The aims were to document conscious reasons for anxiety about childbirth. Pregnant women (n = 100), consecutively referred from antenatal centers to a psychosomatic outpatient clinic because of extreme fear of childbirth, were interviewed. Three subgroups are described: primiparae (n = 36), women with a normal previous delivery (n = 18) and women with a previous complicated delivery (n = 46). Anxiety over the deliver was related to lack of trust in the obstetrical staff (73%), fear of own incompetence (65%), fear of death of mother, infant or both (55%), intolerable pain (44%) or loss of control (43%). In the description of the anxiety, more than one focus could be described. A previous complicated delivery predisposed for fear of death (p < 0.001). In other aspects, the subgroups were similar. Fear of death in a previous labor was associated with this fear regarding the impending delivery (100%, 21%, p < 0.001) and with fear of loss of control (61%, 18% p < 0.01). Many women (37%) had partners who admitted anxiety over the delivery. Anxiety over childbirth is related to fundamental human feelings: lack of trust, fear of female incompetence and fear of death. Fear of pain is important but not predominant. The results are discussed with regard to stress, theoretical and psychodynamic points of view.