title: Cross-cultural development and psychometric evaluation of a measure to assess fear of childbirth prior to pregnancy.
abstract: BACKGROUND
  Assessment of childbirth fear, in advance of pregnancy, and early identification of modifiable factors contributing to fear can inform public health initiatives and/or school-based educational programming for the next generation of maternity care consumers. We developed and evaluated a short fear of birth scale that incorporates the most common dimensions of fear reported by men and women prior to pregnancy, fear of: labour pain, being out of control and unable to cope with labour and birth, complications, and irreversible physical damage.
  
  
  METHODS
  University students in six countries (Australia, Canada, England, Germany, Iceland, and the United States, n = 2240) participated in an online survey to assess their fears and attitudes about birth. We report internal consistency reliability, corrected-item-to-total correlations, factor loadings and convergent and discriminant validity of the new scale.
  
  
  RESULTS
  The Childbirth Fear - Prior to Pregnancy (CFPP) scale showed high internal consistency across samples (α > 0.86). All corrected-item-to total correlations exceeded 0.45, supporting the uni-dimensionality of the scale. Construct validity of the CFPP was supported by a high correlation between the new scale and a two-item visual analogue scale that measures fear of birth (r > 0.6 across samples). Weak correlations of the CFPP with scores on measures that assess related psychological states (anxiety, depression and stress) support the discriminant validity of the scale.
  
  
  CONCLUSIONS
  The CFPP is a short, reliable and valid measure of childbirth fear among young women and men in six countries who plan to have children.
authors.affiliation: School of Population & Public Health, University of British Columbia, 2206 East Mall, Vancouver, BC, Canada. Electronic address: kstoll@alumni.ubc.ca.
authors.forename: Kathrin
authors.initials: K
authors.lastname: Stoll
authors.affiliation: School of Nursing, Midwifery and Paramedicine, Curtin University, Perth, Australia; Department of Nursing and Midwifery Education and Research, King Edward Memorial Hospital, Perth, Australia.
authors.forename: Yvonne
authors.initials: Y
authors.lastname: Hauck
authors.affiliation: Research in Childbirth and Health (ReaCH) group, University of Central Lancashire, UK.
authors.forename: Soo
authors.initials: S
authors.lastname: Downe
authors.affiliation: School of Nursing, Boston College, MA, USA.
authors.forename: Joyce
authors.initials: J
authors.lastname: Edmonds
authors.affiliation: Midwifery Research and Education Unit, Department of Obstetrics, Gynaecology & Reproductive Medicine, Hannover Medical School, Hannover, Germany.
authors.forename: Mechthild M
authors.initials: MM
authors.lastname: Gross
authors.affiliation: Midwifery Education Program, Department of Family Medicine, McMaster University, Ontario, Canada.
authors.forename: Anne
authors.initials: A
authors.lastname: Malott
authors.affiliation: Midwifery Education Program, Department of Family Medicine, McMaster University, Ontario, Canada.
authors.forename: Patricia
authors.initials: P
authors.lastname: McNiven
authors.affiliation: Midwifery Research and Education Unit, Department of Obstetrics, Gynaecology & Reproductive Medicine, Hannover Medical School, Hannover, Germany.
authors.forename: Emma
authors.initials: E
authors.lastname: Swift
authors.affiliation: Maternal and Infant Nutrition & Nurture Unit, University of Central Lancashire, UK.
authors.forename: Gillian
authors.initials: G
authors.lastname: Thomson
authors.affiliation: School of Nursing, University of British Columbia, Vancouver, British Columbia, Canada.
authors.forename: Wendy A
authors.initials: WA
authors.lastname: Hall
mesh_terms: D000293:Adolescent; D000328:Adult; D001290:Attitude; D001315:Australia; D003431:Cross-Cultural Comparison; D005060:Europe; D005239:Fear; D005260:Female; D006801:Humans; D008297:Male; D009656:North America; D036801:Parturition / Q000523:psychology*; D011594:Psychometrics / Q000592:standards*; D015203:Reproducibility of Results; D013334:Students; D011795:Surveys and Questionnaires / Q000592:standards*; D014495:Universities; D055815:Young Adult
keywords: Childbirth fear; Cross-cultural; Psychometrics; Scale; Survey; Young adult