The fear in the room
What every perinatal professional needs to know about reproductive anxiety.
If you work with women before, during or after pregnancy, you're probably already meeting reproductive fear. It might come up at a smear test, a fertility appointment, a booking visit, in a therapy session or in a conversation about whether to have children at all. Often it doesn't arrive with a name, and the woman carrying it may not know what it is either.
This short book is about recognising it, talking about it well and knowing where to send her, with voices from midwives, an obstetrician, researchers and the women themselves.
Eight short chapters · about 30 minutes' reading · free · plus both FFC white papers by email
Where should we send it?
The book arrives by email, and the two white papers follow in the next emails. You'll also get occasional updates for professionals from Fear Free Childbirth. You can leave whenever you like. Privacy
Why this is worth knowing
of pregnant women have severe fear of childbirth: around one in six.
of pregnant women experience tokophobia, the severe fear of pregnancy and birth.
Screening has been suggested so women can be referred for support, yet there's no standardised care pathway for tokophobia in pregnancy. Outside pregnancy, there's no diagnostic language for it at all.
Those figures only count women who are already pregnant. The fear can shape decisions long before that, and it often gets filed under something else: generalised anxiety, OCD, "not maternal", or a request for a caesarean.
On one side are women who often don't know what they're carrying. On the other are professionals who haven't always been taught what they're looking at. Everything on this page is about closing that gap.
What's inside
You're probably already seeing it
The women in front of you may be carrying a fear they're not telling you about, sometimes without knowing themselves.
The tip and the iceberg
What the numbers show, and why the name helps.
Where the fear comes from
Media, family stories, culture, and the part professionals play.
How it escalates
The six stages of the Fear Funnel, and why knowing the facts doesn't switch the fear off.
Where it hides
How it gets filed as anxiety, OCD or nerves, and what can sit behind a caesarean request.
What it costs
For women, for births, for families and for services.
The words we use
Language that frightens, and language that steadies.
Where to go from here
Notice, ask, name it, refer.
Plus both white papers
When you sign up for the book, the two Fear Free Childbirth white papers (second edition, 2026, with fully checked references) follow in the next emails:
- The Case for Reproductive Anxiety Disorder (RAD). Why tokophobia may be the visible tip of a wider pattern of reproductive fear, and a proposed framework for understanding it. RAD is a framework developed by Alexia Leachman, not a clinical diagnosis.
- Fear Sells, But It Doesn't Serve. How fear about pregnancy and birth is created and amplified, and what that means for anyone who talks to women about birth.
Training and tools
Each one stands on its own. Start with whatever fits your role: a GP may only need the first, and a therapist may want to go further.
Tokophobia Screening Training
Coming soonRecognise it. Ask about it. Screen safely. Know when to refer.
A short, practical training for professionals who see women before or during pregnancy and want the confidence to raise the subject, use a screening approach safely and know where to refer. It doesn't cover treatment.
Tokophobia & RAD Awareness Certification
£495 · self-paced · lifetime accessAn awareness-level professional certification covering tokophobia and reproductive anxiety: where the fear comes from, how it escalates, how it presents in practice and how it can be supported. For anyone supporting women through fertility, pregnancy, birth, the postnatal period, hormonal health or trauma.
RAD Responsible™ and the RAD Content Checker
Free pledge · 3 free checksHow pregnancy and birth are talked about shapes how frightened women feel. RAD Responsible is Fear Free Childbirth's standard for talking and writing about pregnancy, birth and reproductive trauma without adding to the fear.
Try the RAD Content Checker on something of your own, such as a leaflet, a handout or a post. Your first three checks are free.
Communication training
Coming soon · led by JJHow to talk and write about pregnancy and birth in a trauma-informed way, and hold space well, without increasing fear.
Fearless Birthing Practitioner Training
From our partner site, Fearless BirthingFor professionals who want to go further and learn to clear reproductive fear with their clients. This is training in the clearance method behind the stories in our white papers, run by our partner site Fearless Birthing, founded, like Fear Free Childbirth, by Alexia Leachman.
Tools to use with clients
Free Tokophobia Test
A short self-assessment women can take on their own. Useful for opening a conversation, and for helping her see that what she feels has a name.
Perinatal Inner Readiness Profile
A detailed assessment of psychological readiness for pregnancy and birth.
Keep reading
The research
The figures we use, where they come from, and what they do and don't show.
What is reproductive anxiety disorder (RAD)?
The framework, and why tokophobia may be the visible tip of something wider.
Tokophobia: the guide
What it is, how it shows up, and what helps.
The podcast
Midwives, obstetricians, researchers and women in their own words.
Free introduction webinar
An introduction to tokophobia and RAD for perinatal professionals.
The fear is often in the room before anyone names it
Eight short chapters on recognising it, asking about it and knowing where to send her, plus both white papers by email.
Where should we send it?
The book arrives by email. You can leave the list whenever you like.