risk of developing tokophobia in subsequent pregnancies. The risks of adverse events are higher for women and birthing people from Black, Asian, and Ethnic minority groups, thereby increasing their risk of developing tokophobia. 

The OCEAN service in Bedfordshire and Luton offers valuable support for tokophobia. However, we have identified an underrepresentation of individuals from Black, Asian, and Ethnic minority backgrounds in our referrals, which does not accurately mirror our local demographic. 

We have just started our Quality Improvement (QI) project aiming to close this equity gap. We have a project team in place, including a service user from the perinatal families together group, coach, sponsor, and an initial measurement plan (see Figure 1). The next step will be to start building our theory of change and create a driver diagram. We plan to share more about our QI project, and the importance of supporting women and birthing people with tokophobia, in a video sometime in the next couple of months. We are eager to get started and hope it will provide invaluable support to our local communities.  

Figure 1: Our initial measurement plan