Quality of the development of self-report instruments assessing women’s antepartum expectations of motherhood: a systematic review

Abstract

ABSTRACT Background The selection of valid and reliable instruments for research and clinical purposes is needed to increase our understanding of the role that expectations of motherhood have in early identification and treatment of perinatal mental health difficulties. We aimed to identify and assess the psychometric properties of self-report measures of expectations of motherhood. Method A systematic review was conducted and articles describing the development or validation of quantitative self-report measures of expectations of motherhood were included. The developmental quality (risk of bias) and psychometric properties of each measure were assessed according to the 2018 COSMIN guidelines. Results Twenty-five articles describing 16 measures were identified and included. Eleven measures were designed to assess a broad range of expectations, while the remaining measures mainly assessed expectations of childbirth. The quality of measure development was mostly poor and rated as adequate or better for only three measures. The most suitable measures with the strongest evidence of good psychometric properties are the Slade-Pais Expectations About Childbirth Scale and the Rigidity of Maternal Beliefs Scale. Conclusions This systematic review of measures of expectations has identified relatively few measures with adequate psychometric properties. Further development of existing measures is needed for use in both research and clinical settings. KEY POINTS What is already known about this topic: Maternal mental health difficulties can have significant and long-term adverse consequences on mothers, their children, and families. Previous evidence suggests that holding unrealistic maternal expectations may contribute to postpartum mental health difficulties. Early identification of the potentially modifiable risk factor of maternal expectations may contribute to improving postpartum mental health outcomes. What this topic adds: This is the first systematic review to assess the developmental quality and psychometric properties of 16 measures of expectations of motherhood. The Slade-Pais Expectations About Childbirth Scale had the strongest evidence for good psychometric properties. For the majority of the measures, adequate methods for ensuring good content validity during measure development and validation were not used.