Abstract
Background
Fear of childbirth causes significant distress and impact on women’s wellbeing. It also contributes to the rising trend of non-medically indicated Caesarean sections worldwide. The Wijma Delivery Expectancy/Experience Questionnaire (Version A) (W-DEQ-A) is a comprehensive instrument for the assessment of fear of childbirth among antenatal women.
Methods
Hong Kong Chinese women at the antenatal booking clinic completed the translated questionnaire, Edinburgh Postpartum Depression Scale, State-trait Anxiety Inventory and indicated their preferred mode of delivery. The validity and reliability of the translated questionnaire were analysed using Cronbach’s alpha coefficient and intraclass correlation coefficient respectively. The subscales of the questionnaire were determined using exploratory factor analysis. The relationship between demographic data, preferred mode of delivery and the W-DEQ-A score were analysed using student’s t test, Mann-Whitney test or Pearson’s correlation.
Results
One hundred and fifty women completed the study. The Cronbach’s alpha coefficient and test-retest reliability of the Chinese version were 0.907 and 0.867 respectively. Convergent validity was demonstrated with other psychological measures at expected levels. The mean W-DEQ-A score among the Hong Kong Chinese population is 65 out of 165, which is negatively correlated with gravidity, parity and partner support. Using a standard cut-off of 85, 11.3% women were found to suffer from fear of childbirth and it is associated with a history of psychiatric history. 72% and 22.7% women preferred vaginal delivery and Caesarean section respectively. Nulliparous women who preferred a vaginal delivery have a significantly lower score than those who preferred a Caesarean section, with mean (SD) W-DEQ-A scores of 67.1 (14.8) compared to 75.9 (15.9) (p = 0.036).
Conclusion
The Chinese version of Wijma Delivery Expectancy/Experience Questionnaire (Version A) is a reliable and valid instrument to measure antenatal fear of childbirth among Chinese women. Clinicians can use this measure to assess the severity of women’s fear over the course of their pregnancy, and to monitor the success of any medical or psychological interventions for women with fear of childbirth in the future.
Fear of Childbirth in Chinese Pregnant Women and Their Preferred Mode of Delivery: Validation Study of the Chinese Version of Wijma Delivery Expectancy/experience Questionnaire Version A
