Birth experience assessment tools covering key dimensions of women´s and their partners´ experience of childbirth

Abstract

Background: Childbirth experiences range from empowering to deeply traumatic and may have lasting implications for parental health, family relationships and reproductive decisions. Recent qualitative syntheses propose a multidimensional framework of childbirth experience, yet it is unclear to what extent existing quantitative instruments measuring childbirth experience reflect these dimensions. Objective: To systematically identify validated instruments and examine how comprehensively they cover evidence-based dimensions and subthemes of women’s and their partners’ childbirth experience. Methods: A systematic literature search was conducted for studies reporting development, validation, translation or use of multi-item quantitative tools. Seventy-five applicable instruments were identified. Item wordings were coded against the four dimensions and ten subthemes of childbirth experience, and a coverage score (0-10) was calculated per instrument. For the five tools with the highest scores, psychometric properties were summarised. Findings: Content coverage was heterogeneous and often unbalanced. No instrument fully encompassed all dimensions and subthemes. Only one instrument reached a coverage score of 8.5/10, one scored 8/10 and three scored 7/10. Many questionnaires focused narrowly on domains such as control or staff interaction, while aspects such as preparation, understanding and varied emotional responses to labour and birth were often neglected. Among the top-scoring tools, the original 30-item Birth Satisfaction Scale provided the broadest coverage, whereas the Questionnaire for Assessing the Childbirth Experience showed the strongest psychometric support. Conclusion: Existing instruments capture the complexity of childbirth experience only partially. On the basis of superior content coverage, the original Birth Satisfaction Scale currently appears to be the most suitable available instrument for assessing childbirth experience, although further psychometric refinement would be beneficial. Refining it into a brief, inclusive and robust tool could facilitate routine screening and support more trauma-sensitive maternity care.