Concurrent analysis: validation of the domains within the Birth Satisfaction Scale

Abstract

Background and aim: Measuring women’s satisfaction with their birth experience has been problematic. Recently, an attempt has been made to capture birth satisfaction’s generalised meaning and incorporate it into an evidenced-based tool. Standard procedures for validation have limitations. Qualitative techniques such as domain analysis offer an alternative and assist in better understanding the importance of each item. This article examines the parsimony of the Birth Satisfaction Scale (BSS), which is a 30-item questionnaire designed to measure satisfaction with childbirth, with women’s actual experience of childbirth. Methods: Primary free text data collected from 207 women who originally tested the BSS was concurrently analysed with first-hand accounts of birth satisfaction collected from 19 qualitative papers. Results: The domain analysis confirmed three explanatory items within the BSS: ‘being in control’, ‘things going as planned’, and ‘being supported’. Conclusions: The BSS accounts for all the analysed data, suggesting it is a robust measure of satisfaction in childbirth. Strengths and limitations of the method are discussed, as are implications for practice. With further development, the instrument could be used to establish correlates with other psychometric measures, i.e. self-efficacy, anxiety, depression, locus of control and bonding; and evaluate models or care systems as a standalone instrument, or as a screening test prior to detailed qualitative work.