At least one woman in six is so terrified of giving birth that she induces a miscarriage or avoids becoming pregnant altogether, even though she desperately wants children.

The first survey into tokophobia - a profound dread and avoidance of childbirth, rather than simply a rational decision not to have children - has found that the condition is much more widespread than previously suspected.

Dr Kristina Hofberg, Britain's leading expert on the syndrome, found that sufferers were to be found across all age, race and cultural boundaries. 'It was a surprise to find how high the rate of suffering was: I had no idea it would be this common,' she said. 'This issue is largely overlooked by experts, yet we have to question what is going on because it is clearly so incredibly important to so many women.'

The study, to be published next year in the Royal College of Obstetricians' and Gynaecologists' year book, found that one in five women, when pregnant for the first time, reported extreme fear about childbirth, while 6 per cent described a fear that was 'disabling'. Almost one in seven of the 370 childless, non-pregnant women interviewed by Hofberg reported a morbid dread of childbirth sufficient to postpone or avoid pregnancy altogether.

'This is much more than just a fear of being pregnant,' said Hofberg, who is carrying out a further study in Warwickshire on 1,200 women. 'It's a pathological terror that, in its most extreme form, can result in women taking steps to abort by behaving recklessly, abusing alcohol or drugs, or even punching their own abdomens. Even after successfully giving birth, tokophobic women can be haunted by the memory for years to come and be deeply traumatised by those images.

'Some women get themselves sterilised to ensure it's a problem they'll never have to face, while others avoid pregnancy altogether. This is particularly sad in the cases of women who badly want babies but just cannot face the realities pregnancy will involve: these women reach menopause knowing they have lost the opportunity to give birth for ever.'

Jane Livne, a former art teacher, experienced such terror while pregnant with her daughter, Kinneret, that she believes that without the support of her husband she would have committed suicide. 'I was convinced that I wouldn't survive the birth mentally, that I'd go mad with the pain,' she said. 'Counselling hadn't worked, so I just gritted my teeth and stopped using contraception.'

Livne became pregnant almost immediately. 'It was a time-bomb ticking away inside of me: I was completely panic-stricken,' she said.

To her amazement, when she finally went into labour Livne realised she could cope. 'Without all the help I received, however, I don't think I'd have survived. I honestly think I could have deteriorated to the point of being suicidal,' she said.

The fear of pain, death and mental instability was reported by many of the women as the reason for being frightened of delivery, alongside a lack of trust in the obstetric team. Those who suffered sex abuse as children appear to be particularly susceptible to the disorder.

Women suffering tokophobia who become pregnant may demand Caesarean sections, although no statistics have been collated and tokophobic women who ask for a surgical delivery can be refused. 'In the absence of an empathic professional ear or relevant medical literature, the only choice of these women may be to terminate the pregnancy and live with the psychological impact,' said Hofberg. 'It is in exactly this way that a vicious cycle is created that can be passed down the generations.'

Paula, a 32-year-old professional, is too ashamed of her phobia to reveal it to anyone except her husband of seven years. 'I feel like a failure and am desperately ashamed. Women who ask for Caesareans are lambasted by society and dismissed by doctors as selfish, but unless I can find a doctor to give me one, I might go through life unable to become pregnant, something I would always regret.'

Laura, a 30-year-old accountant, begged her doctor to give her a Caesarean when she became accidentally pregnant last year. 'I truly believed that I would die or go mad if I ever gave birth,' she said. 'I was in a loving marriage and desperately wanted a family, but I asked for an abortion, prayed I would miscarry and exercised energetically and drank excessively in the hope of inducing one.

'I had terrifying fantasies and images of childbirth, and when I was rushed to hospital with a suspected ectopic pregnancy I was delighted.'

Laura eventually delivered a healthy baby naturally at full term. 'I suffered post-natal depression and had real trouble bonding with my daughter,' she said. 'The whole experience was the most traumatic of my life.'