Table 1 Characteristics of the included PROMs

Fear of childbirth questionnaire

Areskog et al. [37]

Sweden

Pregnant women

19–38 y

–

Self‐report

Yes/No

1 dimension (19 items)

–

Swidish– English– Finnish

–

Fear–of–delivery questionnaire (FDQ)

(A revised questionnaire of Areskog et al.)

Saisto et al. [34]

Finland

Pregnant women and their partners

–

Interview

Yes/No

1 dimension (10 items)

–

Cronbach's α = 0.76;

Correlation:

FDQ–PAS (r = 0.65, p < 0.001)

Wijma Delivery Expectancy/Experience Questionnaire A (w–DEQ–A)

Wjma et al. [31]

Sweden

Pregnant women18–39 y

Qualitative research with Two authors’ clinical experiences of women with FOC

Self‐report

Six–point

Likert: (0 = not at

All to 5 = extremely"

1 dimension (33 items)

–165 (items positively formulated including 2, 3, 6, 7, 8, 11, 12, 15, 19, 20, 24, 25, 27, 31)

Sweden (Swedish), Iran (Farsi), Italy (Italian), Malawi

(Chichew), Turkey (Turkish),

China (Chinese), Belgium (Flemish), Iceland (Icelandic), Denmark (Danish), Estonia (Estonian), Russian, Norway, (Norwegian), Hungary (Hungarian), Spain, (Spanish), Kenya, (Swahili), Slovakia, (Slovak), Japan

(Japanese), Tanzania (Kiswahili), Germany (German), Portugal (European

Portuguese), Greece (Greek)

Nulliparous & Parous groups, respectively:

Correlation of Wijma–A– SRI

(r = 0.52; r = 0.65; P < 0.0001)

Wijma–A—FQ (childbirth) (r = 0.43;

r = 0.78; P < 0.0001); Wijma–A—FQ (agora, social, injury, gynecological examination, elevator,

darkness) (ranging from r = 0.07 in darkness to 0.34 in agora;

r = 0.2 in elevator to r = 0.44 in social; P < 0.0001);

Wijma–A—STAI (r = 0.54 & r = 0.55; P < 0.0001); Wijma –A– KSP (r = 0.43 & r = 0.47; P < 0.0001);

Wijma–A –BDI

Cronbach's α:

α = 0.93; Split–half (α = 1.00)

Wijma Delivery Expectancy/Experience Questionnaire B (w–DEQ–B)

Wjma et al. [31]

Sweden

Pregnant women18–39 y

Qualitative research with Two authors’ clinical experiences of women with FOC

Self‐report

Six–point

Likert: (0 = not at

All to 5 = extremely"

1 dimension (33 items)

0–165 (items positively formulated including 2, 3, 6, 7, 8, 11, 12, 15, 19, 20, 24, 25, 27, 31)

Sweden (Swedish), Iran (Farsi), Italy, (Italian), India (Hindi), Turkey

(Turkish), China (Chinese), Spain (Spanish), Japan

(Japanese), Tanzania (Kiswahili)

Cronbach's α: (2 h after delivery: α = 0.93; 5 w after delivery:

α = 0.94)

Split–half (2 h after delivery: α = 0.95;

5 w after delivery:

α = 0.96)

Delivery Fear Scale (DFS)

Wjma', et al. [32]

Sweden

Pregnant women in labor ≥ 19 y

A list of 60 items written by 2 experts and then comment by 8 experienced midwives

Self–report

1– 10

(1 = 'do not agree

at all', 10 = 'agree totally')

1 dimension (10 items)

1–100

English– Swedish– Turkish– Farsi

Cronbach's α = 0.88

Sercekus et al. [35]

Turkey

Pregnant women in labor

–

Interview

–

1 dimension (10 items)

1–100

–

EFA (factor loading .63 to .83, total variance: 52.3%)

CFA (n = 96, RMSEA = 0.000, P = 0.631);

Cronbach α = 0.90; Split–half: α = 0.81;

Correlation: DFS– STAI: (r = 0.80, p < .001)

Shakarami et al. [36]

Iran

Pregnant women in maternity care

–

Interview

–

2 dimensions (10 items)

1–100

–

CFA (n = 200, RMSEA = 0.034, P < 0.001, CFI = 0.994, TLI = 

0.992);

Cronbach α = 0.77; Split–half: α = 0.83;

Correlation:

DFS–PRAQ: (r = 0.74, P <); DFS–CAQ: (r = 0.72, P < 0.001); DFS– STAI–Y1 (r = 0.71, P < 0.001); DFS– STAI–Y1 (r = 0.63, P < 0.001); DFS–short form of Lowe’s childbirth self–efficacy inventory (r = –0.75 & –0.76, P < 0.001)

Unnamed

Melender et al. [29]

Finland

–

Literature review and semistructured interviews with 20 postpartum women 19–37 y

–

–

–

–

–

Content analysis

Melender et al. [17]

Finland

Pregnant women 17–44 y

–

Self–report

4–point

Likert: (1 = agree, 2 = agree to some extent, 3 = 

disagree to some extent, 4 = do not agree); and a

dichotomous scale (1 = yes, 2 = no)

3 dimensions (Objects, Causes, and Manifestation of Fears) (53 items)

–

Factor analysis: (n = 329; total variance = 63.7)

Cronbach's α = 

0.91 (objects); α = 

0.70 (causes); α = 

0.78 (manifestations)

Unnamed

Eriksson et al. [28]

Sweden

The parents aged ≥ 20 y with an at least one infant

Literature review and Grounded theory with 3 women experienced intensive childbirth fear

Self–report

4–point Likert:

totally disagree = 1, partly disagree = 2, partly agree = 3 and totally agree = 4

4 dimension including ‘exposedness and inferiority’, ‘communicative difficulties’, ‘norms of harmony’ and ‘insecurity and danger’ (29 items)

–

Factor analysis (N women = 328); Variance of four factors and total variance (women), repectively = 20– 15– 11– 6%, 52%)

Cronbach’s α:

varied from 0.72 to 0.49 for women,

for different factors

Unnamed

Waldenstro¨m et al. [40]

Sweden

Pregnant women of childbearing age

–

Self–report

very positive, fairly positive, mixed feelings, rather negative and very negative

1 question

–

–

Unnamed

Laursen et al. [15]

Denmark

Pregnant women who were fluent in Danish

NR

Interview

Not at all’, ‘A little’ or ‘A lot’. Only the last response was considered to represent FOC

1 item

–

Odds ratio:

Symptoms of anxiety: 4.80–fold in women with fear– Symptoms of depression: 2.70–fold in women with fear

Visual analog scale (VAS)

Rouhe et al. [16]

Finland

Pregnant women 16– 47 y

–

Self–report

1– 10

1 item

0–10

N = 1400; Correlation: VAS– W–DEQ A

(r = 0.7, P = 0.01);

In VAS threshold was 6.0: Sensitivity = 89.2%; Specificity = 76.3%

Fear of Birth Scale (FOBS)

Haines et al. [71]

Sweden

Swedish and Australian pregnant women

–

Self–report

Two10–cm lines anchors (a) ‘calm’ and ‘worried’ and (b) ‘no fear’ and ‘strong fear’

1 dimension (A two–item visual analog scale)

0– 100

Cronbach’s α: 0.91

Zhang et al. [72]

China

Chinese pregnant women

–

Self–report

Two 10–cm lines anchors (a) “no worry/strong worry”

1 dimension (A two–item visual analog scale)

0– 100

–

Cronbach’s α: 0.897; Test–retest reliability (0.860); I–CVI of Q1 & Q2: 0.933 and 0.800; S–CVI: 0.867;

Correlation: FOBS– CAQ;

FOBS– Wijma;

FOBS–EPDS; FOBS–GAD–7

Numeric rating scale (NRS)

Storksen et al. [39]

Norway

Pregnant women 18–45 y

–

Self–report

0 (not at all) to 10 (‘extremely

much’)

1 dimension (1 item)

0–10

N = 1642;

Correlation: NRS– the W–DEQ (R = 0.57);

NRS– the SCL–anxiety scores and the EPDS

scores (r = 0.29 for both)

Birth Anticipation Scale (BAS)

Elvander et al. [41]

USA– Pennsylvania

Nulliparous pregnant women aged 18–35

–

Self– report

extremely, quite a bit, moderately, a little, and not at all

1 dimension (6 items)

6–30

N = 3006;

Cronbach’s α = 0.82

Slade–Pais Expectations of Childbirth Scale (SPECS)

Slade et al. [27]

UK

England pregnant women 17– 39 y

Semistructured interviews with 18 Pregnant women 10–38 w aged 17–39 y

Self– report

5–point Likert: 1 (strongly agree), 2 (agree), 3 (undecided), 4 (disagree), 5 (strongly disagree)

6 dimensions including coping and robustness to pain, staff and service responsive to needs, out of control and embarrassed, partner’s coping, positive anticipation of birth. (50 items)

Reverse scoring of 34 items of the scale

PCA: (n = 148; Variance of 42.5%)

Cronbach’s α = 0.89 (for components ranged from 0.77– 0.86);

The correlation between SPECS and STAI including

state anxiety (r = 0.43, p < 0.001) and trait anxiety (r = .38, p < .001)

Fear of childbirth

Prelog et al. [38]

Slovenia

Nulliparas Pregnant women ≥ 18 y

–

Self– report

5–point Likert: 1 (not at all) to 5 (very much)

1 dimension (6 items)

–

Exploratory factor analysis (N = 325, all six items loaded substantially (0.37–0.79) on a single factor); Cronbach α = 0.82;

The correlations amongFOC–anxiety (r = 0.37; p < 0.001)FOC–depression (r = 0.36; p < 0.001)

Fear of Childbirth Questionnaire (FCQ)

Slade et al. [30]

UK

–

Semistructured interviews with pregnant women 25– 43 y (n = 10) and consultant midwives (n = 13) & published meta–synthesis

–

–

–

–

Thematic analysis

Slade et al. [1]

UK

Pregnant women 25–43 y

–

Self– report

4–point Likert:

Strongly disagree (0),

Slightly Disagree (1),

Slightly Agree (2),

Strongly agree (3)

1 dimension (20 items)

0–60

–

Sanjari et al. [43]

Iran

Pregnant women

–

4 dimensions including "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

EFA (N = 400; total variance = 57.87%; the variance of the first to fourth factor = 18.39%, 14.51%, 14.44, and 10.54%, respectively); CFA (N = 200; SRMR = 0.09,

RMSEA = 0.09, CFI = 0.91); CVI = 0.83%; CVR for the 20 items = 81–100%; Cronbach α = 0.84 (for components ranged from 0.70 to 0.84); Test–Retest (r = 0.6, P < 0.01); Split–half > 0.7; Correlation: Slade scale– Wijma (r = 0.79, P > 0.01; Slade scale– CAQ = (r = 0.81;, P > 0.01)

Childbirth Fear Questionnaire (CFQ)

Fairbrother et al. [14]

Canada, the United Kingdom, or the United States

English speaking, pregnant women ≥ 18 y

Literature review

Self– report

5–point Likert: 0 (not at all) to 4 (extremely)

9 dimensions including Fear of loss of sexual pleasure/attractiveness; Fear of pain from a vaginal birth; Fear of medical interventions; Fear of embarrassment; Fear of harm to baby; Fear of cesarean birth; Fear of mum or baby dying; Fear or insufficient pain

medication; Fear of body damage from a vaginal birth (40 items)

0–160

English Spanish

EFA (N = 643; CFI = 0.977, TLI = 0.974, RMSEA

 = 0.064 (90% CI: 0.062, 0.066), SRMR = 0.055); CFA model and invariance between

parity (primiparous vs. multiparous) groups: (SRMR = 0.06, ΔX² = –, Δdf = –);

Cronbach α = 0.94 (for components ranged from 0.71 to 0.94);

The correlations CFQ–WDEQ–

A (fear scales): r = 0.57 (p < 0.001);

CFQ –EPDS: r = 0.35 (p < 0.001),

CFQ– MQ: r = 0.28 (p < 0.001); CFQ–PDS–5: r = 0.24 (p = 0.001)

González–de la Torre et al. [42]

Spain

Pregnant women ≥ 18

–

Self– report

5–point Likert: 0 (not at all) to 4 (extremely)

4 dimensions including fear of medical

Interventions, fear of harm and dying, fear of pain, fears relating to sexual aspects,

and embarrassment (37 items)

0–148

CVI–Total = 0.77;

EFA (n = 279, RMSEA = 0.000);

CFA (n = 278, RMSEA = 0.022);

Cronbach α = 0.947 (for components ranged from 0.71 to 0.94);

Total omega coefficient = 0.945

Childbirth Fear Scale (CFS)

Nuraliyeva et al. [33]

Turkey

Women of childbearing age 18– 49 y including pregnant women

Literature review and the most frequently used Scales

5–point Likert:

strongly agree and strongly disagree

3 dimensions including “Fear of Pregnancy, Childbirth, and Maternal Role”; “Fear of Inability

to Meet Physical and Social Needs”; “Fear of Pregnancy and Childbirth problems” (20 items)

20–100

(The positive items include 4, 7, 9, 11, 13, 16,

18, and 19. The negative items coded reversely include: 1, 2, 3, 5, 6, 8, 10,

12, 14, 15, 17, and 20)

–

PCA (n = 500; KMO = 0.88,

 × 2 = 3673.824 in Bartlett's test of sphericity; The variance of the same 3 factors = from

8.02% to 29.54%, Total variance = 51.93%); Cronbach α = 0.86 (for the factors 0.88, 0.76, 0.75); Test–retest reliability (r = 0.88; P = .000);

CFS– WCF–PPS (r = 0.53, P < 0.01