© 2015 Elsevier Ltd. Tocophobia is a severe fear of pregnancy and childbirth. There is increasing evidence that tocophobia has serious adverse effects on both mother and baby, which can be long term. In this review, the concept of tocophobia is discussed in the context of current maternity practice. Maternity caregivers need to be aware of presentation, symptoms and predisposing characteristics of women with tocophobia so that plans can be put in place to help them. Management of tocophobia is individualized and depends on the cause. Early psychological support is vital. Women need to be involved in developing an appropriate birth plan. For some women, it may be necessary to carry out an elective Caesarean section. Other considerations may be required depending on the cause of the phobia. If tocophobia is not addressed, it may become worse in subsequent pregnancies or women may avoid further pregnancies. The overall aim is to ensure a safe birth outcome for mother and baby.