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The Best Available Tools to Measure Women’s Childbirth Experiences

By: Sarah Hodin, Project Coordinator II, Women and Health Initiative, Harvard T.H. Chan School of Public Health

Understanding women’s experiences during childbirth is an important component of addressing issues related to the quality of maternal health care. However, measuring the quality of maternal health care, and specifically women’s experiences, is notoriously difficult. Researchers, clinicians and patients disagree about what factors are important to capture, and those factors are often context-specific. Numerous tools have been developed in different parts of the world to measure various aspects of women’s experiences with maternal health care. Some have been tested more extensively than others, and many are designed with a specific sub-population in mind.

A paper that was recently published in BMC Pregnancy and Childbirth reviewed existing measurement tools that aim to capture women’s childbirth experiences. The authors assessed 36 diverse instruments and scored each one based on a set of properties focused on validity and reliability. Overall quality scores were calculated based on accuracy, usefulness and relevance.

Based on their analysis, the authors recommended 7 tools with the highest overall quality scores:

Tool Country Items Notes
Patient Perception Score United Kingdom 3 Measures patients’ perceptions following operative delivery
Pregnancy and Maternity Care Patients Experiences Questionnaire Norway 145 Meant for use in health systems that are similar to Norway’s
The Childbirth Experience Questionnaire Sweden 22 For first-time mothers
The Childbirth Perception Scale The Netherlands 12 Includes postpartum assessment
The Maternal Satisfaction Scale for Caesarean Section Canada 22 Measures patients’ perceptions following cesarean section
The Responsiveness in Perinatal and Obstetric Health Care Questionnaire The Netherlands 40 Based on the World Health Organization’s Responsiveness Model
Wijma Delivery Expectancy/Experience Questionnaire Sweden 29 Measures fear of childbirth

While there are several tools available for measuring women’s childbirth experiences, the majority of them require further investigation. It is also important to note that almost all of the tools included in this review were designed and tested in high-income countries. Additional work is needed to adapt these tools for use in diverse settings across the globe to ensure that the constructs being measured are locally relevant. Having accurate, useful tools to measure women’s childbirth experiences is essential for efforts to improve the provision of respectful, high quality maternal health care for every woman.

Read the full open access paper, “Measuring women’s childbirth experiences: A systematic review for identification and analysis of validated instruments.”

Learn about recently developed tools designed to measure the quality of women’s interactions with maternity care providers and their role in decision-making during childbirth.

Are you a researcher who is using or designing an instrument to measure women’s experiences with maternal health care? Tell us about your work!

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