Identifying women who are afraid of giving birth: A comparison of the fear of birth scale with the WDEQ-A in a large Australian cohort
Open accessAbstract
Background The WDEQ-A is the most widely used measure of childbirth fear in pregnant women; however there is increasing discussion in the literature that simpler, more culturally transferrable tools may offer a better solution to identifying fearful women in clinical practice.Aim To compare the two item Fear of Birth Scale (FOBS) with the 33 item WDEQ-A in a large cohort of Australian pregnant women.Method Self-report questionnaires during second trimester including Wijma Delivery Expectancy Questionnaire (WDEQ-A) and Fear of Birth Scale (FOBS). Correlation of FOBS and WDEQ-A was tested using Spearman's correlation coefficients. Receiver operating characteristic (ROC) curve assessed the sensitivity and specificity of possible cut-points on the FOBS against WDEQ-A cut-point of ≥85. Sensitivity, specificity, positive and negative predictive values were determined. Fearful and non-fearful women as classified by both instruments were compared for differences in demographic, psycho-social and obstetric characteristics.Results 1410 women participated. The correlation between the instruments was strong (Spearman's Rho = 0.66, p < 0.001). The area under the ROC was 0.89 indicating high sensitivity with a FOBS cut-point of 54. Sensitivity was 89%, specificity 79% and Youden index 0.68. Positive predictive value was 85% and negative predictive value 79%. Both instruments identified high fear as significantly associated with first time mothers, previous emergency caesarean and women with self-reported anxiety and/or depression. Additionally FOBS identified a significant association between fearful women and preference for caesarean.Conclusion This study supports the use of the FOBS in clinical practice to identify childbirth fear in pregnant women.
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FOBS has previously been used in child-bearing populations and has been proposed as a valid instrument for measuring fear of birth in both research and clinical contexts.
“FOBS has previously been used in child-bearing populations [45,51-53] and has been proposed as a valid instrument for measuring FOB in both research and clinical contexts [11,45].”
From Comparing internet-based cognitive behavioral therapy with standard care for women with fear of birth: Randomized controlled trial (2018) · cites this paper as [51]
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Self-citation
- Authors
- Haines, H. M., Pallant, J. F., Fenwick, J., Gamble, J., Creedy, D. K., Toohill, J., & Hildingsson, I.
- Affiliations
- The University of Melbourne (AU)
- Griffith University (AU)
- Karolinska Institutet (SE)
- Corresponding author
- Haines, H.M.
- Venue
- Sexual & Reproductive Healthcare
- Publisher
- Elsevier BV
- Published
- 2015-12
- Volume
- 6
- Issue
- 4
- Pages
- 204-210
- ISSN
- 1877-5756 (ISSN-L)
- OpenAlex
- W613523101
- Cited by
- 102
- References
- 38
- Citations by year
- 2026: 6 · 2025: 12 · 2024: 11 · 2023: 6 · 2022: 13 · 2021: 10 · 2020: 10 · 2019: 6 · 2018: 14 · 2017: 10 · 2016: 3 · 2015: 1
- FWCI
- 10.62
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Sexual & Reproductive Healthcare (publishedVersion)
- PubMed (publishedVersion)
- Griffith Research Online (submittedVersion, cc-by-nc-nd)
- Funders
- NHMRC (APP1025099)
- Topics
- Health Sciences › Medicine › Obstetrics and Gynecology › Maternal and Perinatal Health Interventions
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- fear of childbirth, Wijma Delivery Expectancy Questionnaire, pregnant women, screening instrument comparison, diagnostic accuracy, primiparous women, maternal anxiety and depression
- MeSH terms
- Adult, Anxiety, Australia, Cesarean Section, Depression, Fear, Female, Humans, Parity, Phobic Disorders, Pregnancy, Pregnancy Trimester, Second, Reference Values, ROC Curve, Cohort Studies, Area Under Curve, Parturition, Delivery, Obstetric, Pregnant Women, Pregnant People, Self Report
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