ArticleBMC pregnancy and childbirth2025
Development and validation of the birth integrity questionnaire for measuring attitudes, maternity care, and perceptions of birth.
Article in BMC pregnancy and childbirth, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPublic health research on maternal health has increasingly focused on care quality, emphasizing subjective evaluations and addressing issues such as obstetric violence and mistreatment during childbirth. In 2014, the WHO called for research to prevent and eliminate mistreatment, advocating for respectful maternity care. While significant research exists in Africa, Asia, and Latin America, research in European settings is lacking. Our Germany-based study on Birth Integrity aims to capture a holistic understanding of the birthing process, encompassing culturally mediated attitudes, actual birth experiences, and perceptions of childbirth.
methodsThe Birth Integrity Questionnaire (BI-Q) was developed through construct definition, item development, expert reviews, and cognitive interviews. Psychometric properties were tested using exploratory factor analysis and structural equation modeling with 1,729 participants recruited via an anonymous, openly available, voluntary, non-incentivised online survey. Data analysis included reliability testing and examination of correlations between latent constructs.
resultsThe BI-Q demonstrated high reliability and validity, with 65 items across eleven latent constructs. The latent outcome construct of Birth Integrity, consisting of 22 items, was also successfully validated. Key influences on birth integrity included CONSENT, RESPECT, SUPPORT, and CARE. High standards of maternity care in Germany likely explained the lack of significant direct effect from constructs such as FACILITY, PRIVACY, INFORMATION, and RIGHTS, though these had indirect effects. GENDER, MEDICALIZATION, and BIRTH WISHES showed indirect effects as well, whereas DISCRIMINATION was omitted in our model due to statistical reasons.
conclusionsThe BI-Q is a validated and reliable tool for measuring birth integrity. Findings highlight the significant impact of healthcare providers' actions and attitudes on birth perception, advocating for improved maternity care and prioritizing women's autonomy. The omission of DISCRIMINATION underscores the need to re-test the BI-Q in more diverse samples.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.