Explaining tokophobia, the phobia of pregnancy and childbirth

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anxiety, birth, childbirth, distress, fear, hyperarousal, labour, media, negative birth experience, panic, positive birth experience, post-birth PTSD, pregnancy, PTSD, social media, symptoms, tokophobia, trauma, treatment

Explaining tokophobia, the phobia of pregnancy and childbirth

For expectant mothers, it’s very normal to approach birth with a feeling of trepidation, particularly for the first baby. From the moment a pregnancy is announced, the average pregnant woman is inundated with horror stories of pain and long labours by supposed well-meaning friends, and it can be hard to focus on a positive birth experience when you don’t know what to expect.

But for some women, the fear of childbirth goes beyond trepidation into full-blown anxiety, panic and fear. Known as tokophobia, this phobia of childbirth affects somewhere between 3-8 per cent of pregnant women.

Symptoms include worries specifically about the pregnancy and birth, a fear of harm or death related to the birth, poor sleep, and a sense of hyper-arousal (rapid heartbeat and breathing, difficulty winding down). The fear of childbirth is a common non-medical reason for requesting a caesarean section, and women with this fear have a much higher rate of both caesarean delivery and use of epidural anaesthesia.

There is no clear path to developing fear of childbirth, but there are some risk factors that we know about. A history of anxiety or depression is one risk factor, as is a history of childhood abuse, be it sexual, physical or emotional abuse.

Some studies have also identified patterns with age, suggesting younger mums are more vulnerable, as are those with less education, and mums without a strong social network.

However, a recent study found that one of the biggest influences women reported on their fear of childbirth was the media. Hospital-based reality television programs and medical dramas often feature storylines with dramatic emergency situations during childbirth and this may be all women know of giving birth prior to the event.

We also know that around 95 per cent of pregnant European women report searching for pregnancy and birth information online, and social media and blogs hold the potential for the circulation of misinformation that may heighten fears rather than allay them.

There is another group of women who may find pregnancy and childbirth frightening due to related fears. One of the most common phobias in adults is blood/injury phobia, often including a fear of injections. Pregnancy and childbirth is hence very confronting for these women, who may faint or experience extreme distress at even routine blood tests throughout their pregnancy.

Researchers have found that for first time mothers, a positive birth experience can often relieve the fear of childbirth so that it is no longer an issue for future pregnancies. However, whether or not women start with a fear of childbirth, a negative birth experience can make them up to five times more likely to develop tokophobia for future pregnancies.

A negative experience of birth may be due to complications, feeling out of control, dissatisfaction with care providers, or just not having the birth that was expected. Between 2-6 per cent of women report post-traumatic stress syndrome (PTSD) following a difficult birth experience. PTSD is the disorder once known as ‘shell shock’ for its affliction of soldiers following war, and is characterised by nightmares and re-experiencing of the birth trauma, avoidance of all reminders of the birth, and hyper-arousal. Without treatment, PTSD can limit family size and cause problems in women’s relationships with their partner and their child.

While we may not hear much about tokophobia and post-birth PTSD, their prevalence suggests we do need to look out for women who may be suffering both before and after birth. In addition to the distress at the time, stress and anxiety during pregnancy are linked to a higher rate of preterm birth and later behavioural problems in children.

The good news is that like all anxiety disorders, the fear of childbirth and PTSD can be addressed and treatments are available. One of the most vital elements of treatment is education on birth, whether through the obstetric care provider, midwives, or antenatal classes. Knowing what to expect and having an agreed plan with your care provider can assist to overcome some of the irrational fears.

Linked to this, a supportive and trusting relationship with the care providers who will manage the birth is essential. This is not always possible as some obstetric settings do not allow for repeated contact with the same provider, but a relationship of trust will be more likely to create a positive birth experience.

When problems do occur in pregnancy and birth, a post-birth debriefing can be useful and may help prevent the development of PTSD symptoms. Understanding what went wrong and why things happened the way they did can help with processing the events and accompanying trauma.

As with other anxiety disorders, relaxation, light exercise and slow breathing can help to calm the body and relieve the hyper-arousal that comes with the fear of childbirth. A psychologist can assist with other anxiety management techniques that can help to minimise fears.

For those who find the idea of pregnancy and birth overwhelming, it is important to know that help is available and such symptoms can be successfully treated. The first step is confiding your fears so that those around you can start to support you through what could be a wonderful journey.

Poll: nearly 50% of year 10 students feel addicted to the internet

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addiction, devices, internet, pupils, social media, social networks, students, young people

Poll: nearly 50% of year 10 students feel addicted to the internet

Almost half of all 14- and 15-year-olds feel they are addicted to the internet, with more than three-quarters of similarly aged pupils taking a web-enabled laptop, phone or tablet to bed at night, according to a survey.

Of those who take a device to bed, the bulk are communicating with friends using social media or watching videos or films, the study of more than 2,200 students in nine schools across England and Scotland found. More than four out 10 girls felt they used the internet on a compulsive basis for socialising, the survey found.

The poll was carried out on behalf of Tablets for Schools, a charity led by technology industry groups such as Carphone Warehouse and Dixons that campaigns for the increased use of iPad-like devices in education. Despite its remit the group has now published an advice guide for pupils and schools about internet devices, advising they be switched off before bed and during study times, with set times allocated for online activity.

The study said fewer than a third of students who used web devices in bed said this was connected to homework, with those more likely to use a computer, phone or laptop in bed also more likely to report feeling addicted to the internet. There were some gender distinctions, with 46% of girls saying they sometimes felt addicted to the internet, as against 36% of boys, but significantly more boys saying they felt a compulsion towards computer games.

The peak age for feelings of addiction was year 10, where pupils are aged 14 or 15, with 49% of those pupils reporting this. The greatest use of devices in bed comes a year later, with 77% of year-11 pupils. Aside from email the most commonly used sites at home were social networks like Facebook, Twitter and Snapchat.

While most students told researchers they were positive about the internet, a number expressed alarm at their apparent inability to disengage. “It’s the first thing I look at in the morning and the last thing at night. It seems I’m constantly on it,” a year-10 boy said. Another boy, a year older, said: “When I’m on YouTube one video leads to another and I cannot stop myself from watching loads of videos and sometimes I’m up till about 2 o’clock in the morning just because I’ve been watching YouTube videos.”

The issue of internet addiction is much debated, with some researchers questioning whether it can be classified as a formal addiction. There is evidence that British children spend more time online than many of their European peers. A 2012 EU-wide study of children aged 11-16 by the London School of Economics found the UK was among the worst nations for indicators of apparently excessive internet use, with more than a quarter saying they spent less time with family, friends or on schoolwork because of being on the web.

 

Massive rise in disruptive behaviour, warn teachers

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aggression, behavioural problems, boundaries, Children, emotional problems, family breakdown, low self-esteem, mental health issues, physical abuse, school, social media, stress, teachers, young people

Massive rise in disruptive behaviour, warn teachers

Teachers have warned that disruptive behaviour in classrooms has escalated sharply in recent years, as funding cuts to local services have left schools struggling to cope.

A survey by the Association of Teachers and Lecturers (ATL) found that the vast majority of staff had recorded a rise in the number of childrenwith emotional, behavioural or mental health problems.

The union collated numerous examples of challenging behaviour, ranging from violent assault to defamatory campaigns on social media.

Suggested reasons for the deteriorating behaviour include a lack of boundaries at home, attention-seeking, an absence of positive role models at home, low self-esteem and family breakdown.

The ATL, which has 160,000 members across the UK, said aggressive cuts to the traditional safety net of local services have left schools dealing with complex behavioural and mental health problems on their own.

Earlier this month it emerged that two-thirds of local authorities have cut their budgets for children and young people’s mental health services since the coalition government came to power in 2010. A freedom of information request by the YoungMinds charity found that 34 out of 51 local authorities which responded said their budgets for children’s and young people’s mental health services had been cut, one by 76%.

Alison Ryan, the union’s educational policy adviser, said: “Services are struggling for survival or operating with a skeleton staff, so there’s now a huge pressure on schools to almost go it alone. Schools are absolutely on the front line of dealing with these children and young people and trying to provide a service that means they don’t fall through the cracks.”

Mary Bousted, general secretary of the ATL, said: “The huge funding cuts to local services mean schools often have to deal with children’s problems without any help.”

The survey of 844 staff found that 62% felt there were more children with emotional, behavioural and mental health problems than two years ago, with 56% saying there were more than five years ago. Nearly 90% of support staff, teachers, lecturers, school heads and college leaders revealed that they had dealt with a challenging or disruptive student during this school year. One primary school teacher in Cheshire said: “I have been kicked in the head, spat at, called disgusting names, told to eff off, had the classroom trashed regularly and items thrown. We accept children who are excluded from other schools so they come to us with extreme behaviour issues.”

A teacher in a West Midlands secondary school said: “One colleague had a Twitter account set up in front of him on a mobile called Paedo ****** [their name], which invited others to comment on him and his sexual orientation.”

Another teacher in a secondary school in Dudley added: “I’ve been sworn at, argued with, shouted at, had books thrown at me, threatened with physical abuse and had things stolen and broken.”

Bousted added: “Regrettably, teachers and support staff are suffering the backlash from deteriorating standards of behaviour. They are frequently on the receiving end of children’s frustration and unhappiness and have to deal with the fallout from parents failing to set boundaries and family breakdowns.”

On the positive side, most of the disruptive behaviour facing staff was categorised as fairly low level, with 79% of staff complaining that students talked in class, did not pay attention and messed around.

Some 68% added that students were disrespectful and ignored their instructions, 55% said they had dealt with verbally aggressive students, and a fifth with a physically aggressive student. Among secondary and sixth-form students, smoking was considered a significant problem.

On most occasions challenging behaviour was deemed an irritation which disrupted class work, according to 74% of staff, but 42% revealed that they suffered stress and almost a quarter said they had lost confidence at work. Forty of those questioned said they had been physically hurt by a student.

Children are ‘upset’ by online violence, study finds

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abuse, behaviour, Children, Cyberbullying, family, internet, sexting, social media, social networks, violence, young people

Children are ‘upset’ by online violence, study finds

Children are as upset by violent videos on YouTube that feature animal cruelty or beheadings and by insensitive Facebook messages from divorced parents as they are by online bullying and pornography, according to the biggest survey of young British people and their internet use.

The research will be unveiled by the UK Council for Child Internet Safety (UKCCIS) on Tuesday – the 10th annual Safer Internet Day – when a charter of rights and responsibilities for children online will also be launched. The findings suggest that government policy, spearheaded by David Cameron, to block sexual content and pornography through parental controls and filters via internet service providers only goes part of the way to securing the online safety of children.

The survey, conducted for the council by academics, asked 24,000 children 25 questions about internet use, including “have you ever seen anything online that has upset you?” Hundreds of schools around Britain were enlisted to help canvass the children, who were aged up to 16.

Andy Phippen, professor of social responsibility at Plymouth University, who helped to devise the report, said: “Upset is caused by a broad range of issues, very varied, and not all sexual content.” One memorable answer from a primary school child who was asked what most upset him was “when my Dad told me on Facebook he didn’t want to see me any more”.

The report, Have Your Say, is consistent with research Phippen was already carrying out. The examples he heard included: a video of a zebra being killed, “someone swearing at me”, “a picture of my baby brother, who I don’t live with any more”, and a picture of a cat that “looked like my pet that had to be put down”.

Phippen said: “There is no silver bullet to crack child safety online. Government’s obsession with filtering is OK, but too narrow.”

Sonia Livingstone, professor of social psychology at the London School of Economics, told the Oxford Media Convention last month that LSE research, which asked 8,000 children aged nine to 16 about the disturbing things they had seen on the internet, supported this picture. She added: “There is a lot of attention given to pornography and bullying on social media, but they also mentioned beheadings, flaying, cruelty to animals.”

Professor Phippen agreed: “Any channel used for communication is potentially a channel for upsetting content, but certainly YouTube is the most prevalent as far as video content is concerned.”

Livingstone said that the issue of online bullying was not covered by efforts to filter out inappropriate content. “Filtering is only about content on established websites”, while filtering and blocking controls could be very clunky to use and problematic.

However, Have Your Say also finds many positive aspects to the internet. The survey shows that what under-11s do most is play games on sites such as Moshi Monsters, followed by schoolwork and keeping in touch with friends. For older children, social networking takes over from playing games.

“I think, in this age group, violent images and upset from abusive nasty comments from their peers are the concerns. It is spoken about as so and so is so mean to me. Cyber bullying – they don’t use that term,” said Phippen. Evidence from the children of being groomed or facing predatory behaviour online is also scanty.

Accessing pornography online, the main concern of parents responding to a government consultation last autumn, did not feature highly in the teenagers’ responses. But there is a growing problem of “sexting” messages in school, when pupils share personal sexual content via smartphones and tablets. Phippen said one answer was better education. “You come back to media literacy. About understanding how to conduct yourself online and what the impact can be of behaviour, when you don’t see the impact of your behaviour, on the victim in front of you.”

Bringing up daughters: The new battlefield for parents

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advertising, alcohol, anorexia, anxiety, bulimia, daughters, Depression, Eating Disorders, family, media, mental health issues, parents, pressure, self-harm, social media, Teens

Bringing up daughters: The new battlefield for parents

It’s a freezing night in Bristol, and snow is forecast – but every seat at Colston Hall in the city centre was sold out weeks ago, and not only for Ronan Keating who’s playing in the main auditorium. Also packing them in is a 59-year-old, softly spoken Australian psychotherapist, who will take to the stage for 90 minutes with just a whiteboard and some ideas that will keep his audience on the edge of their seats.

The psychotherapist is Steve Biddulph, and most of the people queuing up to hear him are the mothers of teenage girls. A few years ago Biddulph toured Britain warning of a crisis facing boyhood: now he is back with a similar message about girlhood. And if the audience here is anything to go by, he’s definitely touched a nerve. “Parents of girls are seriously worried about their daughters,” says Saffia Farr, editor of Juno magazine and the organiser of the Bristol part of Biddulph’s country-wide tour. “They feel there’s this overwhelming tide of advertising that’s targeting their daughters, of inappropriate clothing being sold in the shops, of media messages that encourage their girls to grow up way, way before their time. And they want to know what they can do about it.”

Telling them what they can do about it is Biddulph’s mission. “A few years ago, boys were a disaster area – there was an epidemic of ADHD, they were underperforming in exams, they were drinking too much and getting involved in wild behaviour,” he says. “Back then, girls seemed to be doing just fine. But, about five years ago, that all changed – suddenly, girls’ mental health started to plummet. Everyone knew a girl, or had a girl themselves, who had an eating disorder or who was depressed or was self-harming. It was a huge change in a very short period; I started to investigate why this was happening.”

Biddulph lives and works in Australia, but the crisis he sees brewing for young girls seems to be echoed across the Western world – and, in Britain, the figures suggest it’s worse than in other countries. A few weeks ago, the charity Childline announced a 68 per cent increase in youngsters contacting them about self-harming, and said most of the increase was among girls. The problem also seemed to be affecting teenagers at a younger age, with 14-year-olds now likely to be among callers.

Anxiety and depression in teenage girls is also on the rise: research from the Nuffield Foundation last year found that the proportion of 15- and 16-year-olds reporting feeling frequently anxious or depressed has doubled in the last 30 years, and is more common in girls: it has jumped from one in 30 to two in 30 for boys, and from one in 10 to two in 10 for girls. Meanwhile, a report from the Department of Health found teenage girls in Britain are more likely to binge drink than teenage girls anywhere else in Europe; more than half of 15- and 16-year-olds admit they drink to excess at least once a month. A separate report in 2011 found that one in five girls in this age bracket who drink at least once a week have drunken sex and later regret it.

Anorexia and bulimia are also dramatically on the increase: official figures for hospital admissions released last October pinpointed a 16 per cent rise in hospital admissions for eating disorders, and showed that one in every 10 of these admissions was a 15-year-old girl.

“There’s plenty to be concerned about,” Biddulph says. “Everyone who has a teenage daughter right now sees this, in their child and among their child’s friends.” The people they blame, he says, are the advertising industry and the media. “They are driving girls’ sensibilities and making them miserable. The corporate world has identified them as a new market for products, and is preying on them.” During his talk, Biddulph describes teenage girls as being out in the wilderness, surrounded by hyenas: it’s starting to get dark, he tells his audience, but they are all alone out there.

His message, though, is one of empowerment: he encourages parents to get together, to challenge the advertising industry and to lobby the Government to impose more restrictions on advertisers.

“Take the drinks industry – about 30 per cent of the market is sales to underage drinkers,” he says. “Alcohol companies are extremely powerful – but parents are powerful, too, and they have to stand against this and stop the marketing of alcopops and push for a higher drinking age.”

But the battle needs to be fought on a domestic as well as a policy front. “What we need to do is re-evaluate how we think of teenage girls: the current philosophy is that they’re growing older, so they need us less. But I believe that teenage girls go through a kind of second babyhood, and they in fact need their parents more than ever. We have to spend time with our daughters at this age: talk to them, listen to them, keep in touch with them. Staying connected to their parents makes all the difference to how they cope with the pressures they’re up against.”

Case study

Lindsay Julian, 51, lives in Salisbury. She has three daughters: Emily is 24, Olivia is 14, and Amelia is 11. She also has a son, Alexander, 28

“Emily got into drinking when she was about 15, and she started taking drugs fairly soon after that. It was a real roller-coaster time for all of us: sometimes she’d drink a lot and run off, and we’d have no idea where she was. One time, she didn’t come back all night, and we ended up calling the police. They were difficult times.

“There are so many pressures on young girls today – you’re very aware of that as a mother of daughters. So when my younger girls got close to the age where things got difficult with Emily, I thought: we’re going to do things differently this time round. I sent them to a Steiner school, where I think the pressures are lessened: the philosophy is holistic, it’s not all about exam results, which I think can be very stressful for young girls.

“Some of my daughters’ friends spend a lot of time on social media, texting and on Facebook – but I’m careful to limit those things for my girls, and it does make a difference. They watch TV but I monitor it – in some homes, TV seems like a third parent, and I don’t want it to be like that in our house. A lot of teenage girls never switch off, they’re constantly connected, and that puts them under pressure from one another as well as from advertisers.

“We’ve got friends where you can see that their 14-year-olds are more like adults; the wanting to drink, to go to parties all the time.

“Emily is fine now: things turned around for her eventually, and she now works as a researcher and has written a book. She’s a rock for her younger sisters and I’m very proud of her. I know you could say that she was OK in the end, but I don’t think it’s an experience I’d want to go through with my younger daughters. I think their adolescence could be happier, and less fraught, than Emily’s was.”

The growing problem of cyber-bullying

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abuse, Children, Cyberbullying, parents, school, social media, suicide, Teens

The growing problem of cyber-bullying

Although it’s been around for as long as I can remember, I appreciate that for most adults cyber-bullying is quite a new phenomenon. And I don’t quite think they’ve yet grasped how to treat it. Unlike other forms of bullying, its effects often aren’t seen until it gets completely out of hand, and sometimes when it is too late.

According to the cyber bullying charity the Cybersmile Foundation, every 20 minutes a child between 10 to 19 years of age attempts to commit suicide in England and Wales. While one in three children in the UK suffers from cyber-bullying.

However, apart from the occasional scandalous news story such as the recent suicide of Canadian teenager Amanda Todd, most of it is never brought to light. So what’s really going on?

In my experience, most cases of cyber-bullying incidents aren’t, thankfully, as bad as Amanda Todd’s story. They usually comprise of arguments on Facebook that turn into popularity contests. Someone will spark off the conflict with a claim or rude post on the other person’s wall or photo and it will lead to a string of abusive and sarcastic messages. The rules of the battle are to remain nonchalant throughout and the winner is decided by whose comments received the most “likes”.

It then becomes almost a spectacle with everyone watching the fight unfold and messaging each other on who they think is faring the best. The bravest friends stick up for their comrade with their own comments and those less willing to get involved will simply join the mass of likes. This goes on until the receiver or the poster of the original message has enough sense to delete it and the fight continues in private.

Unfortunately, not all cases are so harmless and some can lead to serious emotional damage. A friend of a friend was a recent target when girls in her year created a Blackberry messenger group about her. It was comprised of over 20 people messaging each other about how they should kill the “slag”, supposedly because she was going out with an older boy. They then added her to the conversation and she wasn’t seen at school for two weeks. A close friend of mine was also a recent victim of abusive texts after false accusations arose around her having cheated with somebody’s boyfriend. “I felt so isolated and exposed,” she told me, “There was nowhere I could turn where they couldn’t get to me”.

There are also instances of malicious public statuses, embarrassing pictures being sent round and abusive questions on sites such as Formspring, a medium on which anonymous questions can be posted to specific people. Teens hiding behind their anonymous identity can post extremely hurtful things, which they would never say in real-life, but which they feel are acceptable in cyber space. Those who don’t answer are often accused of being cowardly and as a result receive even more “hate”.

Over 80 per cent of children fear that cyber-bullying is getting worse. Due to the growth of social media, every move you make on sites such as Facebook and Twitter is watched and regulated. Just a slight slip such as an “uncool status” or adding somebody as a friend, who you supposedly don’t know well enough, leaves the perfect opportunity for bullies to strike.

Victims of cyber bullying are always told they should seek help from school but they can often be just as confused as the perpetrators themselves. Although it is the wrong thing to do, many teenagers believe that their only chance of survival in the social media jungle of bullying is to fight back with equally as harsh and hurtful comments. This just leads to more tension and leaves schools and authorities with no easy way of putting an end to it without being accused of showing favouritism to a particular side.

I spoke to the founder of the Cybersmile Foundation, Scott Freeman on what he recommends when he receives distressed phone calls from victims and parents. Many parents are extremely worried about whether their child is being cyber-bullied and often are not sure how to protect their children if they don’t even know if it’s going on.

They are told to look out for certain signs such as their child acting paranoid and protective about other people looking at their computer and not wanting to go to school. A big reason why children may not want to alert their parents to the problem is the fear that their privileges, such as having a Facebook account and surfing the web may be taken away. Parents must show that they are on their child’s side and want to help them not punish them.

Children who call the helpline are suggested to talk to either to their parents or a member of staff at school about it straight away. If given permission to do so Cybersmile will contact their parents to run them through what can be done. If the child feels uncomfortable with that they should talk to a close friend, the most important thing is not to suffer alone. Cybersmile also offers counselling for anyone who is really having trouble. Most children live in fear of being cyber-bullied and this shouldn’t go on.

The charity also raises awareness of the problem, they fear is growing, by giving talks in schools and universities. They are designed to shock students into thinking about what they do online and who they may be affecting. Cyber-bullying workshops are also on offer for parents and children in order to bridge the gap between both generations and work on ways to combat the problem.

Cybersmile is working on changing the harassment law which they feel is outdated because it does not include online bullying. They believe that the internet should be viewed as a public space in which people who are acting abusive should be punished by law. A petition calling for government action has already received over 1,000 signatures, in the hopes of helping to erase cyber bullying. The foundation is producing anti-cyber-bullying wristbands which will be available from the 5th November. The money raised will be used towards supporting their 24 helpline which can be contacted on 0845 6887277.

For more information about the Cybersmile Foundation visit www.cybersmile.org