Psychometric properties of the Fear of Birth Scale in women in the perinatal period: a multicountry study

Matilde Sousa; Daniela Fidalgo; Cláudia Sousa; Susan Garthus-Niegel; Olga Riklikienė; Paulina Pawlicka; Julie Jomeen; Inês Jongenelen; Lara Seefeld; Gabija Jarašiūnaitė-Fedosejeva; Barbara Baranowska; Kathleen Baird; Diogo Lamela; Raquel Costa; Tiago Miguel Pinto

doi:10.1016/j.jad.2025.01.063

Psychometric properties of the Fear of Birth Scale in women in the perinatal period: a multicountry study

Matilde Sousa, Daniela Fidalgo, Cláudia Sousa, Susan Garthus-Niegel, Olga Riklikienė, Paulina Pawlicka, Julie Jomeen, Inês Jongenelen, Lara Seefeld, Gabija Jarašiūnaitė-Fedosejeva, Barbara Baranowska, Kathleen Baird, Diogo Lamela, Raquel Costa, Tiago Miguel Pinto

Research output: Contribution to journal › Article › peer-review

Abstract

Assessing Fear of Birth Scale's (FOBS) psychometric properties in the perinatal period using multicountry data is a step toward effectively screen clinically significant fear of childbirth (FOC) in maternal healthcare settings. FOBS psychometric properties were analyzed in women in the perinatal period using data from Australia, Germany, Lithuania, Poland, and Portugal. FOBS' reliability, criterion (known group and convergent), concurrent, predictive, and clinical validity were analyzed. FOBS was completed by 3431 women in pregnancy (n = 2984) or postpartum (n = 447). Sociodemographic, obstetric, neonatal, and mental health-related data, depressive and anxiety symptoms, and tokophobia severity were self-reported. FOBS has good reliability. Known-group validity was established based on differences in sociodemographic, obstetric, neonatal, and mental health-related variables. Convergent validity was found with depressive and anxiety symptoms, and birth trauma. Concurrent validity was found with tokophobia severity. FOBS scores in pregnancy predicted elective cesarean section, and postpartum depressive and anxiety symptoms. FOBS discriminates between women with and without clinically significant FOC in pregnancy and postpartum, with optimal cut-offs across countries. This multicountry study suggested that FOBS is a psychometrically strong measure that can be an effective tool to screen clinically significant FOC in the perinatal period.

Original language	English
Pages (from-to)	365-380
Number of pages	16
Journal	Journal of Affective Disorders
Volume	374
DOIs	https://doi.org/10.1016/j.jad.2025.01.063
Publication status	Published - 1 Apr 2025

Bibliographical note

Publisher Copyright:
© 2025 The Author(s)

Funding

This work was partially funded by the Foundation for Science and Technology \u2014FCT (Portuguese Ministry of Science, Technology and Higher Education), under the grant HEI-LAB ( UIDB/05380/2020 ; doi identifier https://doi.org/10.54499/UIDB/05380/2020 ) and project 2022.01825.PTDC ( http://doi.org/10.54499/2022.01825.PTDC ). This research was funded by \u201Cla Caixa\u201D Foundation's Social Research Call 2023 under the project code LCF/PR/SR23/57000014 . Funding was received in Portugal by the FSE and FCT \u2013 Funda\u00E7\u00E3o para a Ci\u00EAncia e a Tecnologia, I.P. (Individual CEEC 2023.06934.CEECIND [RC] ). EpiUnit and ITR are supported by FCT - Funda\u00E7\u00E3o para a Ci\u00EAncia e Tecnologia, I.P. through the projects with references UIDB/04750/2020 and LA/P/0064/2020 ; https://doi.org/10.54499/UIDB/04750/2020 and https://doi.org/10.54499/LA/P/0064/2020 ). Susan Garthus-Niegel received funding for the DREAM study by the German Research Foundation (Deutsche Forschungsgemeinschaft, DFG ; Grant Numbers GA 2287/4-1 , GA 2287/4-2 , and GA 2287/4-3 ). The funders had no role in study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the article for publication. The authors have stated that they had no interests that might be perceived as posing a conflict or bias.

Funders	Funder number
Portuguese Ministry of Science, Technology and Higher Education	UIDB/05380/2020
Fundação para a Ciência e a Tecnologia	LA/P/0064/2020, UIDB/04750/2020

Keywords

Fear of birth scale
Fear of childbirth
Postpartum
Pregnancy
Psychometric properties
Tokophobia

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1016/j.jad.2025.01.063

Cite this

Sousa, M., Fidalgo, D., Sousa, C., Garthus-Niegel, S., Riklikienė, O., Pawlicka, P., Jomeen, J., Jongenelen, I., Seefeld, L., Jarašiūnaitė-Fedosejeva, G., Baranowska, B., Baird, K., Lamela, D., Costa, R., & Pinto, T. M. (2025). Psychometric properties of the Fear of Birth Scale in women in the perinatal period: a multicountry study. Journal of Affective Disorders, 374, 365-380. https://doi.org/10.1016/j.jad.2025.01.063

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abstract = "Assessing Fear of Birth Scale's (FOBS) psychometric properties in the perinatal period using multicountry data is a step toward effectively screen clinically significant fear of childbirth (FOC) in maternal healthcare settings. FOBS psychometric properties were analyzed in women in the perinatal period using data from Australia, Germany, Lithuania, Poland, and Portugal. FOBS' reliability, criterion (known group and convergent), concurrent, predictive, and clinical validity were analyzed. FOBS was completed by 3431 women in pregnancy (n = 2984) or postpartum (n = 447). Sociodemographic, obstetric, neonatal, and mental health-related data, depressive and anxiety symptoms, and tokophobia severity were self-reported. FOBS has good reliability. Known-group validity was established based on differences in sociodemographic, obstetric, neonatal, and mental health-related variables. Convergent validity was found with depressive and anxiety symptoms, and birth trauma. Concurrent validity was found with tokophobia severity. FOBS scores in pregnancy predicted elective cesarean section, and postpartum depressive and anxiety symptoms. FOBS discriminates between women with and without clinically significant FOC in pregnancy and postpartum, with optimal cut-offs across countries. This multicountry study suggested that FOBS is a psychometrically strong measure that can be an effective tool to screen clinically significant FOC in the perinatal period.",

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Sousa, M , Fidalgo, D , Sousa, C, Garthus-Niegel, S, Riklikienė, O, Pawlicka, P, Jomeen, J, Jongenelen, I, Seefeld, L, Jarašiūnaitė-Fedosejeva, G, Baranowska, B, Baird, K, Lamela, D , Costa, R & Pinto, TM 2025, 'Psychometric properties of the Fear of Birth Scale in women in the perinatal period: a multicountry study', Journal of Affective Disorders, vol. 374, pp. 365-380. https://doi.org/10.1016/j.jad.2025.01.063

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AU - Fidalgo, Daniela

AU - Sousa, Cláudia

AU - Garthus-Niegel, Susan

AU - Riklikienė, Olga

AU - Pawlicka, Paulina

AU - Jomeen, Julie

AU - Jongenelen, Inês

AU - Seefeld, Lara

AU - Jarašiūnaitė-Fedosejeva, Gabija

AU - Baranowska, Barbara

AU - Baird, Kathleen

AU - Lamela, Diogo

AU - Costa, Raquel

AU - Pinto, Tiago Miguel

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N2 - Assessing Fear of Birth Scale's (FOBS) psychometric properties in the perinatal period using multicountry data is a step toward effectively screen clinically significant fear of childbirth (FOC) in maternal healthcare settings. FOBS psychometric properties were analyzed in women in the perinatal period using data from Australia, Germany, Lithuania, Poland, and Portugal. FOBS' reliability, criterion (known group and convergent), concurrent, predictive, and clinical validity were analyzed. FOBS was completed by 3431 women in pregnancy (n = 2984) or postpartum (n = 447). Sociodemographic, obstetric, neonatal, and mental health-related data, depressive and anxiety symptoms, and tokophobia severity were self-reported. FOBS has good reliability. Known-group validity was established based on differences in sociodemographic, obstetric, neonatal, and mental health-related variables. Convergent validity was found with depressive and anxiety symptoms, and birth trauma. Concurrent validity was found with tokophobia severity. FOBS scores in pregnancy predicted elective cesarean section, and postpartum depressive and anxiety symptoms. FOBS discriminates between women with and without clinically significant FOC in pregnancy and postpartum, with optimal cut-offs across countries. This multicountry study suggested that FOBS is a psychometrically strong measure that can be an effective tool to screen clinically significant FOC in the perinatal period.

AB - Assessing Fear of Birth Scale's (FOBS) psychometric properties in the perinatal period using multicountry data is a step toward effectively screen clinically significant fear of childbirth (FOC) in maternal healthcare settings. FOBS psychometric properties were analyzed in women in the perinatal period using data from Australia, Germany, Lithuania, Poland, and Portugal. FOBS' reliability, criterion (known group and convergent), concurrent, predictive, and clinical validity were analyzed. FOBS was completed by 3431 women in pregnancy (n = 2984) or postpartum (n = 447). Sociodemographic, obstetric, neonatal, and mental health-related data, depressive and anxiety symptoms, and tokophobia severity were self-reported. FOBS has good reliability. Known-group validity was established based on differences in sociodemographic, obstetric, neonatal, and mental health-related variables. Convergent validity was found with depressive and anxiety symptoms, and birth trauma. Concurrent validity was found with tokophobia severity. FOBS scores in pregnancy predicted elective cesarean section, and postpartum depressive and anxiety symptoms. FOBS discriminates between women with and without clinically significant FOC in pregnancy and postpartum, with optimal cut-offs across countries. This multicountry study suggested that FOBS is a psychometrically strong measure that can be an effective tool to screen clinically significant FOC in the perinatal period.

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KW - Fear of childbirth

KW - Postpartum

KW - Pregnancy

KW - Psychometric properties

KW - Tokophobia

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ER -

Psychometric properties of the Fear of Birth Scale in women in the perinatal period: a multicountry study

Abstract

Bibliographical note

Funding

Keywords

UN SDGs

Access to Document

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