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Abstract

Background

Fear of childbirth (FOC) is a prevalent psychological issue among pregnant women globally, necessitating valid and culturally adapted assessment tools.

Purpose

The study aimed to examine the reliability, validity, and factor structure of the Arabic version of the Childbirth Fear Questionnaire (CFQ) to ensure its suitability for use in the Jordanian context.

Methods

A cross-sectional study was conducted with 452 pregnant women attending prenatal clinics in northern Jordan to assess the psychometric properties of a questionnaire. The evaluation looked at how well the questionnaire was designed and understood, then used exploratory factor analysis (EFA) with IBM SPSS 29.0 and confirmatory factor analysis (CFA) with IBM SPSS Amos 26.0 to check its structure.

Results

EFA identified four distinct factors: fear of harm to the baby (α = 0.88), fear of pain (α = 0.82), fear of body damage from vaginal birth (α = 0.80), and fear of loss of sexual pleasure/attractiveness (α = 0.85). The overall Cronbach's alpha was 0.92, indicating excellent reliability. CFA supported the four-factor model, though some fit indices suggested moderate model fit.

Conclusion

The Arabic version of the CFQ demonstrated robust psychometric properties, making it a reliable and valid tool for assessing childbirth fear among Jordanian women. Its use can aid in the early identification of FOC, guiding targeted interventions to improve maternal and neonatal outcomes.

Keywords

fear of childbirth validation psychometric properties exploratory factor analysis confirmatory factor analysis

Introduction

Giving birth is a life-changing event that frequently involves a complex interplay of emotions, from excitement and expectation to fear and worry (Colciago et al., 2025). While some degree of apprehension about labor and delivery is common, an intense and debilitating fear of childbirth (FOC), sometimes referred to as tokophobia, can significantly impact maternal wellbeing, decision-making, and perinatal outcomes (Barton et al., 2024). Studies suggest that FOC affects approximately 20% to 25% of pregnant women, with a smaller subset experiencing severe levels that may lead to requests for cesarean sections, delayed labor progression, or postpartum psychological distress (Bakhteh et al., 2024). Given its prevalence and consequences, accurately assessing FOC is critical for identifying at-risk individuals, tailoring interventions, and improving maternal care (Alizadeh-Dibazari et al., 2023).

With an emphasis on developing valid and reliable instruments that capture the multifaceted nature of this phenomenon, researchers have created a variety of methods to evaluate the dread of childbirth to meet this demand (Mudgal & Shafqat, 2024). FOC is a complex phenomenon that includes worries about the baby's safety, discomfort, loss of control, and physical harm, among other things (Fairbrother et al., 2022). To guarantee its usefulness in clinical and research contexts, any evaluation instrument must take into consideration these aspects while exhibiting strong psychometric qualities, such as validity, reliability, and sensitivity. The validation of such tools is equally essential, as it establishes their effectiveness across different populations, cultural contexts, and stages of pregnancy.

Review of Literature

There are numerous assessment tools to measure or quantify FOC, in different formats including Likert-type questionnaires, single-item scales, and visual analog scales (VAS) (Gonzalez & Pelham III, 2021). Likert-type questionnaires, for example, the widely studied Wijma Delivery Expectancy Questionnaire (W-DEQ), are made up of multiple items on a graded scale measuring the severity of fear, which allows for in-depth assessment of different childbirth fear dimensions. Single-item measurements are simpler, attempting to have a quick look at the magnitude of fear, but they were insufficient for lasting and intensive measurement since they possess limitations in measuring the multiple dimensions of the phenomenon of childbirth fear (Fairbrother et al., 2022). VAS, including tools like the Fear of Birth Scale (FOBS), offer a natural method of measuring the continuum of fear intensity through a continuous rating scale, thus applying it to clinical practice despite capturing less depth compared to multi-item questionnaires. Each type of tool has its strengths and weaknesses in clinical and research settings, and ongoing psychometric evaluation looks for the most accurate and reliable tools for optimizing fear detection and subsequent care in perinatal patients (Nilsson et al., 2018). The Childbirth Fear Questionnaire (CFQ) is a newly constructed instrument to quantify both the severity of symptoms of FOC and to also serve as a screening tool for clinically relevant fears. It comprises 40 items that are grouped into nine distinct subscales to assess the range of birth-related concerns that women may exhibit (Fairbrother et al., 2022). This comprehensive structure is helpful because it enables one to identify specific areas where healthcare professionals can focus their education and interventions in pregnant women affected by FOC (Fairbrother et al., 2022).

Besides, the CFQ has an accompanying secondary scale that assesses the extent to which FOC disrupts every part of a pregnant woman's life (Fairbrother et al., 2022). Understanding the psychometric foundation of FOC assessment tools has tangible implications for healthcare providers, policymakers, and expectant mothers. A well-validated tool can aid early detection of extreme anxiety, psychological support tactics, and joint decision making about preferred delivery methods. Furthermore, continual validation guarantees that these tools stay pertinent and responsive to modern demands as cultural attitudes and childbirth practices change. Hence, this study aims to examine the reliability, validity, and factor structure of the Arabic version of the CFQ to ensure its suitability for use in the Jordanian context.

Materials and Methods

Study Design

A cross-sectional design was used to examine the psychometric properties of the CFQ among Jordanian women.

Settings and Sample

Data were gathered from the prenatal outpatient clinics at four hospitals in northern Jordan, including three public maternity hospitals and one affiliated university hospital. All Jordanian women who attended the prenatal clinic were the target group. These hospitals were chosen because of their large patient volumes, ability to serve a wide range of expectant mothers, and significance as major suppliers of maternal health services in northern Jordan. Three public maternity hospitals are included to guarantee representation of the general public receiving government-funded care, and the university hospital that is affiliated with it offers access to a more varied patient population and promotes ethical oversight and research collaboration. The objective of this selection strategy was to improve the findings’ generalizability across different healthcare settings in the area.

Inclusion and Exclusion Criteria

Jordanian women who visited the prenatal clinics at the chosen hospitals made up the accessible population. Data were included for (1) a Jordanian woman had to be at least 18 years old, (2) able to read and write Arabic, (3) in the second or third trimester of pregnancy, and (4) willing to participate in the study to be eligible. However, women who had a known psychiatric disorder or were currently receiving psychiatric treatment, experienced a high-risk pregnancy, had a history of traumatic birth experiences, or perinatal loss, were unable to provide informed consent, or had cognitive impairments affecting comprehension, and were currently using medications that may influence psychological status such as antidepressants or anxiolytics were excluded from the study.

A convenience, nonprobability sampling method was applied. According to Thorndike's rule of thumb, the study needed a sample of 360 (Michell, 2020). For attrition and nonresponse (72 individuals), 30% were included. There were 452 participants in the final sample. Data were collected from the period of 1 March to 2 December 2023.

Measures

Data were collected using a two-part self-administered questionnaire. The first part contains the sociodemographic characteristics, obstetric, and gynecological history. The second part consists of the Arabic version of the CFQ. This 40-item questionnaire is a self-report measure of FOC (Fairbrother et al., 2022). Each item is rated on a Likert-type scale ranging from 0 (no fear) to 4 (extreme fear). The total score ranges from 0 to 160 points (the higher the score, the greater the fear). The items are divided into nine subscales, each measuring different domains of fear with a set number of items: fear of loss of sexual pleasure/attractiveness (6 items); fear of pain from a vaginal birth (5 items); fear of medical interventions (7 items); fear of embarrassment (5 items); fear of harm to baby (3 items); fear of cesarean birth (3 items), fear of mum or baby dying (3 items); fear of insufficient pain medication (3 items); and fear of body damage from a vaginal birth (5 items). Each subscale score is derived by adding the individual item scores within the subscale and then dividing by the number of items in the subscale. This approach standardizes the scores so direct comparison between different fear domains is feasible even in the presence of differences in the number of items (Fairbrother et al., 2022). The internal consistency of the CFQ was found to be reliable with a Cronbach’s alpha of 0.94 for the overall scale and a range between 0.76 and 0.94 for the individual subscales (Fairbrother et al., 2022; Stoll, Swift et al., 2018). An expert who is competent in both languages translated the scale into Arabic with the author's consent. Six obstetric and maternal healthcare nursing specialists guaranteed the questionnaire's content validity. To evaluate the questionnaire's readability, reliability, and completion time, a pilot study was conducted with a sample of 40 pregnant women who satisfied the inclusion criteria. The results showed that all participants understood the questionnaire, and it took 15 to 20 min to complete. The reliability of the questionnaire was demonstrated by Cronbach's alpha values of 0.94 for the total scale and a range of 0.80 to 0.94 for the individual subscales. Each item (I-CVI) and the entire scale (S-CVI) had their Content Validity Index (CVI) determined. High item-level agreement was indicated by the I-CVI, which ranged from 0.86 to 1.00. The entire questionnaire's S-CVI/average was 0.94, which is regarded as excellent and surpasses the 0.80 threshold that is advised for newly created or modified instruments.

Ethical Considerations

After receiving approval from the University of Science and Technology Institutional Review Board ((Ref.# 60/149/2022), the procedure of gathering data began. Every participant had enough time to finish the questionnaire, sign the consent form, and read the informational letter.

Data Analysis

The content and face validity of the scale were assessed, and then SPSS version 29 was used to analyze the data. Descriptive statistics and frequencies were obtained (IBM, 2023). Additionally, SPSS was used to calculate Cronbach's alpha values for the CFQ. To develop the final model for the study, six exploratory factor analysis (EFA) models were constructed using various extraction methods, including Principal Component Analysis, Alpha Factoring, and Principal Axis Factoring. Each of these methods was applied both with and without Varimax rotation. The optimal model was determined to be the Principal Component Analysis with Varimax rotation. The Kaiser–Meyer–Olkin (KMO) measure of sampling adequacy yielded a value of .922, indicating excellent sufficiency for conducting factor analysis. Bartlett's test of sphericity produced a Chi-square value of 10,832.96 (df = 780, p < .001), further supporting the appropriateness of the data for exploration. The final model selection criteria included the total variance explained, clear factor loadings, a requirement for each factor to have at least three items, and an eigenvalue greater than one for each factor. The extraction sum of squared loadings for the model was 0.62, consistent with the condition that each factor's eigenvalue exceeded one.

CFA was performed using AMOS (Version 26.0) to validate the four-factor structure derived from EFA for the Arabic CFQ. Model fit indices, including χ²/df = 5.948, Comparative Fit Index (CFI) = 0.891, Tucker-Lewis Index (TLI) = 0.866, Goodness of Fit Index (GFI) = 0.916, Adjusted Goodness of Fit Index (AGFI) = 0.855, and Root Mean Square Residual (RMR) = 0.061, indicated a moderate fit, with all items loading significantly (p < 0.001) on their respective factors (0.48–0.88), and the strongest correlation observed between fear of harm to baby and fear of body damage (r = 0.68); this EFA–CFA integration confirmed the questionnaire's robust psychometric properties, supporting its use in clinical and research settings despite the moderate model fit.

Results

Participants’ Characteristics

A total of 452 pregnant women participated in this study with a mean age of 27.84 years (SD = 5.15; range 18–40). Most of the participants were married (94.9%), and more than half of them held a bachelor's degree or higher (n = 257, 56.8%). Most of the study participants (n = 392, 86.7%) were multigravida with a gestational age ranging from 14 to 40 weeks (M = 27.49; SD = 7.43; Table 1).

Table 1.

Descriptive Statistics for the Study Sample of Women (N = 452).

Variable	N	%
Age (M = 27.84, SD = 5.15); range (18–40)
Marital status
Married	429	94.9
Divorced/widowed	23	5.1
Education level
Secondary school	157	34.7
Bachelor or higher	295	65.3
Number of pregnancies
Primi gravida	60	13.3
Multi gravida	392	60.6
Complications during previous pregnancies
Yes	178	39.4
No	274	60.6
Number of miscarriages
Zero	98	21.7
1–3	289	63.9
More than 3	65	14.4
Weeks of gestation(M = 27.49, SD = 7.43); range (14–40)
14–26 weeks	203	44.9
27–40 weeks	249	55.1
Preferred mode of birth
Normal	265	58.6
Cesarean	187	41.4

Notes: %=frequency; M = mean; N = number; SD = standard deviation.

Exploratory Factor Analysis

The EFA of the short version of the CFQ, comprising 21 items and four subscales, revealed a robust structure with high internal consistency. The overall Cronbach's alpha for the 21-item scale was 0.92, indicating excellent reliability. The four factors identified in the analysis align with distinct dimensions of childbirth-related fears, each demonstrating strong internal consistency.

Factor 1: Fear of Harm to Baby

This factor, with a Cronbach's alpha of 0.88, encompasses concerns related to potential harm to the baby during labor and birth. Items such as “The baby suffocating during labor/birth?” (loading = 0.801) and “The baby dying during labor/birth?” (loading = 0.790) had the highest loadings, indicating that fears about the baby's safety and wellbeing are central to this dimension. Other items, such as concerns about medical interventions (e.g., vacuum or forceps) and the possibility of the baby being damaged or handicapped, also loaded significantly on this factor.

Factor 2: Fear of Pain

The second factor, with a Cronbach's alpha of 0.82, captures fears related to the experience of pain during childbirth. Items such as “Experiencing pain during contractions?” (loading = 0.748) and “Experiencing pain during a vaginal birth?” (loading = 0.738) were the most prominent, reflecting a strong focus on the physical pain associated with labor and delivery. The fear of not being able to receive an epidural if desired also loaded on this factor, though with a lower loading (0.418).

Factor 3: Fear of Body Damage From a Vaginal Birth

This factor, with a Cronbach's alpha of 0.80, reflects concerns about physical damage to the mother's body because of vaginal birth. Items such as “Rectal tearing/damage because of labor/birth?” (loading = 0.730) and “Vaginal tearing during labor/birth?” (loading = 0.548) were significant contributors to this dimension. Additionally, fears related to incompetent medical care and the stretching of the vagina also loaded on this factor, though with slightly lower loadings (loading = 0.606).

Factor 4: Fear of Loss of Sexual Pleasure/Attractiveness

The fourth factor, with a Cronbach's alpha of 0.85, addresses fears related to the impact of childbirth on sexual pleasure and physical attractiveness. Items such as “My partner enjoying sexual intercourse less because of stretching of my vagina from having a vaginal birth?” (loading = 0.735) and “Enjoying sexual intercourse less because of pain or discomfort from the birth?” (loading = 0.709) were the most significant. Concerns about the appearance of the vagina and body postbirth, as well as the possibility of scarring from a cesarean birth, also contributed to the second factor (Table 2).

Table 2.

Exploratory Factor Analysis for Short Version “Childbirth Fear Questionnaire”/21 Items/Four Subscales.

Items	Loadings
Factor 1: Fear of harm to baby/Cronbach's alpha = .88	Factor 1	Factor 2	Factor 3	Factor 4
H1 That the baby suffocates during childbirth	.801	.220	.167	.189
H2 That the baby dies during childbirth	.790
H3 Need a forceps or suction cup	.770	.239		.210
H4 That damage or harm the baby as a result of childbirth	.745		.210	.195
H5 That harm the baby in a medical intervention during childbirth (e.g., vacuum, anesthesia, forceps…)	.730	.171	.253
H6 That the baby suffers some damage during childbirth	.530	.228	.406
Factor 2: Fear of pain /Cronbach's alpha = .82
P1 Experiencing pain during contractions		.748	.185
P2 Feeling pain during a vaginal birth		.738	.182	.191
P3 Feel pain while pushing the baby		.735	.239	.169
P4 Feeling pain during childbirth	.207	.653	.231
P5 Not being able to have an epidural during labor if I want/need one	.370	.418		.244
Factor 3: Fear of body damage from a vaginal birth/Cronbach's alpha = .80
D1 Rectal tearing/damage because of labour/birth		.176	.730
D2 Being harmed because of incompetent medical care	.263		.628
D3 Stretching of my vagina from giving birth vaginally	.156	.296	.606	.410
D4 Vaginal tearing during childbirth	.314	.297	.548	.216
Factor 4: Fear of loss of sexual pleasure/attractiveness/Cronbach's alpha = .85
S1 My partner enjoying sexual intercourse less because of stretching of my vagina from having a vaginal birth	.292	.174		.735
S2 Enjoying sexual intercourse less because of pain or discomfort from childbirth	.230			.709
S3 My vagina looking less attractive following a vaginal childbirth		.274	.268	.704
S4 Enjoying sexual intercourse less because of stretching from a vaginal birth			.273	.695
S5 My body looks less attractive following the childbirth	.261		.365	.574
S6 Being left with scars from a cesarean birth	.163			.547

Confirmatory Factor Analysis

CFA was performed using SPSS AMOS 26.0 software to evaluate the 46-variable model (21 observed, 25 unobserved; 25 exogenous, and 21 endogenous) yielded a standardized solution (Figure 1) with 183 degrees of freedom (231 distinct sample moments and 48 estimated parameters). High standardized loadings (Figure 1) confirmed the robustness of the four-factor model, supporting the EFA findings and demonstrating its ability to capture key dimensions of childbirth-related fears.

Figure 1.

Standardized Estimate for the Short Version “Childbirth Fear Questionnaire.”.

Model Fit Indices

The model fit indices indicated a moderate fit of the model to the data. The Chi-square (CMIN) value was 1088.451 with 183 degrees of freedom, resulting in a CMIN/DF ratio of 5.948, which is above the recommended threshold of 3. The RMR was 0.061, and the GFI was 0.916, which is higher than the desired threshold of 0.90. The AGFI was 0.855, indicating a good fit model. The CFI was 0.891, and the TLI was 0.866, both of which are close to the recommended threshold

Parameter Estimates

The standardized factor loadings for the observed variables on their respective latent constructs were generally significant, with most loadings exceeding 0.60, indicating strong relationships between the observed variables and their latent constructs. For example, the factor loadings for the latent construct “Harm” ranged from 0.609 to 0.884, while those for “Pain” ranged from 0.480 to 0.860. The latent construct “Damage” had factor loadings ranging from 0.625 to 0.758.

The correlations between the latent constructs were also significant. The correlation between “Harm” and “Damage” was 0.678, indicating a strong relationship. Similarly, the correlation between “Pain” and “Damage” was 0.498, and between “Harm” and “Pain” was 0.475, suggesting moderate to strong relationships among the constructs.

Residual Variances

The residual variances for the observed variables were generally low, indicating that the model accounted for a significant portion of the variance in the observed variables. For example, the residual variance for “H1” was 0.367, and for “P1” was 0.458, suggesting that the latent constructs explained a substantial amount of the variance in these observed variables.

Discussion

This study represents, to our knowledge, the first cross-cultural adaptation of the CFQ into Arabic and the first investigation of its psychometric properties within a sample of Jordanian expectant mothers. Our findings provide evidence of robust reliability and validity, establishing the CFQ as a culturally appropriate tool for assessing childbirth-related fears in this population. These results are consistent with previous research, underscoring the importance of culturally sensitive measurement tools for accurately capturing the multifaceted construct of childbirth-related fear (Fairbrother, 2022; Mudgal & Shafqat, 2024).

Exploratory factor analysis identified four distinct dimensions: fear of harm to the baby, fear of pain, fear of body damage from vaginal birth, and fear of loss of sexual pleasure/attractiveness, all showing high internal consistency. Interpretation of our findings is limited by the scarcity of existing research; to our knowledge, this represents only the second validation study of the CFQ in a non-English-speaking population. The first validation study carried out by González-de la Torre et al. (2023) to describe and evaluate the psychometric properties of the Spanish version of CFQ, which revealed that the Spanish version of the CFQ is a valid and reliable 37 items tool to measure four subscales or dimensions of FOC in the Spanish pregnant population. These subscales or dimensions include: “fear of medical interventions”; “fear of harm and dying”; “fear of pain”; and “fears relating to sexual aspects and embarrassment.” Our study findings are consistent but not identical to those reported by González-de la Torre et al. (2023).

Furthermore, this dimensional structure is consistent with other research that emphasizes the complex, multidimensional nature of childbirth fears, which vary across cultures, and include physical, emotional, and social aspects (Dencker et al., 2019; Fairbrother et al., 2022; Nieminen et al., 2016; Nilsson et al., 2018).

The factor “Fear of Harm to Baby” emerged as the strongest dimension, echoing existing findings that concern fetal health and safety during childbirth representing a critical component of childbirth fear (Stoll, Fairbrother et al., 2018). Items related to baby suffocation and mortality showed the highest factor loadings, highlighting deep-seated maternal anxieties that significantly impact perinatal mental health (Khalife-Ghaderi et al., 2021). Similar results were documented in earlier studies, reinforcing the importance of addressing maternal concerns about fetal wellbeing as a core component of prenatal care interventions (Barton et al., 2024; Hosseini et al., 2018).

Concerns related to labor pain also formed a prominent factor, reflecting widespread apprehensions experienced globally. Prior studies consistently documented FOC pain as one of the leading predictors for requesting medical interventions, such as elective cesarean sections (Roosevelt et al., 2025). This finding's consistency emphasizes how important it is for medical professionals to proactively address pain management techniques and make sure that efficient pain relief choices are explained in detail throughout prenatal care.

Another significant dimension revealed in the analysis pertains to fears associated with physical damage due to vaginal birth. Concerns such as tearing or incompetence in medical care are commonly reported internationally, highlighting universal anxieties regarding childbirth-induced bodily changes (Alizadeh-Dibazari et al., 2023). Previous research has indicated that these anxieties can influence women's birth preferences, potentially increasing cesarean section rates if not adequately addressed (Hosseini et al., 2018; Roosevelt et al., 2025).

The dimension related to fear of loss of sexual pleasure or attractiveness reflects social and psychological apprehensions deeply rooted in cultural perceptions of motherhood and femininity. These anxieties have a substantial impact on women's postpartum emotional health and quality of life, although they are less frequently openly expressed (Barton et al., 2024). This finding aligns closely with earlier research indicating a need for sensitive communication by healthcare professionals regarding postpartum body changes and sexual health (Stoll, Swift, et al., 2018).

CFA further supported the robustness of the identified factor structure, demonstrating strong loadings and interfactor correlations consistent with theoretical expectations. However, some fit indices indicated moderate model fit (e.g., CFI and TLI slightly below the recommended thresholds), suggesting that further research might explore minor model refinements or incorporate additional cultural nuances unique to Jordanian women.

The Jordanian version of the CFQ, differs notably from the Spanish CFQ's original 37-item tool in both length and factor structure. These differences likely reflect important cultural and contextual distinctions between the two populations.

The Spanish version conducted by González-de la Torre et al. (2022) and developed in a Western context encompasses a broader range of fears and concerns related to childbirth, capturing nuanced dimensions that may be less relevant or differently expressed in Jordanian women. Conversely, the Jordanian adaptation emphasizes culturally specific aspects of childbirth fear, which may be more salient within Arab societal norms and healthcare experiences. For example, concerns about body damage and loss of sexual attractiveness, included as distinct factors in the Jordanian CFQ, may resonate strongly given cultural values around femininity and modesty. The reduction in items also suggests a refinement process aimed at improving relevance and clarity for the Jordanian context. This comparison underscores the necessity of culturally adapting psychometric tools rather than applying them universally, as fear experiences and expressions can vary significantly across cultures. Further comparative studies could explore these differences in greater detail, supporting tailored interventions and more accurate assessments of childbirth fear in diverse populations.

The high internal consistency (Cronbach's alpha = 0.92 overall) confirms the reliability of the CFQ in the Jordanian context. These findings resonate with global validation studies, suggesting that despite cultural differences, key elements of childbirth fear remain relatively universal (Mudgal & Shafqat, 2024; Hosseini et al., 2018). Additionally, high internal consistency suggests that the CFQ is a reliable tool for screening clinically significant childbirth fears, allowing for early identification and intervention.

Practically, the availability of a culturally validated CFQ offers significant benefits for clinical practice and healthcare policy in Jordan. Early detection of childbirth fears using the CFQ can facilitate timely psychological support and counseling, potentially improving maternal satisfaction and reducing negative birth outcomes such as postpartum anxiety, depression, and unnecessary medical interventions (Alizadeh-Dibazari et al., 2023; Bakhteh et al., 2024). Furthermore, the suggested four-factor structure of the CFQ was validated by the CFA; however, the fit indices, which include TLI and CFI values below the suggested cutoff of 0.90, show a moderate rather than an excellent model fit. This could be a reflection of Jordanian cultural quirks that affect how participants perceive or understand particular items. Variations in item responses that the original model might not have fully captured could be caused by differences in cultural beliefs, childbirth practices, or societal attitudes toward fear and body image. Future studies could look into changing or rewording particular items to better fit local cultural meanings or take into account different factor structures through additional exploratory analyses in order to improve model fit.

Moreover, adapting and validating childbirth fear assessment tools in diverse cultural settings are imperative to understanding how childbirth anxieties manifest across different populations. This study adds to the international literature by emphasizing the importance of cultural relevance in the assessment and intervention strategies addressing childbirth fear.

Implications for Nursing Practice

The CFQ has been validated and cross-culturally adapted among Jordanian women, giving nurses and midwives a psychometrically sound and culturally sensitive tool to measure FOC. This makes it possible to identify women who are experiencing high levels of fear early on and provide them with supportive care, education, and counseling promptly. By including the CFQ in regular prenatal exams, mothers’ psychological health can be improved, their childbirth experiences can be improved, and there may be a decrease in needless, fear-driven cesarean sections. Furthermore, by supporting data-driven decisionmaking and directing customized care plans in both hospital and community settings, the tool promotes evidence-based nursing practice.

Limitations and Recommendations

Despite robust psychometric properties, some limitations should be noted. Because of variations in socioeconomic status, educational attainment, and access to healthcare, the convenience sampling approach used in this study might not be representative of the larger Jordanian female population. To make sure the findings are more representative and generalizable to a larger population, future studies should employ stratified or random sampling techniques. Additionally, longitudinal studies assessing test–retest reliability and responsiveness of CFQ over time are recommended to solidify these findings further.

Conclusion

This psychometric validation confirms that the CFQ is a valid and reliable measure of childbirth fear among Jordanian women. Because it has strong psychometric properties and is relevant to the culture, the CFQ can greatly help in clinical assessments, guiding efforts to reduce fears about childbirth and ultimately improving outcomes for mothers and their babies.

Supplemental Material

sj-doc-1-son-10.1177_23779608251362655 - Supplemental material for Validation and Cross-Cultural Adaptation of the Childbirth Fear Questionnaire Among Jordanian Women

Supplemental material, sj-doc-1-son-10.1177_23779608251362655 for Validation and Cross-Cultural Adaptation of the Childbirth Fear Questionnaire Among Jordanian Women by Salwa Al Obeisat, Salam Bani Hani, Shahd Altarawneh and Muayyad Ahmad in SAGE Open Nursing

Footnotes

Acknowledgments

Thanks to Jordan University of Science and Technology for supporting this study. Also, the authors would like to thank all the participants for their valuable contributions to the data they provided.

ORCID iDs

Salam Bani Hani

Muayyad Ahmad

Ethical Considerations

After receiving approval from the University of Science and Technology Institutional Review Board (Ref.# 60/149/2022), the procedure of gathering data began.

Author Contributions

SAO was involved in conceptualization and discussion and SBH in writing the final draft, introduction, and editing. All authors have read and approved the final version of the manuscript. The corresponding author had full access to all of the data in this study and took complete responsibility for the integrity of the data and the accuracy of the data analysis. ShA contributed to conceptualization and data collection and MA to formal analysis, supervision, and editing.

Funding

The authors received no financial support for the research, authorship, and/or publication of this article.

Declaration Conflicts of Interest

The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Data Availability Statement

The data that support the findings of this study will be available upon reasonable request.

Declaration of Generative AI and AI-Assisted Technologies in the Writing Process

During the preparation of this work, the authors used Grammarly edit language. After using this tool, the authors reviewed and edited the content as needed and took full responsibility for the content of the publication.

Supplemental Material

Supplemental material for this article is available online.

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