Former tokophobia sufferer turned method developer. Creator of Head Trash Clearance and the Perinatal Inner Readiness Profile. The person who named Reproductive Anxiety Disorder.
I want to raise something uncomfortable, and I want to be clear from the outset that it is a critique of a model, not of the many skilled, caring practitioners working within it. Conventional therapy for fear of childbirth often fails the women who need it most, and one of the biggest reasons is pace.
These women are on a clock
A woman with reproductive fear is rarely working to an open-ended timeline. She may only discover she is terrified the moment she sees two lines on a test, with a baby arriving in months. Or she is 38, or 40, deciding whether to try at all, with fertility and time pressing in. Her biology is already applying urgency, whether or not anyone in the therapy room acknowledges it.
Against that backdrop, the gentle, open-ended default of much therapeutic culture, “let it emerge in her own time, we mustn’t rush her”, can quietly let her down. Not because patience is wrong, but because a terrified woman left to set the pace will not set it. The fear is the very thing stopping her from moving forward. Hand her the wheel and she will circle the same junction for years, until time makes the decision for her, and she is left in regret.
Slow should not be the default
Here is the heart of it. If you asked anyone, “would you rather keep your anxiety for another three years, or be free of it in three months?”, almost no one chooses three years. They came to us precisely because they want to be rid of the fear. So why is slow so often the default setting?
I am not arguing against depth, or against the women who genuinely need a longer, gentler road. I am arguing that fast should be on the table, offered openly, and that the practitioner should be able to hold a frightened woman and carry her forward at the pace her life actually requires. If she wants to go slowly, she can choose that. But slow should be her choice, not our habit.
The uncomfortable bit about the model
There is a structural problem worth naming. A model built on clients returning week after week for years, sometimes circling the same issue without it shifting, is not obviously built around the client’s interest in being done. The maternity system has been criticised for not being truly woman-centred. It is worth asking the same hard question of the therapeutic model, not to shame anyone within it, but because the women we serve deserve methods that aim to finish the job.
This is part of why I built and teach the way I do: to get to the root quickly and move a woman toward readiness in the time she has. If that resonates, the free Introduction to Tokophobia webinar is a good starting point, and the Tokophobia and RAD Awareness Training goes further. It pairs closely with the argument that insight does not heal trauma.
Frequently asked questions
Why does conventional therapy struggle with fear of childbirth?
Often because of pace. Women with reproductive fear are frequently on a biological clock, yet much therapeutic culture defaults to slow, open-ended work. A terrified woman left to set the pace tends not to move forward, because the fear itself is what holds her back, so the timeline quietly works against her.
Is fast therapy safe for deep fear?
Moving at the pace a woman’s life requires is not the same as rushing or pressuring her. It means being able to hold her steady and carry her forward, and offering a faster route rather than defaulting to a slow one. Depth and speed are not opposites when you work at the right level.
Are you saying therapists are doing it wrong?
No. This is a critique of a model and a default culture, not of individual practitioners, who are skilled and caring. The point is that slow should be a client’s informed choice, not the automatic setting, especially for women whose biology is already imposing a deadline.
About the author: Alexia Leachman trains and equips perinatal professionals to recognise and support tokophobia and Reproductive Anxiety Disorder. A former sufferer turned method developer, she created the Perinatal Inner Readiness Profile and the RAD framework. More about Alexia →
This is professional education, not clinical supervision, and does not replace your own training or scope of practice.
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