Abstract
BackgroundNegative experiences of first childbirth increase risks for maternal postpartum depression and may negatively affect mothers' attitudes toward future pregnancies and choice of delivery method. Postpartum questionnaires assessing mothers' childbirth experiences are needed to aid in identifying mothers in need of support and counselling and in isolating areas of labour and birth management and care potentially in need of improvement. The aim of this study was to develop and evaluate a questionnaire for assessing different aspects of first-time mothers' childbirth experiences.MethodsChildbirth domains were derived from literature searches, discussions with experienced midwives and interviews with first-time mothers. A draft version of the Childbirth Experience Questionnaire (CEQ) was pilot tested for face validity among 25 primiparous women. The revised questionnaire was mailed one month postpartum to 1177 primiparous women with a normal pregnancy and spontaneous onset of active labor and 920 returned evaluable questionnaires. Exploratory factor analysis using principal components analysis and promax rotation was performed to identify dimensions of the childbirth experience. Multitrait scaling analysis was performed to test scaling assumptions and reliability of scales. Discriminant validity was assessed by comparing scores from subgroups known to differ in childbirth experiences.ResultsFactor analysis of the 22 item questionnaire yielded four factors accounting for 54% of the variance. The dimensions were labelled Own capacity, Professional support, Perceived safety, and Participation. Multitrait scaling analysis confirmed the fit of the four-dimensional model and scaling success was achieved in all four sub-scales. The questionnaire showed good sensitivity with dimensions discriminating well between groups hypothesized to differ in experience of childbirth.ConclusionThe CEQ measures important dimensions of the first childbirth experience and may be used to measure different aspects of maternal satisfaction with labour and birth.
Highlights
Negative experiences of first childbirth increase risks for maternal postpartum depression and may negatively affect mothers’ attitudes toward future pregnancies and choice of delivery method
First-time mothers are vulnerable for negative experiences and in Sweden approximately 9% of all primiparous women are dissatisfied with the birth experience one year after the birth [13]
Twenty-six percent of the women had a labour lasting more than 12 hours and operative delivery accounted for 17% of the births (12% instrumental vaginal deliveries and 5% emergency caesareans)
Summary
Negative experiences of first childbirth increase risks for maternal postpartum depression and may negatively affect mothers’ attitudes toward future pregnancies and choice of delivery method. Postpartum questionnaires assessing mothers’ childbirth experiences are needed to aid in identifying mothers in need of support and counselling and in isolating areas of labour and birth management and care potentially in need of improvement. Negative experiences increase the risk for maternal postpartum depression and may negatively affect attitudes to future pregnancies and births and may prompt women to request caesarean delivery [14]. Knowledge of factors affecting maternal satisfaction is important in order to improve childbirth care. For this purpose, postpartum questionnaires covering multidimensional aspects are needed to comprehensively explore women’s experiences of childbirth
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