“The idea of having children terrifies me. Truly, on a deep level.”

A 31-year-old married woman has opened her heart in a letter to Mamamia. She says that deep down, she’s uncertain if she should be trying to get pregnant or not.

“So all my friends are having babies and my sister has two adorable little girls who I do truly love,” she explains in the letter.

“My friends keep on asking if hubby and I are ‘on the baby train’ and I say yes, because I’m not not on the baby train. We are ‘trying’, but maybe we shouldn’t be.”

The woman, who wants to remain anonymous, is aware that her fear of having children is at least partly due to her mother’s experience.

“I feel pretty responsible, along with my three siblings, for ruining my mum’s life. I mean, she stayed in a relationship with a man she hated for a long time for us, and still now has not left – because it’s ‘too late’, and she’s ‘old and unattractive’.”

Sydney psychotherapist Jodie Gale has worked with women who feel the way this reader feels.

“It’s about helping this woman realise she is not to blame for her mother’s choices,” Gale tells Mamamia. “She has internalised her mother.”

Gale says it’s common for women to feel fearful and uncertain about the idea of becoming mothers.

“You get some women who ‘just know’ they want to be a mother, but I would say the majority have at least some level of ambivalence, even once they’re pregnant.”

She says in therapy, she helps women tease out the underlying reasons for their ambivalence.

“I usually ask women to write two columns, reasons for and reasons not to. Don’t censor it. Then we tease out: Are they her own reasons or has she internalised them from someone else? Do the answers truly reflect the woman’s sense of self and her feelings and thoughts – that is, not her mum and dad’s, or society’s?”

Gale explains that reasons for not wanting to have children may include:

• Picking up your own mother’s ambivalence about being a mother
• Having a difficult relationship with your own mother
• Your own birth being part of a traumatic event (eg, being a “mistake”, your mother’s pregnancy being due to sexual assault, your mother being forced to stay in a relationship for financial reasons)
• Having gone through childhood trauma or neglect that takes away your trust in life, making you question why you would bring a child into the world
• Lacking self-worth and not trusting that you will be a good mother

Gale has seen plenty of women change their minds about motherhood after therapy.

“Once they have worked through their ambivalence, fears and thoughts like, ‘I won’t be a good enough mother’ and other mindsets – stories they have internalised from their history – many decide to have children.”

Meanwhile, Melbourne obstetrician Dr Philippa Costley says she sees many women who are terrified of having children. She says it’s important not to ignore any possible mental health issues.

“We often work with psychologists and psychiatrists to make sure that we figure out exactly what the concern is to give the woman the best care,” she tells Mamamia.

Listen: Should you get pregnant if you don’t like babies? Holly Wainwright and Andrew Daddo discuss on This Glorious Mess. (Post continues after audio.)

If the woman’s fear is purely about the process of childbirth, then Dr Costley can help.

“Our focus will be on trying to maintain some level of control and reduce anxiety, whether that be a controlled induction of labour and an epidural anaesthetic, so that the woman isn’t distressed by the delivery, or whether it be by an elective caesarean section.”

The fear of childbirth can be extreme. Sometimes, it’s women who’ve given birth and had a traumatic experience who fear it the most.

“I’ve seen women terminate pregnancies because of their fears, even though they think they want more children,” Dr Costley says. “If that’s happening, it really needs to be addressed.”

Sometimes, women develop a fear of childbirth from having seen someone else’s baby being born.

“Some have, as children, seen their mothers giving birth, and I’ve seen that be particularly traumatic for some women. To be honest, I try to encourage people to avoid that because I think it can cause more trauma than women sometimes realise.”

Other times, women become fearful purely from hearing other people’s experiences of childbirth.

“I think often women share traumatic birth stories ahead of positive birth stories. There’s a lot in the media and online about traumatic deliveries, and so people sometimes get a warped perception of what can be a more controlled or better experience.”

Dr Costley has seen the look of relief on women’s faces when she’s told them that it’s fine for them to have an elective caesarean.

“Often, then, the women decide against that,” she adds. “But knowing that that option is okay often alleviates anxiety.”

Listen to the latest episode of This Glorious Mess podcast.

Are you concerned about having children? Is there anything you’ve found has helped?