Exploring Fear of Childbirth in the United States Through a Qualitative Assessment of the Wijma Delivery Expectancy Questionnaire

Objective: To explore women's experiences while completing the Wijma Delivery Expectancy Questionnaire (W-DEQ), an instrument used to measure fear of childbirth, and to analyze the readability and applicability of the instrument within a diverse population of women in the United States. Design: Qualitative descriptive study using focus groups with women who were pregnant or had given birth in the last 5 years. Setting: Urban health center in the Detroit metropolitan area. Participants: Participants included 22 women who participated in three focus groups. Methods: Focus groups were used to collect data, which were analyzed using content analysis. The Fry Readability Graph, in computer form, was used to rate the readability of the instrument. Results: Women in the focus groups identified many themes that were consistent with previous research. However, the women indicated many new factors that contributed to their fear that were previously unidentified by the W-DEQ, including fear of abandonment by their clinicians and fear of how the structure of the maternity care system affects care during childbirth. Conclusion: The findings from the focus groups challenge the utility and appropriateness of the W-DEQ for use as a screening tool to identify women who are pregnant and experiencing FOC in a U.S. context.