Tokophobia and fear of birth: a workshop consensus statement on current issues and recommendations for future research Abstract Objective: The workshop aimed to discuss and develop a statement on the current state of the evidence and opinion in the field of Fear of Childbirth (FoC) and Tokophobia (Tocophobia), and to provide some recommendations for research. Background: A group of international researchers, clinicians and a service user met in 2019 to discuss the state of clinical and academic knowledge relating to FoC/Tokophobia. Five key areas were identified and agreed as the focus of discussion at the meeting. Methods: 12 clinicians and researchers, invited for their known expertise in this or a closely related area (e.g. PTSD) met in Hull, UK to discuss their understanding of the evidence for FoC/ Tokophobia and current practice. The meeting focused on identifying areas of uncertainty, key areas of knowledge, emerging research and possible future research within the field. The consensus described in this paper constitutes the expression of the general opinion of the participants and does not necessarily imply unanimity Keys points for discussion: Whilst there is a body of work in the field of FoC, work specifically focussed on tokophobia is more recent. It was agreed that there remains a wide range of issues, for which we need further evidence, which were addressed in the workshop including complexity in defining prevalence, a theoretical lack of understanding of tokophobia, which gives rise to challenges for robust assessment and the identification of risk factors. An improved understanding of the aetiological and developmental aspects of tokophobia is required to underpin appropriate, effective and evidencebased interventions. The development and evaluation of pathways of care and the interventions these might incorporate, should be a focus of future research to explore the potential for positive outcomes. Conclusion: Significant gaps remain within the FoC/tokophobia knowledge base. Further research continues to be needed across all areas identified.

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