Identifying women who are afraid of giving birth: A comparison of the fear of birth scale with the WDEQ-A in a large Australian cohort

H. M. Haines, J. F. Pallant, J. Fenwick, J. Gamble, D. K. Creedy, J. Toohill, I. Hildingsson

Research output: Contribution to journalArticlepeer-review

70 Citations (Scopus)


Background: The WDEQ-A is the most widely used measure of childbirth fear in pregnant women; however there is increasing discussion in the literature that simpler, more culturally transferrable tools may offer a better solution to identifying fearful women in clinical practice. Aim: To compare the two item Fear of Birth Scale (FOBS) with the 33 item WDEQ-A in a large cohort of Australian pregnant women. Method: Self-report questionnaires during second trimester including Wijma Delivery Expectancy Questionnaire (WDEQ-A) and Fear of Birth Scale (FOBS). Correlation of FOBS and WDEQ-A was tested using Spearman's correlation coefficients. Receiver operating characteristic (ROC) curve assessed the sensitivity and specificity of possible cut-points on the FOBS against WDEQ-A cut-point of ≥85. Sensitivity, specificity, positive and negative predictive values were determined. Fearful and non-fearful women as classified by both instruments were compared for differences in demographic, psycho-social and obstetric characteristics. Results: 1410 women participated. The correlation between the instruments was strong (Spearman's Rho = 0.66, p < 0.001). The area under the ROC was 0.89 indicating high sensitivity with a FOBS cut-point of 54. Sensitivity was 89%, specificity 79% and Youden index 0.68. Positive predictive value was 85% and negative predictive value 79%. Both instruments identified high fear as significantly associated with first time mothers, previous emergency caesarean and women with self-reported anxiety and/or depression. Additionally FOBS identified a significant association between fearful women and preference for caesarean. Conclusion: This study supports the use of the FOBS in clinical practice to identify childbirth fear in pregnant women.

Original languageEnglish
Pages (from-to)204-210
Number of pages7
JournalSexual and Reproductive Healthcare
Issue number4
Early online date15 May 2015
Publication statusPublished - 1 Dec 2015
Externally publishedYes


BELIEF study was funded by NHMRC (grant ID APP1025099 ) and registered with Australian and New Zealand Controlled Trials Registry ACTRN12612000526875


  • Antenatal care
  • Fear of birth
  • FOBS
  • Pregnancy
  • Screening
  • WDEQ

ASJC Scopus subject areas

  • Obstetrics and Gynaecology
  • Maternity and Midwifery


Dive into the research topics of 'Identifying women who are afraid of giving birth: A comparison of the fear of birth scale with the WDEQ-A in a large Australian cohort'. Together they form a unique fingerprint.

Cite this