title: Childbirth experience questionnaire: validating its use in the United Kingdom.
abstract: BACKGROUND
  The Childbirth Experience Questionnaire (CEQ) was developed in Sweden in 2010 and validated in 920 primiparous women. It has not been validated in the United Kingdom (UK). Measuring the impact of an intervention on a woman's childbirth experience is arguably as important as measuring its impact on outcomes such as caesarean delivery and perinatal morbidity or mortality and yet surprisingly it is rarely done. The lack of a robust validated tool for evaluating labour experience in the UK is a topical issue in the UK at present. Indeed NICE say 'A standardised method to measure and quantify women's psychological and emotional wellbeing and their birth experiences is urgently required to support any study investigating the effectiveness of interventions, techniques or strategies during birth.'
  
  
  METHODS
  The Childbirth Experience Questionnaire and part of the Care Quality Commission Maternity Survey (2010) was sent to 350 women at one month postnatal. The CEQ was sent again two weeks later. The CEQ was tested for face validity among 25 postnatal mothers. Demographic data and delivery data was used to establish construct validity of the CEQ using the method of known-groups validation. The results of the scored CEQ sent out twice were used to measure test-retest reliability of the CEQ by calculating the quadratic weighted index of agreement between the two scores. Criterion validity was measured by calculating the Pearson correlation coefficient for the CEQ and Maternity Survey scores.
  
  
  RESULTS
  Face validity of the CEQ in a UK population was demonstrated with all respondents stating it was easy to understand and complete. A statistically significantly higher CEQ score for subgroups of women known to report a better birth outcome demonstrated construct validity of the CEQ. A weighted kappa of 0.68 demonstrated test-retest reliability of the CEQ. A Pearson correlation co-efficient of 0.73 demonstrated a strong correlation between the results of the CEQ and the results of the 'gold standard' assessment of childbirth experience in the UK: the Maternity Survey and hence criterion validity of the CEQ.
  
  
  CONCLUSIONS
  The Childbirth Experience Questionnaire is a valid and reliable measure of childbirth experience in the UK population.
authors.affiliation: Maternity Department, Nottingham City Hospital, Nottingham University Hospitals NHS Trust, Nottingham, NG5 1 PB, UK. katefwalker@doctors.org.uk.
authors.forename: Kate F
authors.initials: KF
authors.lastname: Walker
authors.affiliation: Maternity Department, Nottingham City Hospital, Nottingham University Hospitals NHS Trust, Nottingham, NG5 1 PB, UK. p.wilson11@nhs.net.
authors.forename: Philippa
authors.initials: P
authors.lastname: Wilson
authors.affiliation: Maternity Department, Queen's Medical Centre, Nottingham University Hospitals NHS Trust, Nottingham, NG7 2UH, UK. George.bugg@nuh.nhs.uk.
authors.forename: George J
authors.initials: GJ
authors.lastname: Bugg
authors.affiliation: Centre for Person-centred Care, Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. anna.dencker@gu.se.
authors.forename: Anna
authors.initials: A
authors.lastname: Dencker
authors.affiliation: Division of Obstetrics and Gynaecology, University of Nottingham, Maternity Department, Nottingham City Hospital, Nottingham, NG5 1 PB, UK. jim.thornton@nottingham.ac.uk.
authors.forename: Jim G
authors.initials: JG
authors.lastname: Thornton
mesh_terms: D000328:Adult; D036861:Delivery, Obstetric / Q000523:psychology*; D000066498:Emotional Adjustment; D005260:Female; D006801:Humans; D008016:Life Change Events; D009035:Mothers / Q000523:psychology*; D036801:Parturition / Q000523:psychology*; D017060:Patient Satisfaction; D049590:Postpartum Period / Q000523:psychology; D011247:Pregnancy; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires; D006113:United Kingdom