For many people who live with a fear of pregnancy and childbirth, anxiety, or depression, the experience may feel like an emotional led one however it is also a deeply physiological one.
There can exist a very real tension between what is desired and what is experienced, for example, you might want to feel calm, collected, or reassured, yet your body reacts as if danger is imminent which can make you feel frustrated and out of control. A pregnancy announcement sends your heart racing. A medical drama on television makes your stomach drop. A routine appointment feels impossible to book. Or, in the opposite direction, you feel flat, disconnected, heavy, unable to care — even though nothing obvious is “wrong.” and societal pressures tell you that this is the happiest and most exciting period in your life.
These experiences make much more sense when we place it in the context of our nervous system and we understand what the Reticular Activating System (RAS) is doing beneath the surface so we can begin to influence how our attention is directed and what patterns our brain becomes more likely to notice over time which can positively impact our own happiness.
A Brief Overview of Your Nervous System
At its simplest, the nervous system has one primary job: to keep you alive.
The body.s automatic, non-conscious response system is the autonomic nervous system. This system continually monitors for safety or danger, adjusting the body’s state accordinly. It is made up of:
- The Sympathetic Nervous System: Responsible for the fight-or-flight response.
- The Parasympathetic Nervous System: Consists of two states:
- The ventral vagal state (safety).
- The dorsal vagal state (freeze).
When safety is perceived, the body moves into a state of connection, curiosity, and relative ease. You may experience emotions of peace, happiness, joy or calm. Sensations that can be experienced are lightness, a fuller breath, a feeling of being relaxed. In contrast when something feels threatening, the system mobilises and a fight or flight mode is activated resulting in emotional states of anxiety, stress, worry, fear, physical sensations including heart rate increases, thoughts race, and anxiety or panic may arise. If the state persists and the threat feels overwhelming or impossible to escape, the nervous system takes action to keep you safe by conserving energy and shutting down, leading to numbness, exhaustion, low mood, or withdrawal, a behaviour often experienced during depression. This is known as your dorsal vagal or freeze state.
These states are not choices or personality traits nor do they need to be permanent. They are biological responses shaped by your own unique experiences within your life, including trauma (which is not about an event but how we experienced it which will be unique to each individual, stress, loss, and medical events)
The brain moves between these states moment by moment based on what it perceives. One of the key systems guiding what the brain notices and prioritises during these shifts is the Reticular Activating System (RAS)
About the Reticular Activating System (RAS)
The RAS is situated in the brainstem and has a number of important functions however this article focuses the critical roles of, helping prioritise which information reaches conscious awareness (in coordination with other brain systems), because understanding this helps us to increase our own awareness of ourselves, our mind our body and provides us the opportunity to actively shape our future experiences and therefore ourselves.
The reticular activating system (RAS) can be thought about in terms of a doorman for your awareness. It highlights what information should be brought to your conscious awareness and what should not. How your RAS behaves and what is prioritised and brought into your conscious awareness is determined by a number of things including your past experiences, your nervous system state and to some extent your intention.
Have you ever gone through the process of choosing a car to buy? You may look up pictures or information about it, go and view it or look at what is available on line, go for a test drive, talk to friends or family about your choice of car etc. Then all of a sudden as if by magic you start seeing that same model of car on the road with much greater frequency. It is not that they were not there before, simply that because you have been intentional with your focus and ind doing so you have sent out a very clear message to your RAS that that car is something that is important so it acts accordingly and starts filtering sightings of them into your conscious awareness. The same can be said for thinking about conceiving or finding out you are pregnant all of a sudden you see pregnant people everywhere!
The RAS in a Ventral Vagal State
In a ventral vagal state, the body perceives safety. The RAS widens its filter, allowing for generous input - we start to notice the things in life that bring us a sense of calm, or joy, or connection. The ques of safety are highlighted and prioritised and you experience life through a very different lens than when dysregulated. You may feel that your breath is fuller, muscles are more relaxed, and social engagement is available. In this state, the RAS functions as a flexible and discerning filter.
It allows neutral sensations to remain neutral. Sounds stay as sounds rather than threats. Facial expressions are read accurately rather than defensively. Attention can move fluidly between the internal and external world.
This is the state in which learning happens. Memory integrates. Reflection becomes possible. The RAS is not scanning for danger; it is supporting connection, curiosity, and meaning-making.
Tokophobia and the RAS: When Pregnancy Feels Like a Threat
For someone with tokophobia, pregnancy and birth are not neutral concepts. They are filtered by the RAS as potential threats to survival.
This can show up in very ordinary, relatable ways. You might find yourself compulsively researching birth stories, yet feeling more panicked the more you read. You might avoid friends who are pregnant, not because you don’t care, but because your nervous system floods with fear when the topic arises. You may feel an intense need to control contraception, timings, birth or medical decisions, alongside a deep sense of dread about losing control which the process of birth can often represent.
In these moments, the nervous system is often in a sympathetic state (fight or flight). The RAS is constantly scanning for danger — graphic images, worst-case scenarios, bodily sensations — and amplifying them. A mild cramp becomes a warning signal. A news headline becomes evidence. A single story becomes proof.
Logic struggles to reach you here, because the RAS is not filtering for reassurance. It is filtering for threats and what comes into your awareness supports your state of fear.
Anxiety and the Sympathetic RAS Loop
In anxiety, the RAS becomes chronically tuned toward alertness.
You may notice that your mind jumps automatically to “what if.” You replay conversations with healthcare providers. You anticipate future appointments with dread. Your sleep is light, easily disturbed. Your body feels wired, tense, or restless.
The RAS, in a sympathetic state, narrows attention toward anything that could confirm danger. Reassuring information is filtered out; alarming details are pulled forward.
This is why anxiety feels exhausting. The brain is working overtime, not because it’s faulty, but because it believes vigilance is necessary to keep you safe.
Depression, Dorsal Vagal States, and the Quiet RAS
For others — and sometimes for the same person at different times — the nervous system shifts into a dorsal vagal state.
This state can resemble aspects of depression, particularly the low energy, withdrawal, and feeling of disconnection many people experience.
Here, the RAS turns the volume down. Motivation fades. The world feels distant. Decisions feel heavy or pointless. You may cancel appointments, struggle to respond to messages, or feel numb toward things you once cared about.
In the context of pregnancy fear or birth-related distress, this can look like emotional withdrawal, avoidance of planning, or a sense of resignation — “I just can’t think about this.”
This is not a lack of desire or strength. It is the nervous system conserving energy when a threat feels overwhelming or inescapable.
Why These States Can Cycle
Many people move between anxiety and shutdown, agitation and numbness.
This cycling happens when the RAS cannot find a stable sense of safety. Sympathetic activation becomes unsustainable, and the system drops into the dorsal vagal as a means of protection. When dorsal state lift, the RAS often returns straight back to scanning.
Without understanding this pattern, people often blame themselves — for being “too anxious,” “too avoidant,” or “not coping.”
In reality, the nervous system is doing its best with the information it has.
Re-educating the RAS Through Regulation
The RAS does not respond to being argued with. It responds to experience.
For tokophobia, anxiety, and depression, regulation means gently showing the RAS that the present moment is not the past, offering moments of safety and intentionally shifting our focus little by little.
This might look like learning to notice when your body becomes activated while reading or thinking about pregnancy, and with that awareness making an active choice to engage in some nervous system regulation techniques (a techniques booklet is linked below) rather than forcing yourself to continue. It might mean introducing warmth, rhythm, or safe connection when numbness sets in, instead of pushing for motivation.
Over time, repeated experiences of tolerable safety — not overwhelm, not avoidance — begin to shift the RAS filter. Pregnancy becomes a topic rather than a threat. Appointments become uncomfortable rather than unbearable.
We can take a more proactive role by gently training our attention to notice moments of ease, safety, or happiness throughout the day. This might be something simple—feeling the warmth of the sun on your face, sharing a moment of laughter, or stroking your pet—whatever feels meaningful to you.
These small positive moments are often referred to as “glimmers", a term used to describe cues of safety and connection. They can be thought of as the gentle counterparts to triggers, supporting the nervous system in orienting toward safety rather than threat.
Beyond simply noticing, it helps to pause and stay with the experience for a few moments. Allow yourself to fully take it in, and become curious about how it feels in your body—perhaps a sense of warmth, lightness, or softening. Documenting what it was and how it made you feel in a glimmer tracker or journal to remind yourself what you can do to refocus yourself in moments of dysregulation.
Over time, this practice helps to build a richer internal “portfolio” of experiences linked to safety, connection, and wellbeing. This can gradually influence how your attention is directed, making it more likely that these kinds of moments are recognised and registered.
