Development and Validation of the Self-Efficacy Regarding Vaginal Birth Scale

Objectives: The purpose of this study was to develop a scale to measure self-efficacy regarding a vaginal birth (SEVB) during pregnancy and to assess its reliability and validity among nulliparous Chinese women. Design: A panel study. Setting: Five hospitals in Northern Taiwan. Participants: The analysis included 700 (second trimester), 637 (third trimester), and 585 (before birth) women who did not have medical indications for cesarean births at the indicated time points. Methods: The SEVB scale was used to measure the level of confidence in ability to carry the pregnancy to term and give birth vaginally. The scale included nine items, and each was scored on a numeric rating scale from 0 to 10. A higher score indicated a higher level of self-efficacy. Results: Factor analysis confirmed the one-factor structure, which explained 62.77% and 67.08% of the variance, with Cronbach's alphas for the scale of 0.93 and 0.94 during the second and third trimesters, respectively. The test-retest reliability was 0.73 as determined by the intraclass correlation coefficient. Contrasted group validity supported that those women who preferred cesarean births had significantly lower SEVB scores than women who preferred vaginal births during the second and third trimesters. Those women who tried vaginal births had higher SEVB scores than women who had cesareans without trying vaginal births. Conclusion: The scale showed acceptable reliability and validity. Health professionals could use the scale to screen women with low self-efficacy during pregnancy and provide appropriate intervention to increase their willingness to try vaginal births.