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Introduction Sociodemographic and obstetric factors have been shown to impact childbirth experience, but results regarding the effect of certain factors have been heterogeneous. It is important to understand how individual risk factors affect childbirth experience to be able to identify women at risk for negative childbirth experience. The aim of this study was to determine individual associations between sociodemographic and obstetric factors and childbirth experience. Material and Methods The Labor Progression Study (LaPS‐NCT02221427) was a multicenter randomized trial examining clinical consequences of using Zhang's guideline vs the WHO partograph on intrapartum cesarean section rate. Four weeks after delivery, 5810 women received the Childbirth Experience Questionnaire (CEQ) online. The CEQ consists of 19 questions on four subscales (own capacity, professional support, perceived safety, and participation). The total CEQ score is the mean score of each of the subscale scores, ranging from 1 to 4, a higher score indicating a better childbirth experience. Sociodemographic (age, body mass index, education, civil status, and smoking) and obstetric (gestational age, prolonged labor, mode of delivery, and obstetric complications) characteristics of the women were recorded, and associations to total and subscale CEQ scores were examined with log‐linear regression. Results In all, 3604 women answered the questionnaire, a 62.9% response rate. The mean (SD) total CEQ score was of 3.24 (0.43). The subscale score was highest for professional support, mean 3.68 (0.49), and lowest for own capacity, mean 2.61 (0.54). The total CEQ score was not associated with any of the sociodemographic characteristics examined. Smoking in the first trimester was associated with lower scores on the professional support subscale 3.61 (3.55, 3.67) than nonsmokers, 3.69 (3.68, 3.71); p = 0.001. Of obstetric factors, only delivering in week 37 was significantly associated with a higher total CEQ score, 3.34 (3.28, 3.40), vs. 3.24 (3.22, 3.26) at 40 weeks, p = 0.002. Findings remained significant in adjusted analysis. Conclusions In our study, individual sociodemographic factors did not impact overall the childbirth experience. Smoking was associated with a lower score on the professional support subscale. Delivery in week 37 was associated with a better overall childbirth experience. No other obstetric factor influenced the childbirth experience. Individual sociodemographic and obstetric factors have little influence on childbirth experience in first‐time mothers when intrapartum and postpartum care is of a good standard.

Introduction Women with polycystic ovary syndrome (PCOS) have more pregnancy complications like gestational diabetes, hypertension, and preterm labor than other women. Metformin has been used in an attempt to improve pregnancy outcomes. Our study aims to explore childbirth experiences in women with PCOS compared with a reference population. It also explores the potential influence of metformin, obesity, pregnancy complications, and the duration and mode of birth on childbirth experiences. Material and methods This study is a cohort study combining data from two randomized trials conducted in Norway, Sweden and Iceland. The PregMet2 study (ClinicalTrials.gov, NCT01587378) investigated the use of metformin vs. placebo in pregnant women with PCOS. The Labour Progression Study (ClinicalTrials.gov, NCT02221427) compared the WHO partograph to Zhang's guidelines for progression of labor and were used as the reference population. A total of 365 women with PCOS and 3604 reference women were included. Both studies used the Childbirth Experience Questionnaire (CEQ). Main outcome measures were total CEQ score and four domain scores. The CEQ scores were compared using Mann–Whitney U test for women in Robson group 1 with PCOS (n = 131) and reference women (n = 3604). CEQ scores were also compared between metformin‐treated (n = 180) and placebo‐treated (n = 185) women with PCOS, and for different subgroups of women with PCOS. Results There was no difference in total CEQ score between women with PCOS and reference women—Wilcoxon–Mann–Whitney (WMW)‐odds 0.96 (95% confidence interval [CI] 0.78–1.17). We detected no difference in CEQ scores between the metformin‐ and placebo‐treated women with PCOS (WMW‐odds 1.13, 95% CI 0.89–1.43). Complications in pregnancy did not affect CEQ (WMW‐odds 1, 95% CI 0.76–1.31). Higher body mass index (WMW‐odds 0.75, 95% CI 0.58–0.96), longer duration of labor (WMW‐odds 0.69, 95% CI 0.49–0.96), and cesarean section (WMW‐odds 0.29, 95% CI 0.2–0.42) were associated with lower CEQ scores in women with PCOS. Conclusions Women with PCOS experience childbirth similarly to the reference women. Metformin did not influence childbirth experience in women with PCOS, neither did pregnancy complications. Obesity, long duration of labor or cesarean section had a negative impact on childbirth experience. Women with polycystic ovary syndrome have similar childbirth experiences to other women, despite their increased risk of complications. Their childbirth experiences are negatively influenced by high BMI, long duration of labor, and operative delivery.

Background Women’s experiences of labour and birth can have both short- and long-term effects on their physical and psychological health. The original Swedish version of the Childbirth Experience Questionnaire (CEQ) has shown to have good psychometric quality and ability to differentiate between groups known to differ in childbirth experience . Two subscales were revised in order to include new items with more relevant content about decision-making and aspects of midwifery support. The aim of the study was to develop new items in two subscales and to test construct validity and reliability of the revised version of CEQ, called CEQ2. Method A total of 11 new items ( Professional Support and Participation ) and 14 original items from the first CEQ ( Own capacity and Perceived safety ), were answered by 682 women with spontaneous onset of labour. Confirmatory factor analysis was used to analyse model fit. Results The hypothesised four-factor model showed good fit (CMIN = 2.79; RMR = 0.33; GFI = 0.94; CFI = 0.94; TLI = 0.93; RMSEA = 0.054 and PCLOSE = 0.12) Cronbach’s alpha was good for all subscales (0.82, 0.83, 0.76 and 0.73) and for the total scale (0.91). Conclusions CEQ2, like the first CEQ, yields four important aspects of experience during labour and birth showing good psychometric performance, including decision-making and aspects of midwifery support, in both primiparous and multiparous women.

Background Assessing women’s childbirth experiences is a crucial indicator in maternity services because negative childbirth experiences are associated with maternal mortalities and morbidities. Due to the high caesarean birth rate in Iran, measuring childbirth experience is a top priority, however, there is no standard tool to measure this key indicator in Iran. The aim of present study is to adapt the “Childbirth Experience Questionnaire 2.0” to the Iranian context and determine its psychometric characteristics. Methods Childbirth Experience Questionnaire 2.0 was translated into Farsi. A total of 500 primiparous women, at 4 to 16 weeks postpartum, were randomly selected from 54 healthcare centres in Tabriz. Internal consistency and reliability was calculated using the Cronbach’s Coefficient alpha and Intraclass Correlation Coefficient, respectively. Construct validity was assessed using exploratory and confirmatory factor analysis and discriminant validity using the known-group method and the Mann-Whitney U-test. Results The internal consistency and reliability for the total tool were high (Cronbach’s alpha = 0.93; Intraclass Correlation Coefficient = 0.97). Explanatory factor analysis demonstrated the adequacy of the sampling (Kaiser-Meyer-Olkin = 0.923) and significant factorable sphericity ( p  < 0.001). Confirmation factor analysis demonstrated acceptable values of fitness (RMSEA = 0.07, SRMSEA = 0.06, TLI = 0.97, CFI > 0.91, x 2 / df = 4.23). Discriminatory validity of the tool was confirmed where the CEQ score and its subdomains were significantly higher in women who reported having control over their childbirth than women who did not. Conclusion The Farsi version of the Childbirth Experience Questionnaire 2.0 tool is a valid and reliable tool and can be used to measure the childbirth experience in Iranian women.

Negative childbirth experience may cause adverse psychological effects in postpartum mothers. The Childbirth Experience Questionnaire (CEQ) is a multidimensional tool designed to assess women’s perceptions of labour and birth. We aim to validate the Malay version of the CEQ (CEQ-My) and evaluate its psychometric properties. The previously published Malay-translated CEQ was reviewed by a panel of experts and underwent minor changes. The original visual analogue scoring (VAS) was changed to a numerical scale. The reliability and construct validity of CEQ-My was assessed using Cronbach’s alpha and exploratory analysis, respectively. Known-groups validation was conducted using the Mann–Whitney U test, whilst the inter-item correlations between CEQ-My and its subdomains were evaluated through Spearman’s correlation. The final analysis involved 246 women. The questionnaire was easy to understand and all women preferred numeric scoring to the VAS. Based on the principal component factor analysis, we deleted one item and rearranged the domain for four items. The twenty-one items CEQ-My demonstrated good reliability with Cronbach’s alpha of 0.77. Women who had spontaneous vaginal delivery demonstrated significantly greater CEQ-My scores than those who underwent operative delivery (p = 0.002). The domain of professional support was positively correlated to that of own capacity and participation (p-value of < 0.001 and 0.002, respectively). The CEQ-My is a valid and reliable instrument to assess Malaysian women’s childbirth experiences. The easy-to-use electronic version of CEQ-My will improve future research and ease data collection.

Background Several instruments have been designed to assess the childbirth experience. The Childbirth Experience Questionnaire (CEQ) is one of the most widely used tools. There is an improved version of this instrument, the Childbirth Experience Questionnaire (CEQ 2.0), which has not been adapted or validated for use in Spain. The aim of present study is to adapt the CEQ 2.0 to the Spanish context and evaluate its psychometric properties. Methods This research was carried out in 2 stages. In the first stage, a methodological study was carried out in which the instrument was translated and back-translated, content validity was assessed by 10 experts (by calculating Aiken's V coefficient) and face validity was assessed in a sample of 30 postpartum women. In the second stage, a cross-sectional study was carried out to evaluate construct validity by using confirmatory factor analysis, reliability evaluation (internal consistency and temporal stability) and validation by known groups. Results In Stage 1, a Spanish version of the CEQ 2.0 (CEQ-E 2.0) was obtained with adequate face and content validity, with Aiken V scores greater than 0.70 for all items. A final sample of 500 women participated in Stage 2 of the study. The fit values for the obtained four-domain model were RMSEA = 0.038 [95% CI: 0.038–0.042], CFI = 0.989 [95% CI: 0.984–0.991], and GFI = 0.990 [95% CI: 0.982–0.991]. The overall Omega and Cronbach's Alpha coefficients were 0.872 [95% CI: 0.850–0.891] and 0.870 [95% CI: 0.849–0.890] respectively. A coefficient of intraclass correlation of 0.824 [95% CI: 0.314–0.936] (p ≤ 0.001) and a concordance coefficient of 0.694 [95% CI: 0.523–0.811] were obtained. Conclusions The Spanish version of CEQ 2.0 (CEQ-E 2.0), has adequate psychometric properties and is a valid, useful, and reliable instrument for assessing the childbirth experience in Spanish women.

Background The Childbirth Experience Questionnaire (CEQ) was originally designed to study women’s perceptions of labour and birth. The main objective of our study was to adapt the CEQ to the Spanish context and determine its psychometric properties. This would provide an opportunity to evaluate women’s experiences in order to improve evidence in the Spanish context as recommended by national guidelines. Methods The CEQ was translated into Spanish using a standard forward and back translation method (CEQ-E). A convenience sample of 364 women was recruited from 3 Spanish hospitals; all participants were able to read and write in Spanish. Mothers with high risk pregnancies or preterm deliveries were excluded from the study. A self-administered questionnaire on sociodemographic variables was completed by participants before discharge. Data on childbirth variables were obtained from maternity records. Between 1 and 3 months postpartum a postal CEQ-E questionnaire was sent. The CEQ-E structure was examined by a confirmatory factor analysis of polychoric correlations using a diagonally weighted least squares estimator. Reliability was assessed using Cronbach’s alpha. Construct validity was conducted by testing differences in CEQ-E scores between known-groups (to differ on key variables). Results 226 (62.1%) of the recruited participants completed the postal questionnaire. The CEQ-E factor structure was similar to the original one. The Spanish version showed fit statistics in line with standard recommendations: CFI = 0.97; NNFI = 0.97; RMSEA = 0.066; SRMS = 0.077. The internal consistency reliability of the CEQ-E was good for the overall scale (0.88) and for all subscales (0.80, 0.90, 0.76, 0.68 for “own capacity”, “professional support”, “perceived safety” and “participation”, respectively) and similar to the original version. Women with a labour duration ≤ 12 h, women with a labour not induced, women with a normal birth and multiparous women showed higher overall CEQ-E scores and “perceived safety” subscale scores. Women with a labour duration ≤ 12 h and those with previous experience of labour obtained higher scores for the “own capacity” and “participation” subscales. Conclusions The results of this study indicate that the CEQ-E can be considered a valid and reliable measure of women’s perceptions of labour and birth in Spain.

Aim: The study aimed to determine childbirth experience and the overall satisfaction of women with childbirth and its related socio-demographic and obstetric factors. Design: A cross-sectional study. Methods: We used the Childbirth Experience Questionnaire (CEQ) on a sample of 161 primiparous women. Results: Total mean CEQ score was 49.78 (SD = 6.02). The best-rated domain was the Perceived safety domain at 2.66 (± 1.90). The worst-rated domain was the Professional support domain at 1.66 (± 1.30). Regarding childbirth satisfaction, the mode of delivery proved to be a related factor, with the highest level of childbirth satisfaction in women after surgical delivery. Conclusion:Providing quality care and creating a positive experience that can contribute to overall birth satisfaction should be a common target of healthcare professionals in caring for parturient women. In order to create a positive childbirth experience, it is necessary to pay increased attention to the management of labor pain relief, to improving the professional support provided by midwives (i.e., through a more sensitive approach to mothers), to promoting the active participation of the mother during childbirth, and to supporting spontaneous vaginal delivery.

Background The Childbirth Experience Questionnaire (CEQ) is a tool designed to assess women’s perceptions about labor and delivery. The aim of this study was to perform the cross-cultural adaptation and validation of the Brazilian Portuguese version of the CEQ (CEQ-Br). Methods The original version of the CEQ was translated into Portuguese, analyzed by a committee of experts, back translated, and finally submitted to pilot-test. Two applications of the CEQ-Br were performed along with the quality of life questionnaire Medical Outcomes Study 36 - Item Short-Form Health Survey (SF-36). The SPSS software was used for statistical analysis, the intraclass correlation coefficient was used to investigate test-retest reliability, the internal consistency was investigated with the Cronbach’s Alpha, and the construct validity was investigated via the Spearman correlation test. The level of significance was set at 5%. Results The study included 308 women with a mean age of 31.1 ± 8.7 years. The internal consistency results for the total CEQ-Br score was considered adequate (0.89), the test-retest showed a substantial result with an ICC of 0.90, and the construct validity was analyzed via the Spearman correlation between all SF-36 dimensions and the total CEQ-B score, the analyses were considered adequate. Conclusions The results presented in this CEQ-Br validation study showed that the instrument was reliable in measuring the established psychometric properties and was considered valid. Therefore, the CEQ-Br can be applied to the Brazilian population.

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.