Validation of the Slade Fear of Childbirth Scale for Pregnancy in a Sample of Iranian Women: A Cross-sectional Study

The existence of a valid scale of fear of childbirth (FOC) has an effective role in identifying women at risk, so this study was conducted to determine the validation of the Slade FOC scale for pregnancy in a sample of Iranian women.

In this cross-sectional study, initially, the Slade scale was translated based on a forward-backward approach. For sampling among pregnant women in Anbarabad city, 820 pregnant women were selected by multistage cluster sampling method. The research questionnaire included (a) demographic information, (b) Slade FOC scale (new scale), (c) childbirth attitude questionnaire (validated scale), and (d) Wijma scale (validated scale). Face validity, content validity, construct validity (using factor analysis), convergent validity, and concurrent validity (by calculating the present scale correlation with childbirth attitude questionnaire and Wijma scale were used to determine the validity of the scale. Internal consistency (Cronbach’s alpha), split-half, and stability (test-retest) methods were used for scale reliability. SPSS software version 22 and LISREL version 8.8 were used for data analysis.

Target population comments were applied in face validity, the impact score of face validity was in the range of 1.6-4.5. Content validity ratio (CVR) values (81%-100%) and content validity index (CVI) value (83%) were acceptable. The exploratory factor analysis (EFA) showed that the scale had four factors which include uncertainty and injury with 18.39%, the unprofessional behavior of maternity staff with 14.51%, the unpredictable with 14.44%, and negative emotions with 10.54% of the variance. The scale had acceptable convergent validity and the correlation between items and the total score was between 0.41-0.63. The correlation coefficient between the present scale with the childbirth attitude questionnaire and Wijma scale was 0.81 and 0.79, respectively. The reliability result showed an acceptable internal consistency (Cronbach’s alpha = 0.84), acceptable split-half (0.71 for the first half of scale and 0.78 for the second half of scale) and acceptable stability (r = 0.78).

The results showed that the Slade scale has acceptable validity and reliability. Therefore, this scale can be used in scientific research and screening for FOC.