Birth Satisfaction Scale-Revised Research Articles

Translation and validation of the Czech Partner version of the Birth Satisfaction Scale-Revised (BSS-R)

ABSTRACT Background The Birth Satisfaction Scale-Revised (BSS-R) is a widely used, psychometrically robust and brief self-report measure of birth experience from the mothers perspective. The current study sought to adapt and validate the BSS-R for partners, evaluating key psychometric properties, including the underlying tri-dimensional factor structure of stress experienced, personal attributes and quality of care. Aim To translate and validate a Czech speaking partner version of the Birth Satisfaction Scale-Revised (BSS-R) and examine key measurement characteristics and association with fundamental clinical outcome variables. Method Following translation of the UK partner BSS-R into Czech, the Czech Partner BSS-R (CZP-BSS-R) was administered to 225 partners of women who had given birth within the past 5-years. Key psychometric characteristics were examined, including factor structure, divergent and known-groups discriminant validity and internal reliability, Results Established measurement models of the BSS-R observed in mothers were found to offer an excellent fit to partner data. The CZP-BSS-R also demonstrated excellent validity and reliability characteristics. Conclusions The CZP-BSS-R was found to be valid and reliable, with results from Czech partners ‘mirroring’ factor structure and key validity characteristics previously established in Czech mothers. The BSS-R validated for completion by Czech speaking mothers now has a matched version available for use with Czech speaking partners.

Impact of respectful maternal care training of health care providers on satisfaction with birth experience in mothers undergoing normal vaginal birth: A prospective interventional study.

To study the impact of respectful maternity care (RMC) training of health care providers on RMC and birth satisfaction in mothers undergoing normal vaginal birth. A prospective interventional study was performed comparing RMC and birth satisfaction in women undergoing vaginal births before and after RMC training of health care providers from November 2021 to March 2023 in a tertiary care center in India. Person-centered maternity care (PCMC) and birth satisfaction scale-revised (BSSR) scales were used to study women's RMC and birth satisfaction, respectively. A total of 100 women undergoing normal vaginal birth were enrolled in pre- and post-intervention phases. The intervention was done through formal and onsite training of health care providers in RMC. The mean total PCMC scale score in the post-training group demonstrated a remarkable increase to 51.95 ± 6.50, significantly higher than the pre-training mean of 32.82 ± 8.47 (P < 0.0001). The mean ± SD of the BSSR scale total score in the post-training group increased significantly to 27.17 ± 3.67, surpassing the pre-training mean of 21.19 ± 5.48 (P < 0.0001). The study showed significant improvement in RMC and birth satisfaction score in the post-training group thereby emphasizing the importance of RMC training of health care providers in the facility.

The Birth Experience of Women in the Czech Prison System

BACKGROUND:Evidence regarding the incarceration of women generally indicates significant mental health challenges, particularly elevated depression and reduced self-esteem. However, in the Czech Republic, little research has been undertaken on the birth experiences of women in this population, and indeed, more generally, there is little research undertaken on this specific group of women.METHODS:A quantitative questionnaire-based cohort study was undertaken in a major women’s prison in the Czech Republic. The Birth Satisfaction Scale-Revised (BSS-R), the Edinburgh Postnatal Depression Scale (EPDS), and the Rosenberg Self-Esteem Scale (RSES) were administered to participants. Comparisons with normative data using the one-samplettest, comparisons between depression screen positive/negative groups using the independentttest, and correlational analysis were conducted. A measure of postpartum posttraumatic stress disorder (PP-PTSD) was also administered.RESULTS:BSS-R subscale scores were observed to be either similar or higher than the noncustodial population. High screen-positive rates of EPDS-assessed depression were observed, and the study cohort was characterized by low RSES-assessed self-esteem. PP-PTSD levels approximated the noncustodial population.CONCLUSIONS:Women in the Czech prison system report levels of birth satisfaction equal to or better than noncustodial women. However, the mental health of this group is comparatively impoverished, thus presenting a complex relationship between birth experience and mental health during the prison sentence. Limitations of the research are discussed, and the direction of future research is indicated.

Oxytocin vs oral misoprostol for PROM induction in nulliparas with unfavorable cervix: a randomized trial

BackgroundInduction of labor (IOL) is recommended following prelabor rupture of membranes (PROM). The optimal method for IOL and need for cervical ripening in those with PROM and an unfavorable cervical examination is unclear. ObjectiveTo determine if oxytocin or oral misoprostol results in a shorter time to delivery among nulliparous patients with an unfavorable cervical examination and PROM diagnosis and to evaluate patient satisfaction with both methods. Study DesignThis is a randomized clinical trial conducted at an urban tertiary care center from 2019 to 2023. Subjects were nulliparas ≥36 weeks with an unfavorable starting cervical exam (≤2 cm and Bishop <8). The primary outcome was time from IOL to delivery in hours compared between oxytocin vs oral misoprostol. Secondary outcomes included suspected intraamniotic infection, cesarean delivery, composite maternal and neonatal morbidity, and patient satisfaction (assessed by Birth Satisfaction Scale-Revised). Sub-group analyses for those with BMI ≥ 30 kg/m2 and cervical dilation ≥1 cm were performed. We required 148 subjects to have 80% power to detect a 2-hour difference in time to delivery. The study was stopped early by the data safety monitoring board due to feasibility concerns in recruiting desired sample size. ResultsA total of 108 subjects were randomized: 56 oxytocin; 52 oral miso. The median gestational age at induction was 39.5 weeks; the mean starting cervical dilation was 1.1 cm. There was no statistical difference in time to delivery between groups overall: 14.9 hours oxytocin vs 18.1 hours oral misoprostol (P=.06). In sub-group analyses, there was a 5 hours shorter time to delivery with oxytocin for those with a BMI ≥ 30 kg/m2 (16.6 hours oxytocin vs 21.8 hours oral misoprostol, P .04) and 4.5 hours shorter time to delivery with oxytocin for those with cervix ≥1 cm (12.9 hours oxytocin vs 17.3 hours oral misoprostol, P .04). There were no differences in intraamniotic infection, cesarean delivery, maternal or neonatal morbidity between the groups. Patient satisfaction was higher for those receiving oxytocin compared to misoprostol (29.0 vs 26.3, P=.03). ConclusionAmong nulliparas with PROM and an unfavorable cervix, there was no difference in overall time to delivery between oxytocin and oral misoprostol. This result should be interpreted with caution given early study discontinuation and inadequate power. However, a shorter time to delivery with oxytocin was noted in obese patients and those with cervical dilation of at least 1 cm. Furthermore, patient satisfaction was higher in the oxytocin group, and there was no increased risk of neonatal or maternal morbidity with oxytocin.

Translation and validation of the Polish-language version of the Birth Satisfaction Scale-Revised (BSS-R) and its relationship to the type of delivery and the baby’s Apgar score

BackgroundMaternal birth experience is being increasingly recognised as a key clinical outcome parameter. The Birth Satisfaction Scale-Revised (BSS-R) is a short self-report measure designed to assess birth experience. The current investigation sought to trans-late the BSS-R into Polish and validate this version of the BSS-R (PL-BSS-R).Participants and procedureThe BSS-R was translated into Polish by an expert panel using forward and backward translation. A complex within-subjects design with an embedded between-subjects component was used to determine the key psychometric characteristics of the PL-BSS-R. Two hundred ninety-four Polish-speaking women in Poland completed the follow-up component of the study where the PL-BSS-R was administered. The PL-BSS-R measurement properties were examined using confirmatory factor analysis, divergent, convergent validity analysis, internal consistency appraisal and investigation of known-groups discriminant characteristics.ResultsThe PL-BSS-R was found to have generally very good measurement properties and to be equivalent to the original English-language version across key validity indices. The PL-BBS-R was found to be significantly correlated with neonatal physical health immediately postpartum and differed across delivery modes.ConclusionsThe PL-BSS-R is a psychometrically robust measure of birth experience appropriate for clinical and research use within Po-land. Important associations were noted between subjective maternal birth experience and objective measures of neonatal physical health, indicating a critically important future research direction.

Postpartum acute stress disorder symptoms, social support, and quality of couple's relationship associations with childbirth PTSD.

We aimed to examine the hypothesized negative associations between childbirth post-traumatic stress disorder (PTSD) symptoms (using the two-factor model of birth-related and general symptoms), social support, and a couple's relationship quality at 8-12 weeks postpartum. This analysis considered the longitudinal positive shared variance with acute stress disorder (ASD) symptoms measured shortly after birth, while accounting for obstetric and demographic variables. Participants included 246 mothers who gave birth at the maternity ward of a tertiary healthcare center. Self-report questionnaires were used 1-4 days postpartum (T1): Demographic information, the Birth Satisfaction Scale-Revised (BSS-R), and the National Stressful Events Survey Acute Stress Disorder Short Scale (NSESSS). At T2 (8-12 weeks postpartum), the Multidimensional Scale of Perceived Social Support (MSPSS), the Dyadic Adjustment Scale (DAS-7), and the City Birth Trauma Scale (BiTS). In partial support of our hypotheses, three hierarchical regression analyses revealed a significant positive contribution of ASD symptoms to childbirth PTSD general symptoms (β = .33, p <.001) and the total score (β=.29, p <.001), but not to birth-related symptoms. Social support (β = -.21, p = .003) and the quality of the couple's relationship (β=-.20, p = .003) showed negative associations with the BiTS general symptoms. Our study enhances understanding of the shared variance between childbirth ASD and PTSD, supporting the factor structure of general and birth-related symptoms as different aspects of childbirth PTSD and highlighting the negative association of social support and the quality of a couple's relationship with PTSD general symptoms, suggesting potential avenues for targeted interventions.

Assessment of Postpartum Stress Using the Maternal Postpartum Stress Scale (MPSS) in Spanish Women.

Although scales that evaluate postpartum stress exist, they lack specificity in maternal postpartum stress. The MPSS was created because there was a need to assess maternal stress during the postpartum stage. The introduction of the MPSS has enriched the evaluation tools for postpartum stress and has helped understand maternal stress at various postpartum time points and identify women at high risk for postpartum stress during this period. The aim was to translate the MPSS into Spanish and study its psychometric properties. Postpartum women (N = 167) with a mean age of 34.26 (SD = 4.71) were involved in this study. In addition to the MPSS, a battery of instruments was administered: a demographic sheet, the Birth Satisfaction Scale-Revised (BSS-R) and the Edinburgh Postnatal Depression Scale (EPDS). The MPSS data were analyzed, checking item communality first. As a result, three items showed unsatisfactory communality values (h2 < 0.40). Confirmatory Factor Analysis was conducted, comparing factor models using the full pool of MPSS items or the version without items with unacceptable communality. As a result, the original three-factor structure was endorsed on the Spanish MPSS, with better fit indices when removing items with low communality (RMSEA = 0.067, CFI = 0.99, TLI = 0.99). The reliability of this version was satisfactory (ω = 0.93). Finally, group comparisons for some perinatal variables were performed, showing no significant differences between groups of interest (p = 0.05 and above). To conclude, the MPSS will contribute to the existing literature, having a wider capacity to assess perinatal mental health difficulties in Spanish-speaking populations.

Hospital Water Birth: Interim Results of a Pilot Randomized Control Trial [ID 2683557

INTRODUCTION: Water birth is a method of pain relief during labor associated with decreased pain and increased satisfaction. Randomized control trials (RCTs) about water birth and safety outcomes are needed. We conducted an RCT of hospital water birth versus land birth to compare maternal/neonatal outcomes, and differences in analgesia/anesthesia use. This is an updated interim analysis of our findings (Clinical trial: NCT05175599). METHODS: After IRB approval, low-risk pregnant adults were offered study participation between 25 and 34 weeks of gestation. Enrollment began January 2022 using a computer-generated 2:1 (water birth-to-land birth) allocation ratio. Participants in both arms were offered routine care and all available pain relief, with those in the water birth arm given the additional option of birth in the tub. Participants in both groups were excluded if they developed risk factors, including hypertension, preterm labor, or nonvertex presentation. Descriptive and inferential statistics were computed. RESULTS: Overall, n=182 have been enrolled and n=157 have given birth. Following exclusions, n=96 (n=67 water birth, n=29 land birth) remained eligible for the study. Significantly fewer participants had epidural or intravenous narcotic analgesia in the water birth group (37.3% versus 82.8% land birth; P&lt;.0001). Ultimately in the water birth group, n=35 (52.2%) gave birth in water. Using the Birth Satisfaction Scale-Revised Indicator scale, water birth patients expressed a significantly higher level of satisfaction (Mdn=33.0 versus 29.0 land birth; P=.009). To date, no adverse events occurred. CONCLUSION: These preliminary findings suggest that when offered to low-risk laboring people, hospital water birth reduces pain and increases satisfaction without leading to adverse events.

Translation and validation of Vietnamese version of the Birth Satisfaction Scale-Revised (BSS-R)

ABSTRACT Background The 10-item Birth Satisfaction Scale-Revised (BSS-R) is a quick and easy survey instrument recommended by the International Consortium for Health Outcome Measures as the tool of choice for measuring women’s birth satisfaction. Aim To translate and validate a Vietnamese-language version of the BSS-R. Method A quantitative cross-sectional method was used to gather data post translation and back-translation of a Vietnamese version of the BSS-R (VN-BSS-R). Data collected were psychometrically evaluated using key indices of validity and reliability. Participants Vietnamese women who were within one month postpartum of birth (N = 383) took part in the study. Results Findings illustrate that a two-factor model offered excellent psychometric properties. With the two-factor VN-BSS-R, five items loaded onto a subscale ‘Positive birth experiences’ and the other five onto a second subscale ‘Negative birth experiences’. This two-factor model offered a fit to data (root mean square error of approximation [RMSEA] = 0.07, 90% confidence interval [CI] [0.05, 0.09], root square mean residual [RMSE] = 0.04 and comparative fit index [CFI] = 0.97). Mean scores for the exploratory factor analysis [EFA]-derived ‘positive’ and ‘negative’ sub-scales were 17.12 (SD 2.34) and 8.40 (SD 4.18) respectively. Conclusion The translated and validated VN-BSS-R is a psychometrically robust tool for measuring birth satisfaction in Vietnamese postpartum women. The VN-BSS-R is available for use to measure experiences and perceptions of intrapartum care received by Vietnamese women.

Translation and validation of the Hungarian version of the Birth Satisfaction Scale-Revised (BSS-R)

BackgroundEvidence relating maternal birth experience to a range of maternal and neonatal outcomes is increasingly compelling. Consequently valid and reliable self-report of birth experience from the mothers perspective is critical. AimThe current study sought to translate and validate a Hungarian-language version of the Birth Satisfaction Scale-Revised (BSS-R). MethodFollowing forward and backwards translation into Hungarian, the Hungarian BSS-R (HU-BSS-R) was administered to women in a major Transylvanian hospital maternity unit within 72 h postpartum. Key psychometric characteristics were then examined in relation to factor structure, divergent and convergent validity, internal consistency, and known-groups discriminant validity. ResultsTwo-hundred and thirty-two women completed the HU-BSS-R. Confirmatory factor analysis revealed the HU-BSS-R to offer an excellent fit to data for the established tri-dimensional measurement model. The HU-BSS-R was also found to offer excellent convergent and divergent validity and known-groups discriminant validity. No significant differences were observed between internal consistency observations between the current study and the original UK validation study. ConclusionsThe HU-BSS-R is a valid and reliable translation of the original BSS-R, it has proved itself to have excellent psychometric properties and is suitable for use in the Hungarian maternity context.

Measuring Women's Satisfaction with Childbirth: A Literature Review of Measurement Properties.

Patient satisfaction is an important indicator of the quality of care provided. Evaluating women's satisfaction with childbirth is essential to improving obstetric care and ensuring a positive experience for mothers and newborns. The tools used to measure women's satisfaction with childbirth are very heterogeneous and multidimensional. Assessment tools used in practice should be tested and meet characteristics that are consistently validated.The aim is to identify currently available instruments measuring women's satisfaction with childbirth and to evaluate their structure, content and psychometric properties. A systematic search for sources was carried out according to the criteria set. For the included studies, psychometric properties were assessed in accordance with the principles of the guideline for completing systematic reviews of patient-reported outcome measures, COSMIN. The review included 31 studies that reported the psychometric properties of six measurement instruments (questionnaires, scales). Content validity, structural validity, internal consistency, reliability and cross-cultural validity were assessed for the included studies. The Childbirth Experience Questionnaire (CEQ/CEQ2) and Birth Satisfaction Scale - Revised (BSS-R) were the most commonly used questionnaires in the studies. Thorough testing of tools measuring women's satisfaction with childbirth, and adapting them to cultural and social contexts, is still essential. It is crucial that valid and reliable questionnaires are available for midwives in practice, for use in research, to inform clinical practice and for the results to help develop the services offered.

Psychometric properties of a Saudi Arabian version of the Birth Satisfaction Scale-Revised (BSS-R).

Maternal outcomes are closely associated with birth satisfaction, and the Birth Satisfaction Scale-Revised (BSS-R), a concise, multidimensional self-report measure, has undergone translation and validation internationally. However, research on birth satisfaction in Saudi Arabia is scarce. The absence of valid Arabic-language tools for the Saudi population may impede critical research on this topic, necessitating the translation and use of psychometrically sound instruments for measuring birth satisfaction in Saudi women. This study aimed to translate and evaluate the psychometric properties of the Saudi Arabian version of the BSS-R (SA-BSS-R). A total of 218 Saudi women participated in the study, and psychometric analysis of the translated SA-BSS-R involved confirmatory factor analysis, divergent validity analysis, and known-group discriminant validity assessment within a cross-sectional study design. The three-factor BSS-R measurement model displayed poor fit, and internal consistency fell below the threshold value. Additionally, it was observed that women undergoing an episiotomy had significantly lower overall SA-BSS-R scores. The SA-BSS-R manifested atypical measurement properties in this population. Despite insightful observations related to episiotomy, the identified measurement shortcomings highlight the need for a more robust and culturally sensitive translation to enhance measurement characteristics.

Risk factors associated with postpartum depression and PTSD after birth in a sample of Slovak women

BackgroundPregnancy, childbirth and the postpartum period represent a unique experience in a woman's life that significantly changes their life. MethodsThe aim of the study is to analyse risk factors of postpartum depression and posttraumatic stress disorder symptoms after birth in a sample of women in Slovakia. Data from the INTERSECT project were collected, including 437 postpartum women (mean age 30.5 ± 4.8). Posttraumatic stress disorder was (PTSD) measured through the City BiTS questionnaire, postpartum depression (PPD) symptoms were detected using the Edinburgh Postnatal Depression Scale (EPDS) and birth satisfaction was measured by the Birth Satisfaction Scale- Revised (BSS-R). ResultsAn increased risk for the development of PPD (the EPDS score >12.5) was found in 11.4 % of respondents, PTSD after birth was identified among 2.8 % of respondents. In the linear regression models, birth satisfaction (95%CI: 0,56; −0,19), subjective perception of birth (95%CI: 0,82; 1,63), previous trauma (95%CI: 0,27; 3,74), respect during birth (95%CI: 5,08; −0,45), and health complications of both mother (95%CI: 0,12; 2,81) and child (95%CI: 1,53; 1,84) were found significantly associated with the posttraumatic stress symptoms after birth (total explained variance 37 %). Subjective perception of birth as traumatic (95%CI: 0,82; 1,63), previous trauma in the anamnesis (95%CI: 0,27; 3,74) and respect during birth (95%CI: 5,08; −0,45) were significantly associated with the depression symptoms (total explained variance 15 %). ConclusionSubjective perception of birth, birth satisfaction, previous trauma in anamnesis as well as lack of respect during birth were found as crucial risk factors for both PPD and postpartum PTSD.

Comparison of maternal outcomes in caring by Doula, trained lay companion and routine midwifery care

IntroductionThe aim of this study was to compare maternal and neonatal outcomes in the care provided by Doula, trained lay companion, and routine midwifery care in the labor and obstetric units. In this study, only results related to maternal outcomes were presented.MethodThis is a quasi-experimental study, which was conducted on 150 women with low-risk pregnancies who had been selected for vaginal birth at private clinics and public hospitals of Arak, Iran. Participants were divided into three groups, two intervention groups, doula and trained lay companion, and one control group, midwife’s routine care. The intervention groups, in addition to receiving routine care from the labor and maternity units, also received support and training by doula or a trained lay companion, but 50 the control group received only routine midwifery care. In the control group and the trained companion, the samples were taken from 10 clinics of different parts of the city by random sampling method using the SIB center system. Then, among selected numbers, we randomly selected samples for each group. But in Doula group, because of limited number of samples, convenience sampling was used and all women enrolled in doula care were included in the study until the number reached 50. In each group, outcomes such as the duration of active phase and second stage of labor, as well as the severity of pain, anxiety and maternal satisfaction with birth were measured and compared with other groups. Data were collected by a researcher-made checklist, the Spielberger’s State-Trait Anxiety Inventory (STAI), the Pain Visual Assessment Scale (VAS), and the Hollins Martin’s Birth Satisfaction Scale-Revised (BSS-R). Data were analyzed by SPSS-22 statistical software using Kruskal Wallis, Chi-Square, ANOVA and Fisher’s exact tests.FindingsBased on the results, the mean duration of active phase between three groups was 234.68 ± 118.74, 256.66 ± 108.75 and 279 ± 94.37 min, respectively (p = 0.022). Also, the mean duration of second stage in three groups was 10 ± 5.61, 10.35 ± 5.1 and 22.30 ± 75.57 min, respectively (p < 0.001). The difference between mean pain scores in the first, second, third, fourth and fifth hours was not statistically significant. The average difference in anxiety score in the two stages of labor was higher in the lay companion group, and this difference was statistically significant (p < 0.001); however, the level of satisfaction in doula group was higher compared to the lay companion and control groups (p < 0.00 1).ConclusionAccording to present study, doula care has a greater effect on reducing the duration of labor than other care models. Based on the study, there was no statistically significant difference between the three groups in terms of variables such as the severity of labor pain. However, the level of anxiety of pregnant mothers in the group supported by lay companion was lower than the other two groups, which indicates the positive effect of mothers’ training on increasing maternal comfort and satisfaction. It is suggested that further research investigate the severity of labor pain in groups supported by different care models and also we recommend the use of lay companion’ support during childbearing of mothers who could not afford doula.Trail registrationThis article has been registered in Iran’s Clinical Trial Center with the code: IRCT20230620058548N1. 2023/08/29.

Translation and validation of the Japanese version of the Birth Satisfaction Scale-Revised.

This study aimed to develop a Japanese version of the Birth Satisfaction Scale-Revised and evaluate its reliability and validity. After translating the Birth Satisfaction Scale-Revised into Japanese, we conducted an Internet-based cross-sectional study with 445 Japanese-speaking women within 2 months of childbirth. Of these, 98 participated in the retest 1 month later. Data were analyzed using the COSMIN study design checklist for patient-reported outcome measurement instruments. Content validity was evaluated through cognitive debriefing during the translation process into Japanese. Confirmatory factor analysis was conducted to verify structural and cross-cultural validities. For hypothesis testing, we tested correlations with existing measures for convergent and divergent validities, and for known-group discriminant validity, we made comparisons between types of childbirth. Internal consistency was calculated using Cronbach's α, and test-retest reliability was evaluated using the intraclass correlation coefficient. For the Japanese-Birth Satisfaction Scale-Revised, the established three-factor model fit poorly, whereas the four-factor model fit better. Full metric invariance was observed in both the nulliparous and multiparous groups. Good convergent, divergent, and known-group discriminant validities and test-retest reliability were established. Internal consistency observations were suboptimal; however for vaginal childbirth, the Cronbach's α of the total score was .71. The Japanese-Birth Satisfaction Scale-Revised is a valid and reliable scale, with the exception of internal consistency that requires further investigation. If limited to vaginal childbirth, research, clinical applications, and international comparisons can be drawn.

The importance of communication and involvement in decision-making: A study in Ireland exploring birth satisfaction using the Birth Satisfaction Scale-Revised (BSS-R).

Evaluation in healthcare services has become a priority, globally1. The Government of Ireland has highlighted the importance of stakeholder engagement to identify the needs of women in the design and delivery of high-quality health services, driven by necessity rather than financial ability2. The Birth Satisfaction Scale-Revised (BSS-R), an internationally validated tool, and recommended for measuring childbirth satisfaction by the International Consortium for Health Outcomes Measurement (ICHOM)3; however, it has yet to be considered in the Irish context. The aim of the study was to explore birth satisfaction with a sample of new mothers in Ireland. A mixed-methods study was conducted including a survey that involved collection of data from the BSS-R 10-item questionnaire from 307 mothers over an 8-week period in 2019, in one urban maternity hospital in Ireland. Quantitative and qualitative data were collected. Qualitative data from the free-text comments of the survey questions were analyzed using content analysis. Overall, women reported positive relationships with their care providers and were satisfied with the communication and support they received, as well as high levels of control and choice. Postnatal care, however, was highlighted as being less satisfactory with staffing levels described as inadequate. Understanding women's birth experiences and what is important to them could facilitate midwives and other health professionals to improve the quality of their care and develop guidelines and policies that focus on women and their families' needs. The vast majority of women rated their birthing experience as extremely positive. The main elements of care that contributed to a positive birthing experience for women were quality relationships with clinicians, choice and control, and emotional safety.

Risk factors for a negative birth experience using the Birth Satisfaction Scale-Revised.

To evaluate the risk factors for a negative birth experience using the Birth Satisfaction Scale-Revised (BSS-R) questionnaire. A cross-sectional study including women who gave birth at a single tertiary hospital between February 2021 and January 1, 2022. Birth satisfaction was measured using the BSS-R questionnaire. Maternal, pregnancy, and delivery characteristics were collected. Negative birth experience was defined as a BSS-R score lower than the median. Multivariable regression analysis was used to examine the association between birth characteristics and negative birth experience. A total of 1495 women answered the questionnaire and were included in the analysis; 779 women comprised the positive birth experience group and 716 women comprised the negative birth experience group. Prior deliveries, prior abortions, and smoking (adjusted odds ratio [aOR], 0.52 [95% confidence interval (CI), 0.41-0.66]; aOR, 0.78 [95% CI, 0.62-0.99]; aOR, 0.52 [95% CI, 0.27-0.99], respectively) were independently associated with lower risk of negative birth experience. Immigration, answering the questionnaires in person, and cesarean delivery were independently associated with increased negative birth experience risk (aOR, 1.39 [95% CI, 1.01-1.86]; aOR 1.37 [95% CI, 1.04-1.79]; aOR, 1.92 [95% CI, 1.52-2.41], respectively). Parity, prior abortions, and smoking were associated with a lower risk of negative birth experience, while immigration, answering questionnaires in person, and cesarean delivery were associated with a higher risk of negative birth experience.

Translation and validation of the Swedish version of the Birth Satisfaction Scale-Revised (BSS-R)

BackgroundOptimizing women's childbirth experience is essential for development of quality mother infant relationships. The Birth Satisfaction Scale-Revised (BSS-R) can be used to measure birth satisfaction. AimThe current investigation sought to translate and validate a Swedish version of the BSS-R. MethodFollowing translation, a comprehensive psychometric validation of the Swedish-BSS-R (SW-BSS-R) was carried out using a multi-model, cross-sectional, between- and within-subjects design. ParticipantsA total of 619 Swedish-speaking women participated, from which 591 completed SW-BSS-R and were eligible for analysis. Data analysisDiscriminant, convergent, divergent and predictive validity, internal consistency, test-retest reliability, and factor structure were evaluated. ResultsThe SW-BSS-R was found to have excellent psychometric properties and hence is a valid translation of the original UK(English)-BSS-R. Important insights into relationships between mode of birth, post-traumatic stress disorder (PTSD), and postnatal depression (PND) were observed. Conclusions and implications for practiceThe SW-BSS-R is a psychometrically valid translation of the original BSS-R and is suitable for use in a Swedish-speaking population of women. The study has also highlighted important dynamics between birth satisfaction and areas of significant clinical concern (i.e., mode of birth, PTSD and PND) in Sweden.

Role of mode of induction and delivery and women’s satisfaction after induction of labour at term: An observational study

This cross-sectional study aimed at evaluating the impact of different modalities of induction of labour (IOL) and delivery on levels of woman’ satisfaction. All women aged 18 years or older, who underwent IOL for at-term pregnancy (≥41 weeks of gestation) in randomly selected days during the study period in 6 participating centres were eligible for the study. The questionnaire investigated women’s opinion regarding information about induction, pain control, length of induction, their experience about induction, labour and delivery and their attitude towards induction in a subsequent pregnancy. Women were also asked to fill in the Italian version of the Birth Satisfaction Scale-Revised (BSS-R).A total of 300 women entered the study. The answer to the question about a “positive attitude towards induction in a subsequent pregnancy was “absolutely yes” or “yes” respectively in the 77.8%, 52.8% and 48.6% of women who were induced with oral drugs, vaginal drugs and Cook balloon (heterogeneity chi-square p = 0.05). The corresponding values for women who delivered vaginally or by caesarean section (CS) were 63.3% and 36.4% (chi-square p = 0.0009). The mean BSS-R total score was higher among women who underwent IOL with oral drugs than with vaginal drugs (p < 0.0001) or Cook Balloon (p < 0.0001), and among women who delivered vaginally than in those who delivered by CS (p < 0.0001). Women were asked “What do you think is important for a method of induction?”: 47.3% (95% CI 41.7%-53.0%) of women answered that “should make the induction as painless as possible”, 47.0% (95% CI 41.4%-52.7%) “should induce labour quickly”, 44.3% (95% CI 38.8%-50.0%) “should be safe for baby”.This study showed that vaginal delivery was associated with a higher rate of satisfaction among induced women. Considering mode of induction, oral drugs were associated with a higher level of satisfaction. Control of pain and quick induction were the most appreciated characteristics.

Effectiveness of an Early Skin-to-Skin Contact Program for Pregnant Women with Cesarean Section: A Quasi-Experimental Trial.

This study aimed to clarify the effectiveness of early skin-to-skin contact (SSC) after a cesarean section (CS) program. An "early SSC after CS" program was implemented at a tertiary care hospital in Tanzania. A non-equivalent group design was used. A questionnaire was used to collect data on exclusive breastfeeding, breastfeeding intention, Birth Satisfaction Scale-Revised Indicator (BSS-RI) score, perioperative pain with a visual analogue scale, and infant hospitalization for infectious diseases and diarrhea at 2-3 days postpartum. Follow-up surveys were conducted until 4 months postpartum regarding exclusive breastfeeding, breastfeeding intention, and hospitalization of the infants. This study involved 172 parturient women who underwent CS, with 86 in the intervention group and 86 in the control group. The exclusive breastfeeding rates at 4 months postpartum were 57 (76.0%) in the intervention group and 58 (76.3%) in the control group, with no significant difference. The BSS-RI score was higher in the intervention group (7.91, range 4-12, SD 2.42) than in the control group (7.18, range 3-12, SD 2.02) (p = 0.007) for women who underwent emergency CS. The survival probability for infants hospitalized owing to infectious diseases, and diarrhea was significantly higher in the intervention group (98.5%) than in the control group (88.3%) (χ2 = 5.231, p = 0.022) for multiparas. The early SSC after CS program showed a positive effect on the birth satisfaction of women undergoing emergency CS. It also reduced the incidence of infants hospitalized owing to infectious diseases and diarrhea for multiparas.